Motion preservation refers to surgical methods that can be used in place of conventional spinal fusion. The goal of these methods is to preserve the natural movement of the spine in the impacted area. One of the main goals of treatment is to preserve range of motion or maintain normal, or near to normal motion. Patients with spine disorders that require surgery first go through a physical exam, then other imaging techniques are applied such as electromyography (EMG), X-ray, MRI scan, CT scan, as well as various blood and bone density tests. A patient’s disease condition (and severity) will influence the treatment recommendation, but Dr. Jeremy Smith’s goal is to provide patients with a well-informed set of options.
Disc replacement is a surgical procedure. When an intervertebral disc in the spine has begun to degenerate, it can be replaced with an artificial disc implant. This surgery can occur in the lumbar or cervical spine and is known as an arthroplasty. Disc replacement can offer a long-lasting treatment response to a damaged or dying spinal disc. Before total disc replacement was available, spinal fusion was the surgical norm most widely accepted as the tool used to resolve pain in the spine caused by a degenerated disc. However, fusion eliminates movement in the injured segment of the spine, which then may cause stress on the surrounding vertebrae.
Total disc replacement was developed as an alternative to fusion. Artificial – or manufactured – discs are designed to support the spine, and still allow for forward and backward bending as well as twisting and side-to-side movement. Total disc replacement, while more technically demanding during surgery than fusion, allows for movement to still be possible in the injured section of the spine and thus, does not put undue stress on other areas.
Cervical disc replacement replaces your natural cervical disc with an artificial one. This surgery restores normal neck movements to a patient and reduces the likelihood of degeneration of adjacent discs.
Lumbar disc replacement replaces your natural lumbar disc with an artificial one. It restores normal movement in the spine between the lowest ribs and the pelvis and reduces the likelihood of degeneration of adjacent discs.
A cervical laminoplasty is a procedure that reshapes and repositions bone in order to relieve stress on the cervical spinal nerves – the surgery essentially enlarges the spinal canal. This procedure can relieve pain and other symptoms caused by nerve compression. Cervical laminoplasty is a non-fusion, decompression procedure, and is most commonly indicated for patients with multilevel stenosis.
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Lamina are leaf-like layers of bone – also referred to as a “plate” or “roof” or “layer” – that make up part of the structure of a vertebrae. When this area is impacted, and too much pressure is then put on the spinal nerves, a laminectomy may be performed to relieve pressure and pain. This procedure is done to decompress the area for the spinal cord and nerves, so that the patient may feel relief. A laminectomy is a major spine operation that can create residual scar tissue and may result in post laminectomy syndrome. Depending on the problem, more conservative treatments may be a more viable route for treatment.
A laminectomy may be performed in two ways – through an open surgery (laminectomy) or a keyhole surgery (foraminotomy). The removal of the lamina, or the arch of the vertebral bone that protects the spinal canal, may be the most effective treatment for pain relief from certain spinal conditions.
A cervical foraminotomy is generally recommended when a spinal condition in the neck region is accompanied by nerve damage that results in numbness or weakness in the arms. During the procedure a portion of the vertebrae is surgically removed via minimally invasive techniques to relieve pressure put on the nerves.
A thoracic laminectomy is generally recommended when a spinal condition in the mid-back region is causing pain that is not responding to more conservative measures. Non-surgical alternatives to a thoracic laminectomy may include: pain management strategies, physical therapy, neurotomy, a spinal cord stimulator, or an intrathecal pain pump. During the procedure a portion of the vertebrae is surgically removed to relieve pressure put on the nerves.
During a lumbar laminectomy, the “roof” of a spinal vertebrae is surgically removed to relieve pressure put on the nerves. This procedure may be recommended by your doctor if other treatments fail to relieve pain such as conservative, non-surgical treatments and/or less-invasive surgical options.
Coflex is a titanium alloy device that is inserted into the spine in order to preserve lumbar motion and to provide support to the spine. Coflex surgery is a neurological procedure wherein the Coflex Interlaminar Stabilization device is implanted. This motion-preserving and minimally invasive procedure is often used in treating patients with spinal stenosis, who have developed bone spurs or experience wear and tear in the spine due to aging.
Microdiscectomy (also called microdecompression) is a minimally invasive surgical procedure typically performed to alleviate pain caused by pressure or stress being put on the nerve root. It is effective for relieving extremity pain and back pain caused by a herniated disc. Portions of the herniated disc are removed during surgery, in order to relieve pressure on the spinal nerve structures.
