Back surgery is typically considered by patients who have a history of back pain that has not been resolved despite treatment. Before undergoing spinal surgery your doctor will help you determine which type of surgery will be most effective for you. Two of the most commonly performed spinal surgeries are spinal fusion and spinal decompression, either of which can be performed using open, or minimally invasive surgical techniques.
This procedure fuses together two or more vertebrae in order to eliminate movement between the vertebrae. The surgeon will join the adjacent vertebrae with a bone graft. The spinal disc may be replaced with spacers made from metal, or plastic, or with donated bone. Screws and rods are then put in place to support the vertebrae, while they heal into a single bone. There are several reasons your surgeon might recommend a spinal fusion including spondylolisthesis, spinal arthritis, abnormal curvature of the spine, and injuries to the bones in the spine.
Spinal decompression is a common surgical procedure to treat a pinched nerve, resulting from bone or disc material encroaching upon, and therefore squeezing, the nerves of the spinal cord. The surgical procedure to alleviate this pressure and reduce associated pain is called decompression. During a surgical decompression the surgeon typically removes a small portion of the bone, called the lamina, to give more room to the spinal cord. There are three different types of spinal decompression techniques: shaving off part of the lamina, removing the entire lamina, or in the instance that the pressure is the result of a disc instead of bone, the partial removal of the disc that is causing the pressure. Decompression procedures are performed to treat sciatica, a herniated disc, or the symptoms of spinal stenosis including weakness, numbness, or pain in the legs.
Open Spine Surgery
In this technique, the surgeon makes an incision and pulls back the muscles covering the spine to allow access to the spine itself, thus opening up the patient's back. This type of surgery allows the surgeon greater access to the spine and increased visibility over a minimally invasive procedure. The recovery time for open spine surgery can be significantly longer than for minimally invasive techniques.
Minimally Invasive Spine Surgery
A minimally invasive approach has multiple benefits for the patient, including decreased blood loss, a smaller incision scar, less pain medication needed during recovery, and shorter hospital stays post surgery. These benefits are possible because minimally invasive spine surgery does not require the surgeon to pull the muscle back significantly. Instead, a specialty tool known as a tubular retractor is used to create a small tunnel to the spine. Through the tunnel, the surgeon is able to perform spinal fusions and decompressions, while the tubular retractor keeps the muscles out of the way. When the procedure is completed, the surgeon removes the tubular retractor and closes the incision.
Deciding if a traditional open spine surgery or a minimally invasive technique is the appropriate choice will depend on many factors. Dr. Kelly Kiehm specializes in minimally invasive spinal surgery and can help you determine if it is the right choice for you.