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Advances in Spine Treatment

Advances in Spine Treatment

Doctors at the Hospital of Saint Raphael use one of the latest surgical techniques – the minimally invasive lateral interbody fusion  – to access the spine and relieve back pain.  By approaching through the side (versus the front or back), surgeons can remove degenerative discs, decompress nerve roots and insert  “cages” to restore disc space height and provide structural support.  The procedure minimizes disruption of tissue and organs, blood loss and scarring while providing faster recovery.

NOTE:  Click here to view this video on a Mac.  

At the Hospital of Saint Raphael, we pride ourselves on our continued efforts to keep up with the latest advances in technology and treatments.  We strive to be at the forefront by participating in clinical trials and taking advantage of the expertise of our experienced physicians and surgeons.

Among the latest advances in spine treatment implemented at the hospital are:

The X-Stop Spacer* for spinal stenosis

One of the most common surgeries for spinal stenosis — a narrowing of the channel that protect the spinal cord — is intended to decompress the squeezed and inflamed nerve.  A straightforward way of doing this is a procedure called a laminectomy, where a section of the lamina, one of the bony processes on the back of the spine is removed. This releases pressure on impinged nerves, but leaves the spinal cord more exposed.

There is one way to relieve pressure without cutting through bone, rupturing ligaments, or slicing tendons. Medtronic Spine LLC of Sunnyvale, Calif., manufactures the “X-Stop® Spacer,” a metal assembly that is installed between the vertebral processes, pushing them apart, and giving more space to the nerves.

It is shaped like an “H.” The cross bar fits between the lamina, preventing the two vertebrae from squeezing together, thus, sparing the spinal cord. The “uprights” of the H keep the device in place.  The X-Stop can be repositioned as required or removed in the event that more involved surgery is necessary.

Disc replacement

The Prestige® Cervical Disc, also made by Medtronic, is an artificial disc replacement for a cartilage disc in the neck.  Its use is as an alternative to spinal fusion for degenerated or herniated discs in the neck. When a cervical disc shrinks or disintegrates, nerves running through the vertebrae of the neck can become pinched, leading to problems superficially similar to spinal stenosis, including pain, tingling and loss of motion.

The Prestige device bolts onto the two vertebrae on either side of the degenerated disc, which is removed. In place of the disk are a convex piece of stainless steel on the end of the one vertebra that fits into a concave piece of steel mounted carefully on the other vertebra.

This procedure can be performed on outpatients. Like the X-Stop, no bone or tissue is removed, so further surgery can be undertaken if necessary.

Lateral interbody fusion

The Lateral Interbody Fusion approach is a minimally invasive procedure that gives the surgeon direct access to the intervertebral disc space of the spine from the side of the body (lateral) as opposed to the front or back.  By accessing the spine through the side, the surgeon has less soft tissue to have to go through to get to the spine minimizing the amount of tissue (muscles, ligaments, blood vessels, and abdominal organs) disruption.

Before minimally invasive spine surgery, surgeons generally reached the spine through one large incision in the front or back of the body.  With the minimally invasive approach, surgeons can reach the spine through small incisions.  With lateral interbody fusion, in addition to causing less tissue trauma, the procedure involves less blood loss, creates less scarring, a shorter hospital stay, less postoperative discomfort, reduced need for postoperative pain medication and faster recovery.

A fusion links (fuses together) two vertebral bones on either side of a diseased disc to maintain alignment and provide stability and strength to the spine. An implant is put into the disc space between the “vertebral bodies,” eliminating motion across the damaged area. The procedure allows minimally invasive exposure of the spine, a powerful amount of correction to spinal deformity, complete and thorough removal of the disc and indirect decompression of the spine. 

Using real-time monitoring provides safe access of the spine. The technique employs a neuromonitoring system that lets physicians view nerves electronically. Patients are generally walking the same day they undergo surgery. 

*The “X-Stop® Spacer” and “Prestige® Cervical Disc ” are trademarks of Medtronic Spine LLC of Sunnyvale, Calif.

 

Mac version of the Lateral Interbody Fusion Spine video – using QuickTime:   

    

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Page last updated on Mar. 09, 2010