for Patients

Spine Surgery

Philosophy and Experience

The goal of spine treatment is to address the underlying problem, whether it be neck or back pain, pain down the arm or leg or weakness. Sometimes these issues can be resolved through non-surgical techniques, such as physical therapy or injections, but some patients require surgery.

The decision for surgery is a complex one, and education of our patients about their options is extremely important. Our physicians stress this in creating your treatment plan.

All of our surgeons are not only experienced but also fellowship trained. We specialize in spine surgery only, and each of our spine surgeons typically perform over 100 such procedures each year. We are specialists in scoliosis, tumor surgery, failed back surgery repairs along with minimally invasive spine surgery and all common surgical problems in the neck and low back, as well as new innovations including disc replacement. This experience translates into improved patient care of all spinal problems.

Overview


About 200,000 Americans undergo fusion surgery each year in order to relive pain from serious degenerative disc disease and spondylolisthesis. The outcomes from these surgeries can be improved drastically with a proper evaluation by an experienced spine team. Coastal Spine has such a team in place. New developments in minimally invasive techniques have improved the way a surgeon can access the spine. This makes the recovery process easier.  These techniques are quickly replacing conventional surgical approaches. 

Minimally Invasive Surgery

Minimally Invasive Surgery (MIS) is a type of surgery that enables spine surgeons to crease the smallest incisions possible - sometimes only a half an inch long - while at the same time achieving identical and often better results than through open spine surgery. That's because traditionally “open” spine surgery can involve a long incision, and muscles and ligaments are stripped from the spine to gain access during surgery. This can result in trauma to the surrounding tissues and blood loss, which could mean a several–week recovery period.

MIS techniques provide the opportunity to successfully treat back problems with far less interruption to normal muscles and ligaments with the same results. By using minimally invasive techniques, access and repair to the damaged disc or vertebrae is achieved without harming nearby muscles and tissues. MIS recovery time is less with less visible scars, reduced pain and blood loss.

Benefits

  • Less recovery time
  • Less post-operative pain
  • Less blood loss
  • Less damage to tissues and muscles
  • Minimal scars
  • Quicker return to activity

Posterior Cervical Foraminotomy / Discectomy


For patients whose herniated discs or bone spurs in the neck affect only the nerve roots, a posterior discectomy and foraminotomy can be performed. Discectomy is the removal of the herniated portion of a disc to relieve the pressure on nearby nerves as they exit the spinal canal.  The disc functions as a shock absorber between two bony vertebrae.  An injury, damage from a lifting accident or a twist may cause the center of the disc to break thought the wall of the disc.  When a disc herniates, the center can press on nearby nerves. In the neck this can cause arm, shoulder, scapula and in extreme cases spinal cord compression. This type of procedure is minimally invasive and avoids spinal fusion, which minimizes recovery time. These procedures are done on an outpatient basis in a surgery center.

Corpectomy


A corpectomy is performed on patients who suffer from multiple levels of cervical stenosis with cord compression. The procedure will decompress the spinal canal by removing bone spurs and possibly one or more degenerating vertebrae with discs above and below. This gives more room for your cervical spinal cord and nerve roots. The corpectomy is followed by a fusion using bone harvests from your hip or from a bone bank. The bone is grafted to reconstruct the spine and provide support and stability post-surgery along with the plate and screws.

Anterior Cervical Discectomy and Fusion


In this type of procedure, our surgeon will remove a piece of damaged neck disc tissue to relieve pressure on the spinal cord and/or nerve roots. In some cases, we will fuse the vertebrae to stabilize the spine after the disc is removed. Most cervical fusions are done in an outpatient setting in a surgery center. 
For more information, please visit www.necksurgery.com.

Laminoplasty


A laminoplasty is a procedure performed on patients suffering from spinal stenosis in the neck. This procedure creates more space for the spinal cord and roots by cutting a “hinge” into one side of the lamina. This allows it to swing open like a door, which relieves pressure on the spinal cord by increasing the size spinal canal, leaving room for the spinal cord. 

Microdiscectomy / Minimally invasive discectomy


A discectomy will remove the herniated portion of a disc to relieve the pressure on nearby nerves. In a lumbar discectomy, the surgeon typically only removes the portion of the disc that is causing a problem. Removing a disc may cause instability in the joint. Therefore, your surgeon may recommend that this procedure include a fusion to re-stabilize the area. Our surgeons typically perform this as a minimally invasive surgery done in an outpatient basis in a surgery center. 

Lumbar Fusion


Fusion is a procedure that will stabilize a patient's spine, whether this is performed in tandem with another spinal surgery, or on its own to correct spinal deformity or to treat patients with severe degenerative pain. The goal of fusion surgery is to graft bone between to vertebrae, thus stabilizing the spine.
For more information, please visit www.backsurgery.com.

Anterior lumbar interbody fusion (ALIF)


In this type of procedure, the space between discs is fused by approaching the spine through the abdomen, thus not affecting your back muscles and nerves. This procedure is performed on patients with relatively stable spines but with significant collapsed disc space, and in cases of degenerative disc disease.
For more information, please visit www.backsurgery.com.

Posterior lumbar interbody fusion (PLIF)  / Transforaminal lumbar interbody fusion (TLIF)

This spinal fusion surgery is very similar to the anterior lumbar interbody fusion. Here, though, the surgeon approaches the spine through the low back. It's typically used for patients with less stable spines. The surgeons at CoastalSpine perform this procedure exclusively through a minimally invasive technique.   The transforaminal lumbar interbody fusion (TLIF) utilizes a slightly different approach to the disc space from behind.  Depending on the situation, if this approach is able to be used it minimizes the exposure of the nerve roots to injury with similar fusion results to a PLIF.

Extreme lumbar interbody fusion (XLIF)  This fusion is performed with an approach where the surgeon access the disc space and fusion the lumbar spine from the side rather than the from or the back.  This surgery may be completed to treat lumbar degenerative disc disease, spondylolisthesis, scoliosis and deformity, some lumbar disc herniations and certain types of stenosis.  This can type of fusion surgery can be used from parts of the thoracic spine to L4-5 in the lumbar spine.  When this approach is utilized, it may avoid injury to the abdominal area. 
For more information, please visit www.backsurgery.com.

Lumbar laminectomy


A laminectomy removes part or all of the bone covering the spinal canal. This can free nerve roots, remove a tumor, remove a bone spur or allow your surgeon to perform certain types of fusion procedures. CoastalSpine surgeons always perform this procedure through a minimally invasive technique with just one-inch incisions. 

We often use this procedure to treat recurrent disc herniations, or in cases where scar tissue is involved. Laminectomy may also be used for spinal stenosis where the entire canal is narrowed.
For more information, please visit www.backsurgery.com.

Scoliosis and spinal deformity surgery


Many cases of scoliosis, if caught early, can be remedied through non-surgical techniques, and many cases are not serious. However, if not treated, surgery may be required to correct the curve and prevent pain and deformity.

Surgery for this condition is done through the placement of hooks, rods and screws, which corrects the curve and stabilizes the spine. This can be followed by a fusion so that the corrected position is made permanent.  The fusion may be done through a transforaminal lumbar interbody fusion (TLIF) or an extreme lateral interbody fusion (XLIF).