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Thoracic & Lumbar Spine

CONDITIONS

  • Radiculopathy / Pinched Nerve

Sciatica

Sciatica is an inflammation of the sciatic nerve, the longest nerve in the body. The sciatic nerve stretches from the spinal cord to the end of each leg and may become inflamed for a number of reasons, including age-related changes in the spine, obesity, or a sedentary lifestyle. Sciatica usually develops gradually as the nerve is compressed over time. This results in pain along the nerve pathway, as well as numbness, tingling and muscle weakness in the affected area.

  • Bulging Disc / Disc Protrusion

Herniated Disc

A herniated disc, also known as a ruptured or slipped disc, is a damaged spinal cushion between two bones in the spine (vertebrae). Normally, the gelatinous discs between the vertebrae hold the bones in place and act as shock absorbers, permitting the spine to bend smoothly. A herniation can occur when a disc protrudes beyond its tough outer lining leading to potential pressure on the spinal cord and/or nerve root(s).

  • Bone Spurs
  • Facet Synovial Cyst
  • Spinal Stenosis
  • Foraminal Stenosis
  • Spondylolisthesis

Scoliosis and Deformity

Scoliosis is an abnormal curving of the spine. While all spines have a natural curve, patients with scoliosis have excessive spinal curving. Usually scoliosis develops during the growth spurt before puberty, between the ages of 9 and 15. Although some cases of scoliosis are congenital, and some are the result of underlying neuromuscular conditions, such as cerebral palsy or muscular dystrophy, most cases of scoliosis are idiopathic, meaning their cause is unknown. Both girls and boys can develop scoliosis, but cases in females are more likely to require treatment. In some cases, scoliosis appears to be hereditary.

  • Fractures
  • Instability
  • Degenerative Spine Disease
  • Back Pain

PROCEDURES

Microscopic Discectomy (Microdiscectomy)

A microdiscectomy, also known as microdecompression spine surgery, is a surgical procedure that removes part of an impinged intervertebral disc in order to relieve pain, weakness and numbness throughout the body. It is usually reserved for patients with severe symptoms that do not respond to more conservative treatments, and significantly affect the patient's quality of life.

The microdiscectomy procedure is most effective in relieving lower back and leg pain caused by lumbar disc herniation, although it may be performed in the cervical and thoracic spine as well. A herniated disc is a common condition that occurs as a result of gradual wear and tear or an injury to the intervertebral discs, causing it to bulge and break open. Patients with this condition often experience pain, numbness and weakness in the affected area, as well as through the legs or arms, depending on the location of the disc.

In some cases, microdiscectomy can be performed laparoscopically, in which surgical instruments and a camera are inserted through several tiny incisions. The camera allows the surgeon to magnify the view of the affected area and precisely remove the disc with no damage to the surrounding area.

Microscopic Decompressive Laminotomy / Laminectomy

Minimally-invasive lumbar microdecompression surgery is a procedure that can effectively reduce pain caused by impingement of the nerves in the lower spine. The nerves of the spine are very sensitive tissues that relay messages between different parts of the body. However, this uninterrupted cord of communication is subject to the wear and tear of daily life and sometimes acute injuries such as a car accident.

A minimally-invasive lumbar microdecompression procedure is ideal for treating conditions that cause pressure on the spinal nerves, such as lumbar spinal stenosis. It will attend to the cause of the symptoms, providing pain relief as well as improved mobility in patients. A minimally-invasive lumbar decompression procedure can also benefit those patients whose pain is the result of excess ligament. Using imaging technology to guide the procedure, your doctor will insert specialized instruments through the small incision to remove the ligament and bone putting pressure on your spinal canal.

Minimally-invasive lumbar microdecompression offers several benefits over traditional surgical approaches, including:

• Only a one-inch incision needs to be made

• It is typically an outpatient procedure

• Complications are rare

• No implants are used

• Recovery time is minimal, with patients generally returning to work and light activity in approximately one week

  • Microscopic Foraminotomy
  • Percutaneous Instrumentation
  • Kyphoplasty / Vertebroplasty
  • Spinal Cord Stimulator
  • Spinal Fusion Techniques
  • ALIF (Anterior Lumbar Interbody Fusion)
  • OLIF (Oblique Lumbar Interbody Fusion)

DLIF / XLIF (Lateral Lumbar Interbody Fusion)

Lateral lumbar interbody fusion (LLIF) is a spinal fusion technique performed from the side of the body rather than from the back or through the abdomen. Spinal fusion procedures are performed for the relief of persistent pain in the lower back, the lumbar region of the spine. Interbody fusion refers to surgery in which an interverterbal disc is removed and the adjacent vertebrae are joined. The connection between the two vertebrae is accomplished through the use of a bone graft. LLIF can be used to treat nerve compression, disc degeneration, spondylolisthesis and other painful lower back conditions.

TLIF (Transforaminal Lumbar Interbody Fusion)

Transforaminal lumbar interbody fusion (TLIF) is a fusion technique for the relief of persistent lumbar back and leg pain. When done minimally invasively, TLIF is performed off-midline with an incision of about an inch. Transforaminal refers to crossing the foramen, which is the opening within each of the spinal bones that allows nerve roots to pass through. This approach is chosen because it allows excellent decompression with minimal manipulation of the pinched nerve roots. Interbody fusion refers to the removal of an interverterbal disc, which is replaced with a spacer cage packed with bone graft, to fuse the adjacent vertebrae together.

TLIF can be used to treat nerve compression, disc space collapse, spondylolisthesis and other painful lower back conditions.

This surgery is very similar to posterior lumbar interbody fusion (PLIF) except that a TLIF exposure allows a larger and potentially safer window in which to place the cage, thus minimizing nerve root manipulation and potential damage. Our practice is to also perform this surgery through state of the art minimally invasive techniques.

PLIF (Posterior Lumbar Interbody Fusion)

Posterior lumbar interbody fusion (PLIF) is a spinal surgical procedure performed to provide relief from debilitating back and leg pain. Though it is a procedure that pre-dates the more modern TLIF, it is effective in select patients.

  • Synovial Cyst Resection
  • Posterolateral Fusion
  • Reconstructive Spine Surgery
  • Scoliosis Correction