Laser Spine Surgery: Philosophy & Procedures
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 weakness. Sometimes these issues can be resolved through non-surgical techniques, such as physical therapy or injections, but some patients require surgery.
All Coastal Spine surgeons are not only experienced but also fellowship trained. We specialize in laser 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 as well as minimally invasive spine surgery and all common surgical problems in the neck and low back. We are also knowledgeable regarding innovations such as disc replacement.
About 200,000 Americans undergo fusion surgery each year to relive pain from serious degenerative disc diseases and spondylolisthesis. The outcome from these surgeries can be improved drastically with minimally invasive spine surgery and proper evaluation by an experienced spine team. Coastal Spine has such a team in place.
Minimally Invasive Surgery
Minimally invasive surgery (MIS) is a type of procedure that enables spine surgeons to make the smallest incisions possible while achieving identical results compared to open spine surgery. 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 longer recovery period.
Laser spine surgery performed with MIS techniques help 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 shorter with less visible scars, reduced pain and minimal blood loss.
- Reduced recovery time
- Reduced post-operative pain
- Reduced blood loss
- Reduced damage to tissues and muscles
- Minimal scars
There are many different MIS procedures based on a patient’s condition. These include:
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 through 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. These cervical spine surgeries are minimally invasive and avoid spinal fusion, which minimizes recovery time. These procedures are done on an outpatient basis in a local surgery center.
Anterior Cervical Discectomy and Fusion
In this type of minimally invasive spine surgery, 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.
A laminoplasty is a procedure performed on patients suffering from spinal stenosis in the neck. This cervical spine surgery 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 of the spinal canal.
Microdiscectomy / Minimally invasive discectomy
A discectomy surgery removes 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, because the removal of a disc may cause instability in the joint. As a result, your surgeon may recommend this procedure include a fusion to re-stabilize the area.
The goal of fusion surgery is to graft bone between two vertebrae, thus stabilizing the spine. The procedure can be performed with another spinal surgery or on its own..
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.
Posterior lumbar interbody fusion (PLIF) / Transforaminal lumbar interbody fusion (TLIF)
This spinal fusion surgery is similar to anterior lumbar interbody fusion. Here, the surgeon approaches the spine through the low back for patients with less stable spines. The surgeons at Coastal Spine 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. If this approach can be used, it minimizes the exposure of the nerve roots to injury with similar fusion results to a PLIF.
During extreme lateral interbody fusion (XLIF), a surgeon accesses the disc space and fuses the lumbar spine from the side rather than the front 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 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.
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. Lumber laminectomies are performed through a minimally invasive technique with 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.
Scoliosis and spinal deformity surgery
If caught early, many cases of scoliosis can be remedied through non-surgical techniques. However, if not treated, cervical spine surgery may be required to correct the curve and prevent pain and deformity.
Surgery for scoliosis is done through the placement of hooks, rods and screws. This can be followed by a fusion, so 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).
For more information, please visit www.backsurgery.com.