Back Pain and Spine Surgery
Surgery is reserved for the most severe cases of back pain spinal cord impingement, structural deformity, severe cases of spine stenosis.Surgery should be considered only after you’ve tried several months of non-surgical treatment. Many surgical procedures can be performed using minimally invasive techniques—meaning less “cutting” or entering the body. These techniques result in smaller incisions, shorter hospital stays, less pain after surgery, and a faster recovery.
Some Typical Spinal Surgeries Include:
Laminotomy:
A procedure that removes only a small portion of the lamina (a part of the vertebra) to relieve pressure on the nerve roots. Operations that remove a vertebra (laminectomy) or shave off part of a vertebra (laminotomy) may be used if you have spinal stenosis or some other vertebral abnormality pressing on a nerve. This surgery may also be considered to remove a tumor on the spine. Like disectomy, many people will feel immediate relief after the procedure. However, recurrent back pain is very common
Discectomy:
A procedure that removes a disc through a small incision .This surgical procedure removes the disc that is causing your pain. By doing this, pressure on your spine is relieved. There are now ways to perform this surgery with as little invasion as possible; for example, very small incisions may be used.
Spinal Laminectomy :
A procedure for treating spine stenosis by relieving pressure on the spinal cord. A part of the lamina (a part of the vertebra) is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.
The Operation:
Incision : Surgery for lumbar laminectomy is performed with the patient lying on his abdomen or side. A small incision is made in the lower back.
Laminectomy:After a retractor is used to pull aside fat and muscle, the lamina is exposed. Part of it is cut away to uncover the ligamentum flavum - a ligament that supports the spinal column
Entering the Spinal Canal : Next an opening is cut in the ligamentum flavum through which the spinal canal is reached. The compressed nerve is now seen, as is the cauda equina (bundle of nerve fibers) to which it is attached. The cause of compression may now also be identified - a bulging, ruptured or herniated disc, or perhaps a bone spur.
Removal of the Herniated Disc : The compressed nerve is gently retracted to one side, and the herniated disc is removed. As much of the disc is taken out as is necessary to take pressure off the nerve. Some surgeons will remove all "safely available" disc material. After the cause of compression is removed, the nerve can begin to heal. The space left after removal of the disc should gradually fill with connective tissue.
Foraminotomy :
This surgery can be done alone or with a laminotomy is a surgical procedure for widening the area where the spinal nerve roots exit the spinal column. A foramen is the opening around the nerve root, and otomy refers to the medical procedure for enlarging the opening. In this procedure, surgeons widen the passageway to relieve pressure where the spinal nerve is being squeezed
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