Neurosurgery of the spine
Some of the common operations in neurosurgery for the spine include:
1. Discectomy: This is a surgical procedure that involves the removal of an intervertebral herniated disc.
2. Laminectomy : Removal of part of the bone-covering the spinal cord or nerves to relieve pressure and thereby release any compression on the nerves.
3. Fusion : This is the stabilization of the spine through joining two or more vertebrae with the aid of bone grafts or implants.
4. Instrumentation : This is the use of medical implants in the form of rods, screws, and plates for the stabilization of the spine.
5. Foraminotomy: This is the enlargement of a passage of an intervertebral nerve root to relieve pressure
6. Vertebroplasty/Kyphoplasty: Stabilization of a vertebral bodies with the aim of strengthening for the handling of fractures and compression
7. Spinal tumor resection: Removal of tumors that are affecting the spine
8. Chiari malformation surgery: Decompression of the spinal cord to the treat Chiari malformation
10. Spinal cord stimulation: The implantation of a device in managing chronic pain.
What Is a Neurosurgery of the spine?
Spine neurosurgery is a kind of terminology used to mention spinal neurosurgery. It is termed as medical specialties dealing with the diagnosis and treatments of disorders and conditions affecting the spine and the nervous system. Surgical procedures restore function, ease pain, and enhance the quality of life in patients with spinal conditions.
Procedures Involved in Spine Neurosurgery
1. Surgical decompression
2. Stabilization
3. Fusion
4. Instrumentation
5. Tumor resection
6. Spinal cord stimulation
7. Vertebroplasty/Kyphoplasty
These procedures are prepared for various conditions, including spinal problems such as:
1. Herniated discs
2. Degenerative disc disease
3. Scoliosis
4. Spinal stenosis
5. Spondylolisthesis
6. Spinal fractures
7. Spinal tumors
8. Chiari malformation
9. Syringomyelia
10. Spinal cord injuries
Spine neurosurgery is an art which needs high expertise and precision. The system of the spine and the nervous system is complex as well as delicate. The neurosurgeons are experts in spine surgery and develop various technologies as well as techniques that help to reduce risks as well as maximize results.
Common Conditions Treated with Spinal Neurosurgery:
- Herniated Disc: When the soft material inside the spinal disc pushes through the outer layer, pressing on nearby nerves and causing pain.
- Spinal Stenosis: Narrowing of the spinal canal, which can compress the spinal cord or nerves, leading to pain, numbness, or weakness.
- Degenerative Disc Disease: Wear and tear of the intervertebral discs that may cause instability or nerve compression.
- Spinal Tumors: Both benign and malignant growths in and around the spinal cord or vertebrae.
- Spinal Fractures: Traumatic injuries, often due to accidents, osteoporosis, or tumors, that result in broken or compressed vertebrae.
- Spondylolisthesis: A condition where one vertebra slips over the one below it, causing pain and instability.
- Infections: Infections of the spinal bones (vertebrae), discs, or surrounding tissues can lead to abscesses or other complications.
- Spinal Deformities: Conditions like scoliosis or kyphosis that cause abnormal curvature of the spine.
- Spinal Cord Compression: Any condition that compresses the spinal cord, such as tumors, fractures, or stenosis, can result in serious neurological symptoms.
- Chiari Malformation: A condition where brain tissue extends into the spinal canal, requiring surgical decompression of the spine or skull base.
Types of Spinal Neurosurgery Procedures:
- Discectomy:
– Indication: This is done to remove part or all of a herniated disc that is compressing the nerve.
– Procedure: The herniated portion of the disc is removed through a small incision by relieving pressure from the nerve root.
– Microdiscectomy: A minimally invasive type of this surgery under a microscope for a smaller incision and faster recovery. - Laminectomy:
– Indication: In the treatment of spinal stenosis.
– Procedure: The surgeon removes part of the vertebra (the lamina) to enlarge the spinal canal and relieve pressure on the spinal cord or nerves.
-Decompression Laminectomy: The most common use is in patients with severe nerve compression. - Spinal Fusion:
– Indication: Condition like spondylolisthesis, spinal fractures, or severe degenerative disc disease.
– Procedure: Two or more vertebrae are fused together with bone grafts and metal hardware (rods, screws, plates) to stabilize the spine.
Types:
– Posterior Lumbar Fusion (PLF): Done from the back.
– Anterior Lumbar Interbody Fusion (ALIF): Done through the abdominal window.
– Transforaminal Lumbar Interbody Fusion (TLIF): It is a sided approach, which opens up both the anterior and posterior aspect of the spine. - Foraminotomy:
– It is indicated in cases of nerve compression as they leave the spinal column. Nerves are compressed either due to bone spurs or disc herniation.
