Surgical Procedures

Cervical spine (neck) procedures

Anterior cervical discectomy

This operation is performed on the neck to relieve pressure on one or more nerve roots, or on the spinal cord. The cervical spine is reached through a small incision in the anterior (front) of your neck. If only one disc is to be removed, it will typically be a small horizontal incision in the crease of the skin.

If the operation is more extensive, it may require a slanted or longer incision. After the soft tissues of the neck are separated, the intervertebral disc and bone spurs are removed. The space left between the vertebrae may be left open or filled with a small piece of bone or device through spinal fusion. In time, the vertebrae may fuse or join together.

Cervical fusion

This surgery fuses the cervical vertebrae together to stabilize the spine and relieve compression on the spinal cord and nerve roots. It is usually performed with a laminectomy.


Cervical total disc replacement

This procedure replaces an intervertebral disc with a mechanical prosthetic device that functions similarly to a normal disc. This surgery (also known as an artificial disc replacement, or ADR) is done when the space between a patient’s vertebral disc has become too narrow and part of the vertebrae or cervical disc is pressing on the spinal cord or spinal nerves.

Anterior cervical corpectomy

This operation is performed in conjunction with the anterior cervical discectomy. The corpectomy is often done for multi-level cervical stenosis with spinal cord compression caused by bone spur formations. In this procedure, the neurosurgeon removes a part of the vertebral body to relieve pressure on the spinal cord. One or more vertebral bodies may be removed including the adjoining discs. The incision is generally larger.

The space between the vertebrae is filled using a small piece of bone or device through spinal fusion. Because more bone is removed, the recovery process for the fusion to heal and the neck to become stable is generally longer than with anterior cervical discectomy. Your surgeon may select to use a metal plate that is screwed into the front of the vertebra to help the healing process.


Posterior microdiscectomy

This procedure is performed through a vertical incision in the posterior (back) of your neck, generally in the middle. This approach may be considered for a large soft disc herniation that is located on the side of the spinal cord. A high-speed burr is used to remove some of the facet joint, and the nerve root is identified under the facet joint. The nerve root needs to be gently moved aside to free up and remove the disc herniation.


Posterior cervical laminectomy

This procedure requires a small incision in the middle of your neck to remove the lamina (the back bony part of the vertebrae). Removal of the section(s) of bone is done to allow for of thickened ligament, bone spur formation or disc material that may be pushing on your spinal cord and/or nerve roots. The foramen, the passageway in the vertebrae through which the spinal nerve roots travel, may also be enlarged, to allow the nerves to pass through.


Lumbar spine (back) procedures

Anterior Lumbar Interbody Fusion (ALIF)

This surgery involves the removal of the degenerative disc by going through the lower abdomen. After removing the disc, bone graft material or a metal device filled with bone is then placed into the disc space. This graft material or metal device acts as a binder to maintain normal disc height. Over time, this graft material and the adjacent vertebrae will fuse, helping stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to support the vertebral structure during the healing process.

Foraminotomy

A foraminotomy is a decompression surgery. This procedure involves the surgical opening or enlargement of the bony opening (foramen) where the nerve root exits the spinal canal. The spine surgeon may remove bone or tissue that obstructs the passageway and pinches the spinal nerve root, which can cause inflammation and pain. This procedure helps to increase space over a nerve canal and can be done alone or with a laminotomy.

Laminotomy/laminectomy

A lumbar laminectomy is also known as an open decompression and typically performed to alleviate pain caused by neural impingement that can result from spinal stenosis. This surgery involves removing or widening the opening made in the lamina, a part of the vertebral arch that forms the roof of the spinal canal. This is used to relieve pressure on the nerve roots.

Laparascopic Spinal Fusion

Spinal fusions can also be performed with a minimally invasive approach. This procedure is done with small incisions through which a graft is placed into the disc space.

Posterior Lumbar Interbody Fusion (PLIF)

This surgery involves removal of the posterior bone of the spinal canal, retraction of the nerves, and removal of the disc material from within the disc space. This is followed by insertion of bone graft and sometimes hardware in order to fuse the bones.