On the opposite end of the spectrum from various non-surgical therapies and minimally invasive surgical options are a host of conventional “open” surgical procedures. When a severe back or neck condition fails to respond to more conservative therapies and treatments, a more aggressive, and typically more invasive, surgical procedure may be recommended. Such procedures may, in fact, also require a hospital stay as well as several months to achieve a recovery.
ACDF – The goal of an anterior cervical decompression and fusion (ACDF) surgical procedure is to treat severe nerve root or spinal cord compression by decompressing the nerve roots of the cervical spine in order to stabilize the corresponding vertebrae. This procedure is typically utilized when other non-surgical treatments have consistently failed.
Corpectomy – The goal of a surgical corpectomy procedure is to achieve the removal of a portion of the vertebra and adjacent discs for decompression of the spinal cord and spinal nerve roots.
Discectomy – An open discectomy is the most common surgical procedure used to treat a herniated or ruptured disc. The goal of this treatment is to achieve the partial or complete surgical removal of a damaged intervertebral disc. Removing the damaged disc eliminates the source of pressure and irritation on the nerve roots, which in turn removes the cause of the symptomatic back pain and weakness. Although this type of procedure may be done either as an open surgical procedure or via a minimally invasive method, a stay in the hospital or clinic of one to three days is typically required.
Facetectomy – The goal of a facetectomy procedure is to achieve the partial or complete removal of the articular facet of a vertebra. It is often done as part of a laminectomy procedure that is performed to alleviate issues caused by severe spinal stenosis.
Foraminotomy – The goal of a foraminotomy procedure is to achieve the removal of the roof of an intervertebral foramina. This enlarges the bony hole where a nerve root exits the spinal canal and relieves nerve root compression. It is often done as part of a laminectomy procedure that is performed to alleviate issues caused by severe spinal stenosis.
Laminotomy – The goal of a laminotomy or microdecompression procedure is to achieve the partial removal of the shingle-like elements (lamina) of a vertebra in order to relieve pressure on nerve roots or to allow additional access for the surgeon to remove a bone spur or a portion of a damaged vertebral disc.
Laminectomy – The goal of a laminectomy procedure, also known as spinal decompression (and the most common form of surgery to treat spinal stenosis), is to achieve the removal of the shingle-like elements (lamina) of a vertebra and increase the size of the spinal cord canal in order to relieve pressure on the spinal cord and nerve roots.
Lumbar Spinal Fusion – The goals of a lumbar spinal fusion procedure are to strengthen the spine and prevent painful movements. Typically, both are achieved by removing one or more damaged intervertebral discs and then “fusing” together the adjacent vertebrae utilizing bone grafts and/or metal devices secured by special screws.
Common approaches are anterior and posterior approaches:
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