– Procedure: The surgeon enlarges the holes in the spinal canal where the spinal nerves branch out thereby reducing compression on nerves. Kyphoplasty and Vertebroplasty:
– Indication :This is most commonly performed for vertebral compression fractures commonly as a result of osteoporosis or trauma .
– Procedure: A needle is passed through the fractured vertebra and bone cement is injected to stabilize the bone. In kyphoplasty, a balloon is first passed to retrieve some height before injecting the cement .- Spinal Tumor Surgery:
– Indication: Tumor evacuation from the spinal cord, nerve roots, or vertebra.
– Procedure: Surgery is based on the location and the nature of the tumor. Neurosurgeons attempt to excise as much of the tumor as possible with minimum damage to the neurological function. - Syringomyelia Surgery:
– Indication: To treat a syrinx, which is a fluid-filled cavity within the spinal cord, causing pain and neurological symptoms.
– Procedure: The surgeons can provide the decompression surgery or create a drainage pathway for the syrinx to reduce pressure on the spinal cord. - Spinal Cord Stimulation:
– Indication: The treatment is used in chronic pain cases when other treatments fail to provide relief.
– Procedure: A device near the spinal cord releases electrical impulses that interrupt the pain signals from reaching the brain. - Decompression for Chiari Malformation:
– Indication: Chiari malformation; brain tissue extends into the spinal canal.
– Procedure: The surgeon removes a part of the skull or vertebrae to relieve pressure on the brainstem and spinal cord. - Cervical Disc Replacement:
– Indication: Patient having cervical disc herniation or degenerative disc disease.
– Procedure: Removal of the damaged disc and replaced by an artificial disc. It is found to preserve neck movement unlike the traditional spinal fusion.
Techniques in Spinal Neurosurgery:
- Minimally Invasive Spine Surgery (MISS):
- Minimally invasive techniques use small incisions and specialized instruments, such as endoscopes or microscopes, to access the spine.
- Benefits include shorter recovery times, less pain, and reduced risk of complications compared to traditional open surgery.
- Commonly used for discectomy, laminectomy, or spinal fusion.
- Robotic-Assisted Spine Surgery:
- Robotic systems guide the surgeon in placing screws, rods, and other instrumentation with greater precision.
- This technique reduces variability and improves accuracy, leading to better outcomes for complex spine surgeries.
- Endoscopic Spine Surgery:
- A small camera (endoscope) is inserted through a tiny incision, allowing the surgeon to visualize and treat the spinal pathology with minimal disruption to surrounding tissues.
Risks and Complications:
As with all surgeries, spinal neurosurgery carries some risks, including:
- Infection: At the incision site and deep within the spine.
- Bleeding: Excessive bleeding during surgery, especially in complex cases.
- Nerve Damage: Injury to the spinal cord or nerve roots, which can result in weakness, numbness, or paralysis.
- Hardware Failure: Metal implants may become loose or break over time.
- Spinal Fluid Leak: A tear in the dura (the membrane around the spinal cord) can cause cerebrospinal fluid (CSF) leakage.
- Failed Back Surgery Syndrome: In some cases, pain may persist after surgery due to incomplete decompression, scarring, or misdiagnosis.
- Adjacent Segment Disease: After spinal fusion, nearby vertebrae may experience added stress, leading to degeneration.
Recovery and Rehabilitation:
- Hospital Stay: Patients may stay in the hospital for the several days, depending on the complexity of the procedure.
- Pain Management: Pain medication is provided after surgery, and physical therapy may begin soon after to help with mobility and healing.
- Activity Restrictions: Heavy lifting, twisting, or bending are typically restricted during the recovery period.
- Full Recovery: Recovery times vary but typically range from several weeks to months, especially for complex surgeries like spinal fusion.
What procedures Neurosurgery of the spine?
Neurosurgery of the spine encompasses a host of procedures involving treatment in relation to spinal disorders.
- Decompression
-Laminectomy
-Foraminotomy
-Discectomy - Stabilization
-Fusion: Posterolateral fusion, interbody fusion
-Instrumentation: Rods, screws, plates, etc. - Tumor resection
-Intradural tumor resection
-Extradural tumor resection - Spinal cord stimulation
- Vertebroplasty/Kyphoplasty
- Minimally invasive spine surgery
- Deformity correction
- Spinal reconstruction
-Instrumented Spinal Fusion - Spinal osteotomy:
-Ponte osteotomy
-Smith-Petersen osteotomy - Disc replacement:
-Artificial disc replacement
All the above procedures treat various spinal conditions: herniated discs, spinal stenosis, scoliosis, spinal tumors, and spinal fractures. The case and surgeon determine the procedure.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.