Overview

At the The Spine Institute, patients have access to comprehensive and coordinated care from world-renowned specialists. Our expert surgeons can treat a range of spinal conditions, from neck and back pain and herniated disks to the most serious and complex disorders, such as spinal tumors and deformities, degenerative spine disease and spinal stenosis. By using the latest medical procedures and minimally invasive back surgery techniques, our surgeons can help patients move beyond painful spine conditions.

Minimally Invasive Back Surgery Procedures

A Microdiscectomy is performed for patients with a painful lumbar herniated disc. Microdiscectomy is a very common, if not the most common, surgery performed by spine surgeons. The operation consists of removing a portion of the intervertebral disc, the herniated or protruding portion that is compressing the traversing spinal nerve root. Years ago, most spine surgeons would remove a herniated disc using a rather large surgical incision and surgical exposure without the use of a microscope or telescopic glasses, which would often involve a long hospital stay and prolonged recovery period. Today, many surgeons use a microscopic surgical approach with a small, minimally invasive, poke-hole incision to remove the disc herniation, allowing for a more rapid recovery.

Lumbar Disc Microsurgery

Post-Operative Care

Most patients are able to go home the same day after surgery. Patients are instructed to avoid bending at the waist, lifting more than five pounds and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury or recurrent disc injury. Patients should try to avoid sitting in the same position for more than 45 to 60 minutes in the first few weeks after surgery. After sitting for 45 to 60 minutes, patients should get up and stretch or walk for a little bit, then sit down again if desired. Patients are generally not required or recommended to wear a back brace after surgery.

Microdecompression

Minimally Invasive Lumbar Microdecompression

Overview and Indications

Microlaminectomy is performed for patients with symptomatic, painful lumbar spinal stenosis. It is performed to remove the large, arthritic bone spurs that are compressing the spinal nerves. Our experts perform a microscopic surgical approach using a small, poke-hole incision with minimal dissection to accomplish a lumbar decompression of three spinal levels or less. This minimally invasive approach allows for a more rapid recovery and may provide an improved long-term outcome because there is less muscle and tissue damage.

Post-Operative Care

Most patients are usually able to go home the same day after surgery. Patients are instructed to avoid bending at the waist, lifting more than five pounds and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after one to two weeks as the pain subsides and the back muscles get stronger.
Patients are generally not required or recommended to wear a back brace after surgery.

Micro Cervical Foraminotomy

Cervical Posterior Foraminotomy

Using innovative technology, a cervical decompression can now be accomplished using a small poke-hole incision with minimal tissue dissection and a faster recovery. A microscopic posterior cervical foraminotomy can both be performed in less time, with less tissue damage and less pain than traditional open cervical spinal back surgery.

A microscopic posterior cervical foraminotomy is performed for patients with a symptomatic cervical herniated disc with foraminal stenosis occurring at one or two levels of the spine. It is performed to remove the large, arthritic bone spurs and a portion of the herniated disc(s) compressing the spinal nerves. A microscopic posterior cervical foraminotomy is favored for patients with a small or moderate herniated disc and foraminal stenosis at one or two levels, yet it is not recommended for patients with cervical kyphosis, severe neck pain or large herniated discs.

Post-Operative Care

Most patients are able to go home the same day after surgery. Patients are instructed to avoid excessive bending and twisting of the neck in the acute postoperative period (first one to two weeks). Patients can gradually begin to bend and twist their neck after two to three weeks as the pain subsides and the neck and back muscles get stronger. Patients are also instructed to avoid heavy lifting in the acute postoperative period (first three to four weeks).

Most patients are not required to wear a neck brace after surgery, but most patients are issued a soft cervical collar. This reduces the stress on the neck area and helps decrease pain in the early postoperative period.

