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Spine

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There are six Kinds of spine surgeries, namely Nucleoplasty, PLDD, MLD, Laminectomy, Pedicular Screw Fixation and Vertebroplasty. Nucleoplasty is a minimally invasive procedure for percutaneous disc decompression that uses radiofrequency based technology to ablate and coagulate soft tissue to decompress contained herniated discs. This causes the disc herniation to reabsorb, taking pressure off the exiting spinal nerves.

Percutaneous disc decompression techniques have been used since the late 1970s to provide a minimally invasive method of decompressing the nucleus pulposis, thereby depressurizing disc herniations, and reducing the compression of the disc herniation on nerve roots and other spinal structures.  Various methods have been devised to accomplish the decompression and subsequent reduction in pain including the use of mechanical, chemical, laser, radiofrequency, and ultrasound.  Some of the advantages of the minimally invasive percutaneous techniques include more rapid return to work, less pain after surgery, lack of production of scar tissue around the nerve roots as a result of the procedure,  lower incidence of developing disc space collapse and spinal instability later, and few complications.  The success rates of these techniques range from 55% to 90% depending on the technique.

The aim of operation is decompression of the nerve root. Under general anesthesia a 1 inch incision is made in the low back overlying the nerve root. Using the operative microscope a small crescent of bone is removed from the spine, exposing the nerve root and herniated disc material (laminotomy). The disc material compressing the nerve root is removed and the underlying central disc space is curretted free of retained, degenerated disc nucleus (discectomy).

Laminectomy is surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back. The procedure can take pressure off your spinal nerves or spinal column.Laminectomy opens up your spinal canal so your spinal nerves have more room. It is usually done along with a diskectomy, foraminotomy, and spinal fusion. You will be asleep and feel no pain (general anesthesia).

Spinal fusion is a surgical procedure used to correct problems with the small bones of the spine (vertebrae). It is essentially a "welding" process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

Spine surgery is usually recommended only when your doctor can pinpoint the source of your pain. To do this, your doctor may use imaging tests, such as x-rays, computed tomography (CT), and magnetic resonance imaging (MRI) scans.

In Vertebroplasty after confirmation of diagnosis on X-ray, MRI or C.T. Scan patient requires a day’s admission in hospital.

The procedure is performed under computerized fluoroscopy with ‘C’ Arm image intensifier. Patient is administered local anesthesia in most cases or short general anesthesia for some patients if fit. A needle is passed at the fracture site through pedicle (a part of vertebra). The position is reconfirmed on ‘C’ Arm. About 2 to 3 cc of liquid bone cement is passed into the fractured vertebra. It takes 8-10 minutes for the cement to solidify. Once it solidifies it bonds the fracture site and almost instantly the fracture is solidified. Patient gets immediate miraculous pain relief on table, which he communicates to the surgeon as it is under local anesthesia. There are no stitches required. It is bloodless procedure and thus safe.

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