Discs are the soft pads of tissue between the vertebrae. The discs absorb shock caused by movement. The most common back problems occur when discs tear, bulge, or rupture. When this happens, an injured disc can no longer cushion the vertebrae and absorb shock. The disc may press on or pinch a nerve. This can lead to pain, stiffness, and other symptoms.
Common Spinal Conditions
Degenerative Disc Disease (DDD)
- Naturally occurring process, which may become symptomatic in certain individuals
- Protrusion or migration of disc from the inner core. Also known as a “slipped” or “ruptured” disc.
- One vertebrae slips over another, causing misalignment
- Narrowing of the spinal canal that places pressure on the spinal cord, cauda equina, and/or nervesCan be caused by slippage of bone or progressive degenerative changes associated with aging
Facet Joint Osteoarthritis
- Cartilage between joints breaks down, causing friction. Can possibly result in nerve compression or back pain
- Bone mineral loss resulting in fragile bones. May cause vertebral compression fractures.
Non-surgical options may include:
- Physical therapy
- Pain medication
- Anti-inflammatory medications
- Chiropractic care
- Behavior modification
Why Minimally Invasive Spinal Surgery (MISS)
Potential patient benefits include:
- Less invasive surgery
- Shorter hospital stay
- Less blood loss
- Earlier ambulation
- Less post-operative medication use while in hospital
The aim of minimally invasive techniques is to accomplish these same surgical goals while minimizing approach-related trauma to surrounding soft tissue.
Operative treatment options include:
- Laminotomy – A portion of the lamina (back of the spinal canal) is removed from the vertebra above and below the pinched nerve. The small opening created is sometimes enough to take pressure off the nerve. But in most cases, disc matter or a bone spur that is pressing on the nerve is also removed.
- Laminectomy – The entire lamina is removed from the affected vertebra. The opening created may be enough to take pressure off the nerve. If needed, the surgeon can also remove any bone spurs or disc matter still pressing on the nerve.
- Discectomy – A portion of the disc nucleus is removed, releasing the pressure on the nerve. As a disc degenerates and flattens, the vertebrae slip back and forth. This is referred to as instability and can irritate nerves.
- Spinal fusion – Adjacent vertebrae are joined together, or fused. This limits the movement of these bones, which may help relieve pain. Fusion can be done from the front (anterior) side of the body or the back (posterior) side of the body. The neurosurgeon decides which is best for each individual patient.
Conditions that can be treated with minimally invasive procedures:
- Ankylosing Spondylitis
- Annular Disc Tear
- Arthritis and the Spine (Spondylosis)
- Arthritis of the Spine
- Bone Spurs / Osteophytes
- Brain Tumors
- Burst Fractures
- Cancer and Spinal Fractures
- Chiari Malformation
- Compression Fracture
- Deformity corrections
- Degenerative Disc Disease
- Disc Herniation / Disc Bulging
- Discogenic Back Pain
- Drop Foot (Foot Drop) and Steppage Gait (Footdrop Gait)
- Epidural Abscesses
- Facet Joints and Low Back Pain
- Herniated Disc
- Osteoarthritis (Spondylosis)
- Osteopenia / Osteoporosis
- Osteoporotic vertebral compression fractures
- Pinched Nerves / Sciatica / Radiculopathy
- Piriformis Syndrome
- Pregnancy and Back Pain
- Radiculopathy / Sciatica
- Scheuermann’s Kyphosis (Scheuermann’s Disease)
- Spinal Stenosis
- Spondylolisthesis (Slippage of the Spine)
- Synovial Cyst of the facet
- Wedge Fractures