05 Nov WHAT ARE THE TYPES OF SPINE SURGERIES?
Spine surgeries are well known both in the world and in Lithuania. Type of surgery depends on the clinical situation, adjacent diseases, other factors. And only when the neurosurgeon evaluates magnetic resonance imaging (MRI) the diagnose can be set.
Neurosurgeon MD Ph.D. Bronius Špakauskas talks about the most popular type of spinal surgery. He describes the procedure and when minimally invasive methods can be used.
CAN YOU LIST THE TYPES OF SPINE SURGERIES AND MARK OUT THE MOST POPULAR ONE?
There is a wide range of spine surgeries, but all of them are divided into two types. One is decompression of the spinal canal. This includes spinal canal distribution due to stenosis and also removal of intervertebral disc herniation – discectomy. Another group of operations is the stabilization of vertebrae that are being practiced in the world for more than 50 years. It is used in cases of displacement, fractures, oncological diseases. The most popular and most commonly performed spinal surgery is the classic microdiscectomy. It is performed due to intervertebral disc herniation. During this operation, the neurosurgeon makes a small incision in the lumbar region of the patient’s abdomen. The incision is from 2.5 to 3 cm length and is done with the microsurgical technique by using a microscope that identifies the nerve elements. The neurosurgeon removes some ligaments, part of the bone surface and also a piece of intervertebral cartilage that is trapped in the spinal canal and compresses the nerve elements. At the same time, nerve cells are released and treatment results are quite good. This operation is one of the most popular.
WHAT IS A MINIMALLY INVASIVE OPERATION – NUCLEOPLASTY?
Nucleoplasty can be performed for patients that are very strictly selected. This surgery may be performed in these and similar occasions if:
- intervertebral disc is not massively sequestered in the spinal canal;
- intervertebral disc does not cause significant compression of nerve elements and vascular fibers but causes discomfort when flexing, moving;
- structure of disc changes without signs of sequestration and compression of nerve elements;
- intervertebral disc causes backaches that sometimes spreads to the legs or arms.
Nucleoplasty – radiofrequency destruction of a damaged disc is done by puncture and it is called nucleoplastics. However, I emphasize that this method is not suitable for all diseases. It is only used for a select group of patients, including clinical complaints, patient status, age, other illnesses, even patient body mass index. Only after a full examination, a doctor can tell whether this method will work or not, whether it is worth performing this operation or not.
SPINE CEMENTING – VERTEBROPLASTY
Vertebroplasty is another method classified as minimally invasive surgery when no section is used. Through the dorsal side of the back using a special needle, a special polymer that is called bone cement is injected into the damaged vertebrae. This procedure is done in x-ray’s control. After less than half an hour the bone cement becomes hard and stabilizes the spine. A patient that is diagnosed with osteoporosis suffers from pain that is caused by spinal cord injuries, fractures. In this case, after performing the vertebroplasty a sufficiently good analgesic effect is reached. Another group of patients is those with oncology, such as oncology of the spine such as hemangiomas, certain forms of solitary myeloma, blood diseases. In some cases, it is also possible to perform this operation for two purposes. One is to reduce or eliminate pain, and the second is to stabilize the vertebra to prevent further fracture, deformity and the risk of nerve fiber damage.