Minimally Invasive Posterior Lumbar Fusion and Transforaminal Lumbar Interbody Fusion

Minimally Invasive TLIF (Transforaminal Lumbar Interbody Fusion)

Using innovative technology, a minimally invasive surgery (MIS) spinal fusion can be accomplished using two small poke-hole incisions with minimal tissue dissection resulting in a faster recovery. Using the MIS procedure, posterior lumbar fusions (PLF) and transforaminal lumbar interbody fusions (TLIF) can both be performed in less time, with less tissue damage and less pain than traditional open spinal fusion surgery.

Posterior lumbar fusion (PLF) is the general term used to describe the technique of surgically mending two or more lumbar spine bones together along the sides of the bone. Bone graft is placed alongside the spine bones (not in between the disc spaces as in an interbody fusion), and ultimately fused together. Minimally invasive PLF is generally always performed in conjunction with the use of metal screws and rods so as to impart immediate stability while the bone mends and to increase the fusion rate. MIS TLIF includes the PLF described above, as well as performing an interbody fusion, which means the intervertebral disc is removed and replaced with a bone spacer. A MIS TLIF involves placing only one bone graft spacer in the middle of the interbody space without retraction of the spinal nerves.

A MIS TLIF is commonly performed when one or two spinal levels are being fused in conjunction with a partial posterior decompression (facetectomy and laminectomy), and interbody fusion is indicated.

MIS PLF and MIS TLIF are commonly performed for a variety of spinal conditions, such as spondylolisthesis, stenosis and degenerative disc disease, among others.

Post-Operative Care

Most patients are usually able to go home the day after surgery. Before patients go home, physical therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting more than five pounds, and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after four to six weeks as the pain subsides and the back muscles get stronger. Patients are generally not required to wear a back brace after surgery.

Minimally Invasive Lateral or Anterior Lumbar Fusion

XLIF® Lateral Lumbar Interbody Fusion

Anterior Lumbar Interbody Fusion (with bone graft and pedicle screws)

Anterior lumbar interbody fusion (ALIF) is a type of spinal fusion that utilizes an anterior approach to fuse the lumbar spine bones together. Interbody fusion means the intervertebral disc is removed and replaced with a bone or metal spacer using an anterior or lateral approach in this case. ALIF may be performed in conjunction with or without a posterior decompression (laminectomy) and/or use of metal screws and rods. Sometimes this type of back surgery is staged into two parts with the anterior column support being done on the first day and the posterior column support accomplished in the second stage.

ALIF is commonly performed for a variety of painful spinal conditions, such as spondylolisthesis and degenerative disc disease, among others.

Post-Operative Care

Most patients are usually able to go home the day after surgery. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Patients are instructed to avoid bending at the waist, lifting more than five pounds and twisting in the early postoperative period (first two to four weeks) to avoid a strain injury. Patients can gradually begin to bend, twist and lift after four to six weeks as the pain subsides and the back muscles get stronger. Patients are generally not required to wear a back brace after this type of back surgery.

Anterior Cervical Discectomy and Fusion

Anterior Cervical Discectomy and Fusion (Intervertebral Spacer)

Anterior cervical discectomy and fusion (ACDF) is performed for patients with a symptomatic, painful herniated disc in the neck. Anterior cervical discectomy and fusion is the most common neck surgery performed by spine surgeons. It is performed to remove a portion of the intervertebral disc, the herniated or protruding portion that is compressing the spinal cord and nerve root. However, in order to do so generally involves removing nearly the entire disc, which must be replaced with an artificial spacer and a piece of bone graft fused together to maintain stability.

Post-Operative Care

Most patients are able to go home the day of or day after surgery. Patients are instructed to avoid bending and twisting of the neck in the early postoperative period (first two to four weeks). Patients can gradually begin to bend and twist their neck after two to four weeks as the pain subsides and the neck and back muscles get stronger. Patients are also instructed to avoid heavy lifting in the early postoperative period (first two to four weeks).

Most patients are placed in either a soft cervical collar or padded, plastic neck brace. This reduces the stress on the neck area and helps decrease pain.