Minimally Invasive Spine Surgery

There is an ever-expanding range of minimally invasive spine surgical procedures, with several options for each type of spine condition. Some of the most common are described here.

Discectomy

Discectomy is the removal of a spinal disc or the bulge of the disc, eliminating its pressure on a nearby nerve root and relieving pain.

• The procedure may be performed as a “microdiscectomy,” operating through a half-inch incision to carefully remove the herniation and free the nerve.
• People with stenosis of the cervical spine (neck) may have anterior cervical discectomy and spinal fusion, where the surgeon operates from the front of the neck guided by a high-powered microscope to remove the affected disc(s) and relieve pressure on the spinal cord. Spinal fusion may then be performed to stabilize the area.
• Some people who have a disc removed also have an artificial disc inserted into the space between the vertebrae.

Spinal decompression

Minimally invasive spine decompression procedures relieve pressure on the spinal cord or nerves caused by disorders such as spinal tumors or spinal stenosis.

• Bone grafts and metallic implants may be used to restore the spine's stability in patients with fractures and those who need extensive tumor removal.
• Lumbar decompression is one of the most common procedures used to treat spinal stenosis in the lower back. The surgeon removes a part of the bone and excess ligament that is creating pressure.
• During a laminotomy, only part of the lamina is removed (the part of the vertebra that covers the spinal canal, which houses the spinal cord and nerves); the surgeon creates a hole just large enough to relieve the pressure in a specific location.

Endoscopic minimally invasive spine surgery

Och Spine surgeons are among the few trained to perform minimally invasive spine surgery through an endoscope.

• Endoscopic discectomy is an advanced technique performed through an incision less than a quarter-inch across to treat a herniated disc during an outpatient procedure.
• With endoscopic spinal decompression, the surgeon decompresses the nerve by opening the foramen (the passage in a vertebra through which the nerve passes), and many patients go home the same day.

Laminectomy with discectomy

Laminectomy is removal of the part of the bone of a vertebra that is pressing on the spinal cord or a nerve.

• During laminectomy for spinal stenosis, the surgeon enters through the back of the spine and removes the lamina (the section of bone that covers the spinal canal) to relieve the pressure. This surgery is typically performed with a discectomy.
• If a single nerve is compressed in the cervical spine, minimally invasive “foraminotomy” can be performed through a small tube the size of a dime. Part of the bone is drilled off to create more room for the nerve. Sometimes if a herniated disc is present, it can be removed at the same time.

Lumbar spinal fusion

If other surgical techniques are ineffective in treating spinal stenosis, fusing two vertebrae so there is no longer any motion between them may be an option. This reduces spinal pressure, pain, and nerve damage. Our surgeons often use minimally invasive techniques to unite the two vertebrae while avoiding injury to nearby delicate nerve tissue.

Vertebral compression fracture repair

Vertebroplasty and kyphoplasty are treatments for compression fractures of the vertebrae caused by osteoporosis. Both procedures are performed under X-ray guidance.

• During vertebroplasty, the surgeon injects artificial bone cement into a vertebra that has been fractured by osteoporosis. The cement stabilizes the bone and prevents further damage from occurring.
• With balloon kyphoplasty, a tiny balloon is first inflated inside the fractured vertebra to restore its height. The cement is then injected into the expanded space to ensure the bone does not collapse again.