Services
Operative and Non-operative Treatments
The spine physicians and surgeons at BWMC use operative techniques to treat spine conditions and disorders. While there are many conditions and disorders of the spine, some degenerative disorders of the spine and their surgical treatments include:
- Disc disease - Degenerative disc disease is relatively common and is a normal part of aging. This occurs when the disc (the cushions) in between the vertebra (the bones) in your back or neck wear out. The symptoms can range from mild to severe. Treatments include physical therapy, injections, bracing, and surgery in severe cases. Surgery usually entails removing the degenerated disc, placing a spacer were the disc was removed and fusing the spine at that level.
- Sciatica - Sciatica is a term used to describe pain traveling down you leg. Your doctor may also refer to it as a radiculapathy. This can be caused by a disc herniation, degenerative diseases, spondylolisthesis and in rare cases tumors or infections and generally results in nerve compression. Surgical management consists of removing the cause of the compression by taking out a portion of the disc, in the case of a disc herniation, or by removing part of the bone or bone spur). If there are other problems your surgeon may also perform a fusion at the time of the decompression.
- Disc herniation - The disc acts as a cushion and is situated in between the vertebrae. The disc is composed of a tough outer structure (annulus) and a softer, jelly like inner structure (nucleus) that is responsible for most of the "cushion." When this softer nucleaus leaks out it is called a disc herniation. This can not only cause problems by pressing on a nerve in your back or neck, it also irritates the nerve by releasing chemicals that irritate the nerve. Surgical management aims in removing this leaked disc material and may be accomplished by many different surgical techniques including minimally invasive techniques. You should ask your surgeon what surgical technique is best for you.
- Spinal stenosis - This is a narrowing of the spine canal which may compress nerve roots or your spinal cord. It is caused by a number of conditions including congenital (you are born with it), however usually occurs as a process of aging and is most common in patients over 50 years of age. Most operative treatments consist of removing the structures that may be causing the stenosis. Common procedures to treat this condition include laminectomy, discectomy or interspinous process spacer.
- Spondylolisthesis - This is a slipping forward of one vertebrae on another. This can be caused by a congenital disorder (you are born with it), degenerative disorder (from wear and tear) or repetitive injuries. Common symptoms may include back pain and in some cases leg pain. Surgical correction involves a decompression and an instrumented fusion.
- Myelopathies - This is caused by a compression of the spinal cord usually in the neck area. This should be treated with a decompression with or without a fusion.
- Tumors and fractures
Minimally invasive surgeries involve a small incision and surgical times of typically less than one hour. Some minimally invasive techniques, treating the spine, provide our patients with the best care possible and allow them to recover quickly. They include:
- Balloon Kyphoplasty - This is a minimally invasive technique treating spinal fractures. It can reduce back pain and improve mobility, including the ability to perform daily activities such as walking, hobbies and work. With a small instrument, a spine surgeon creates a narrow pathway into the fractured bone. An orthopedic balloon is guided through the instrument into the vertebra. The balloon is then inflated in an attempt to raise the collapsed vertebra and return it to its normal position. The balloon is then deflated and removed, leaving a cavity. The specialist fills the cavity with a special cement to support surrounding bone and prevent future collapse.
- Facet fusions - Facets are the joints in the spine. This is a newer technique for spinal fusions and has been gaining popularity as it allows a minimally invasive approach to spinal fusions. This involves placing a screw, bone plug or a similar device through the facet joints of the back.
- Microdiscectomy - This is a minimally invasive technique that allows a surgeon to remove a herniated disc. This theoretically allows for a smaller incision and a quicker recovery however, not all disc herniations may be treated with this technique.
- Interspinous process spacers - When a patient has stenosis or a narrowing of the spinal canal and bends forward the canal opens. This can open enough so the patient is no longer symptomatic. An interspinous process spacer tries to achieve a flexed position of the area of the spine that is narrowed and therefore allows the patient to be asymptomatic without undergoing a decompressive surgery.
Spinal deformities, also known as curves of the spine, can happen as a child or as a degenerative process as you get older. Some spinal deformities that require treatment are:
- Spinal fractures - If left untreated, spinal fractures can lead to subsequent fractures and will continue to cause stooped posture and potentially chronic pain.
- Kyphosis - curvature of the spine or "humpback."
- Scoliosis - Scoliosis means a curvature of the spine examined from the patient's anterior or posterior.
- Spinal tumors
- Failed fusions/revisions
Non-operative techniques that treat spinal conditions and disorders are:
- Physical Therapy
- Bracing
- Medications
- Spinal Injections
- Acupuncture
- Massage
