Surgical Options

Sometimes a narrowing of the spinal canal can lead to less room for the nerves, which causes them to be pinched. We call this spinal stenosis. Not all pinched nerves are caused by spinal stenosis, but when it occurs in the low back it can cause serious symptoms that could require surgery.

If you have a lumbar herniated disc in your spine (sometimes called a "slipped" or "ruptured" disc), you've probably gotten several opinions from spine doctors regarding surgical options for your condition. Surgery may help to alleviate your pain and increase your mobility, but it's important to know all the information about the pros and cons of surgical treatment before deciding to go this route.

When a surgeon recommends an operation, it is generally a good idea to get a second opinion. Not all surgeons are alike. Different surgeons look at spine problems differently and there are multiple ways to get a good result. It helps a patient to get another perspective on the problem, including recommended options and possible outcomes.

Informed surgical patients have the best chance of a successful surgery. Patients who are well informed about their options and their surgical procedure have the least stress before and after surgery.

I’ve been hearing more frequently from patients who want to spend less time in the hospital after surgery.  The sentiment makes sense, given the trend towards outpatient surgery in a variety of specialties.

It’s not unusual for the subject of laser surgery to come up when I am discussing treatment options with patients. The curiosity about laser spine surgery makes sense given the benefits touted by laser spine surgery providers. Laser spine procedures are often promoted as a less-invasive alternative to traditional back surgeries promising high success rates, shorter hospital stays and quicker recovery periods.

Spine surgery is a continually evolving specialty.  Some recent changes have been positive, while others can be viewed negatively. For example, an important positive change is the trend toward less invasive surgery, which results in faster recovery times, allowing patients to return to daily activities more quickly.

Artificial Cervical Disc Replacement is an option for patients with symptomatic cervical disc disease. The historical choice has been to perform a discectomy (disc removal) and fuse the spine with bone and/or a plate. The concern is that fusion may place added stress at the level above and below the fusion and eventually lead to additional surgery in the future.

Minimally invasive surgery is a popular trend. When we talk about minimally invasive cervical spine surgery, it describes an operation on the cervical spine (neck) that leaves minimal residuals from surgery. The advantage is that if a patient has arm pain and numbness from a degenerative process like arthritis, or a herniated disc, we can address it with less invasive techniques.

In the past, neurosurgeons typically performed decompression surgery on the spine that involved maneuvering the nerves and spinal cord, while orthopaedic surgeons performed fusion surgery and scoliosis reconstructions.

Spinal stenosis is a narrowing of the space for the nerves and/or the spinal cord. It can occur developmentally and as part of the aging process of the spine. When it occurs in the lower (lumbar) part of the spine, the symptoms of spinal stenosis can include pain radiating to the legs (sciatica), a heavy feeling in the legs when walking, numbness, and tingling sensations.