Spinal Surgery

To perform minimally invasive spine surgery, surgeons make small incisions and use small cameras designed for viewing internal portions of the body. This inside view of the patient's body is shown on television screens in the operating room to help the surgeon get a clear view of the surgical area during the procedure.

Minimally invasive techniques can offer several advantages, including smaller scars instead of one large scar, minimal muscle-related injury, a shorter hospital stay (two to three days versus five to six days), reduced postoperative pain, a shorter recovery period and the ability to return to work and daily activities much sooner.

Neurosurgeons and orthopedic surgeons at Wellington Regional Medical Center perform the following minimally invasive spine procedures:

Cervical (Neck)

Surgeons offer minimally invasive treatment for both cervical and lumbar radiculopathy. A small incision can be made in the neck for patients who have cervical radiculopathy without arthritis of the joints in the neck. A microscope decompresses the spinal nerves to relieve pain. Many patients go home the same or next day following the procedure.

The best option for patients with pre-existing arthritis of the neck can be anterior discectomy and either fusion or disc replacement. Anterior discectomy for decompression of the nerve roots is a minimally invasive procedure with very high success rates. The procedure involves a small incision on the neck. Either a fusion or disc replacement may be performed once the decompression is performed. That decision is made preoperatively based on the extent of arthritis and number of levels in the neck that are diseased. Most patients are able to go home from the hospital the same or next day for either procedure.

Lumbar (Low Back)

Sciatica causes a stabbing pain that shoots from the back or buttocks into the leg. It can also cause numbness or weakness in the leg and foot. The most frequent cause of this condition is a herniated or ruptured disc in the back, also known as lumbar disc disease. A herniated disc can create pressure against one or more of the spinal nerves, leading to severe pain, numbness or weakness in the lower back, legs or feet.

A half-inch incision is made in the back during minimally invasive disc surgery so the procedure can be performed through a small hollow tube. A tiny camera is placed into the tube, allowing a clear view of the nerve and its relationship to the herniated disc.

This enables the surgeon to remove the herniated disc. Not all herniated disc patients are eligible for minimally invasive spine surgery. Benefits of this approach may include reduced time in the hospital and a faster recovery.

Spinal Stenosis Surgery

Lumbar spinal stenosis (LSS) occurs as a result of aging and everyday wear and tear on the spine. Symptoms can include persistent, progressive lower back pain, numbness or weakness in the buttocks and legs and symptoms that improve with resting, lying down or bending forward. Stenosis of the spine can also occur in the cervical (upper spine and neck) or thoracic (middle spine) region of the body.

Micro-endoscopic laminotomy (MEL) is an exciting new treatment option for patients who are candidates for spinal stenosis surgery. MEL accomplishes the same goal of an open laminectomy, but is minimally invasive.

A thin needle is placed under the skin on one side of the midline spine with fluoroscopic (X-ray) guidance. A small (up to one-inch) incision is made around this needle. A set of tapered metal dilators is passed over the guiding needle, and the tissue and muscles are then gently spread off of the underlying bone.

Next, a hollow metal cylinder is passed down to the area of the stenosis and secured. A small camera placed through this working channel provides the surgeon with a close-up, magnified view. The surgeon then removes the bone compressing the nerve roots. Benefits may include reduced time in the hospital and a faster recovery.

Spinal Fusion for the Lumbar Spine

Patients with degenerative spinal disease may require spinal fusion surgery to stabilize the vertebrae and alleviate severe, chronic back pain. Spinal fusion involves correcting an unstable part of the spine by joining two or more vertebrae. Traditional open-surgery spinal fusion has been associated with a low complication rate and pain relief for 90 percent of patients; however, many patients report back pain and fatigue as a result of muscle loss that can occur following surgery.

Laparoscopic spinal fusion is a minimally invasive alternative. The lower spinal vertebrae are repaired through an incision directly over the spine. The upper spinal vertebrae are repaired through an incision in the back or side of the neck. The middle spinal vertebrae are repaired through an incision made in the chest and abdomen. The abnormal or injured vertebrae are repaired and stabilized with bone grafts, metal rods or both. Benefits to patients may include reduced time in the hospital and a faster recovery.