Surgical Procedures

Some of the most common spine and neck surgical procedures that Riverside neurosurgeons perform are:

Spinal Fusion
If your spine has become unstable due to illness, trauma or surgery, your doctor may recommend a spinal fusion. A spinal fusion is also used to first stabilize your spine when surgery to remove material such as a disk or tumor is pressing on your spinal cord. Spinal fusions are performed to:

  • Straighten a spine deformed by scoliosis, neuromuscular disease, cerebral palsy, or other disorder
  • Prevent further deformation
  • Support a spine weakened by infection or tumor
  • Reduce or prevent pain from pinched or injured nerves
  • Compensate for injured vertebrae or disks

Spinal Fusion Procedure
Your neurosurgeon will remove all disks between two or more vertebrae, roughening the bones so that the vertebrae fuse together as they heal. A small piece of bone taken from your hip is grafted on your spine and attached with metal screws or plates to support the lumbar vertebrae. While spinal fusion surgery decreases pain it may also decrease spinal mobility. 

During this procedure, your neurosurgeon will relieve pressure on the spinal nerves by removing the disk, piece of bone, tumor or other structure in your spine that is causing compression and pain. Sometimes a spinal fusion is performed simply to stabilize the spine.

A laminectomy for relief of pain in the lower back is called a lumbar laminectomy. This procedure is used to treat:

  • Herniated disk
  • Spinal Stenosis
  • Osteoarthritis
  • Sciatica

Laminectomy Procedure
You will be placed under general anesthesia, usually positioned lying on your side or stomach. The procedure will generally take between one to three hours.

Your neurosurgeon will begin by making a small, straight incision over the damaged vertebra and using a retractor, spreading out the muscles and fatty tissue overlying the spine. A portion of the bone will be cut exposing a band of yellow tissue that fills space between the vertebral arches. Your neurosurgeon will cut an opening in this tissue in order to reach the spinal canal and expose the compressed nerve. The cause of the compression (herniated disk, tumor, bone spur, or a fragment of the disk that has separated from the remainder) will be visible.

Bone spurs, if any, are removed. If the disk is herniated, your neurosurgeon will move the compressed nerve aside, removing as much of the disk as necessary to relieve pressure on the nerve. A spinal fusion may be performed to stabilize your lower back.  Your neurosurgeon will close the incision in layers, using different types of sutures for the muscles, connective tissues, and skin.

Discectomy (Disk Removal) and Microdiskectomy
Disk removal is one of the most common types of back surgery. Diskectomy (also called discectomy) is the removal of an intervertebral disk that connects any two adjacent vertebrae in the spine.  If disk material is pressing a nerve, your neurosurgeon may be able to remove the portion of the disk that is causing the problem.

Disk Removal Procedure
You will be placed under general anesthesia. Your neurosurgeon will cut an opening into the vertebral canal and move to the side a bundle of nerves called the "cauda equina" in order to expose the disk. If a portion of the disk has moved into the nerve canal, it will be removed. If the disk is fragmented and partially displaced or is significantly bulging, the damaged part of the disk is removed. 

There are minimally invasive surgical techniques for disk removal, including microdiskectomy. where neurosurgeons rely on the use of a magnifying instrument or special microscope to view the disk. Magnification makes it possible to remove a herniated disk with a smaller incision, causing less damage to nearby tissue. Video-assisted arthroscopic microdiskectomy has yielded good results with less use of narcotics and a decreased recovery period. 



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