If conservative treatment options have failed, surgery may be necessary to correct some severe conditions or ailments of the spine. When you choose Campbell Clinic Spine Center, you can be certain you have selected the top team of spine surgeons in the Mid-South. The inherent risk associated with any surgery must be weighed against the severity of symptoms and potential benefits from undergoing such a procedure. For some patients, spine surgery can provide beneficial results and improve quality of life.
There are different approaches or forms of spine surgery; each correcting a specific problem. Your physician may need to remove bone or disc tissue, relieve pressure or fuse vertebrae together to provide more stability or support. Your surgeon’s goal will be to identify the most reasonable course of surgical intervention that will serve two purposes: correct or relieve your condition and cause the least amount of disruption in the process.
We perform spine surgery at multiple facilities in Memphis, and some patients may even be candidates for outpatient spine surgery at one of our two ambulatory surgery centers. Several factors dictate where your spine surgery will be performed, including your overall health, specific spine condition and insurance.
Various types of spine surgery include:
During a discectomy, a surgeon may relieve the pressure on the spinal cord or a nerve root by removing some of the herniated disc material causing the pressure or discomfort. The inner portion of the intervertebral disc – the nucleus pulposus – is removed during this type of spine surgery. The most common types of this procedure are the lumbar discectomy (in the lower back) or cervical discectomy (in the neck). In addition, a laminectomy or bone fusion may be necessary in conjunction with the discectomy. A laminectomy removes a small portion of the corresponding vertebra, allowing the surgeon to have better access to the central portion of the disc. A bone fusion may provide additional support after the affecting portion of the disc is removed.
Some surgeons recommend replacing a problem disc that causes pain with an artificial one. Artificial discs serve the same purpose as natural ones – providing support to the spinal column and acting as “shock absorbers” between vertebrae. Artificial discs provide an alternative to patients who do not wish to have a lumbar fusion or are not ideal candidates for such a procedure. Artificial discs only work to replace one disc, so they are not an appropriate surgical option for patients with multiple levels of disc failure.
A total disc replacement involves the removal of the entire disc and implantation of an artificial disc in its place. In some instances, though, your surgeon may only need to remove and replace the inner portion of the disc.
During a spinal fusion, a surgeon will join two or more vertebrae together by using supplemental bone tissue. This bone may be taken either from the patient or a donor. Abnormal movement of incompetent vertebrae may cause significant pain, and a spinal fusion serves to immobilize these vertebrae.
The bone graft, itself, does not form a fusion at the time of surgery, but it rather serves as a sort of foundation for natural bone growth to occur and stabilize the vertebrae over time. Rods and screws are also inserted at the time of surgery to allow for stability in the immediate aftermath of surgery. Once the bone heals together naturally the affected area of the spine gradually becomes more stable.
Most patients elect to use their own bone from another part of their body for the graft. Bone is typically harvested from the pelvis to use in the spinal fusion. In some cases, bone may be taken from another part of the spine or the ribs.
As noted above, your surgeon may need to remove a portion of the bone covering your spinal column to relieve pressure on nerve roots or better access a disabled disc. A narrowing of the spinal canal (called stenosis) may compress nerves and cause a variety of symptoms including weakness and numbness in other parts of the body.
A laminectomy may serve a variety of functions and may be done independent of other spine surgery procedures or to supplement procedures such as fusions or discectomies. During a laminectomy, your surgeon will make an incision, pull away soft tissue in the area to expose the spine, and remove the lamina to create room and relieve compression.
Total Disc Replacement
A relatively new surgical treatment option for cervical or lumbar disc problems is total disc replacement. For decades, orthopaedic surgeons have replaced hip, knee and shoulder components worn down over time because of osteoarthritis and other degenerative issues in joints through the use of artificial components. Spinal disc replacement became prevalent in the U.S. in 2004, but even now the procedure continues to evolve through recent advancements.
In a total disc replacement of the spine, your surgeon will remove the painful, problematic disc and replace it with a metal component to help relieve pain and restore motion. Many of these artificial components also have a plastic surface designed to bear stress and limit wear and tear associated with natural movement.
For some patients, an artificial disc replacement is a viable alternative to spinal fusion surgery which may limit rotational movement or cause increased stress on other areas of the spine. Your surgeon will discuss which option may be best for you and carefully weigh all factors as you consider your course of care. While artificial components continue to improve and their life spans continue to lengthen, natural movement and stress placed on them for years after implantation may cause gradual wear over time.