Laminectomy and Discectomy

Laminectomy and Discectomy

Vertebral Arthrodesis, Artificial Discs, Herniated Disc.

Laminectomy and Discectomy

Vertebral Arthrodesis, Artificial Discs, Herniated Disc.

A herniated disc consists of the partial or massive exit of the nucleus pulposus of the intervertebral disc through a rupture in the fibrous ring that surrounds it. Behind the intervertebral disc are the nerve roots that provide sensation and movement to the extremities. When the nucleus pulposus material herniates backwards, it can compress these neurological structures and produce severe pain in the lower back, or along the territory innervated by the compressed nerve (along the leg), or even loss of strength or paralysis of a leg or foot muscle.

The surgical procedure is usually performed under general anesthesia. It consists of making a small opening in the posterior area of the vertebra (laminectomy) to gain access to the herniated disc, and then removing the herniated disc material (discectomy), thus releasing the compression of the neurological structures.

After the operation it is common to have discomfort in the wound area due to the surgery and the healing process, which may last for a few weeks.

Rest is required for a few days. It is usually necessary to wear a brace (girdle) for a limited time. Subsequently it is recommended to start rehabilitation exercises.

Cervical arthrodesis

When there is pain caused by a herniated cervical disc, either limited to the cervical region or with pain radiating to the arm, treatment by cervical discectomy, or cervical disc removal, may be indicated.

It is a procedure that requires general anesthesia. It is performed through an incision in the front of the neck. The intervertebral disc that is causing the nerve compression, or that is causing pain, is accessed and removed. The two adjacent vertebrae can then be fixed by various procedures, either by placing an artificial disc, by implanting a bone graft (from the patient’s own bone) and by placing a metal plate in the anterior region to immobilize the affected vertebrae.

In the postoperative period it may be necessary to wear a neck brace for a few weeks. Subsequently, appropriate rehabilitation will be recommended.

Vertebral fixation is also called spinal fusion, spinal instrumentation or arthrodesis. It can be performed at any level of the spine. It is performed to provide stability to a group of two or more vertebrae that are displaced or unstable, either because of congenital problems, intervertebral disc disease, or after surgery to treat lumbar stenosis. It can also be performed after fractures that compromise the stability of the spine, or after vertebral instability caused by bone infections or tumors.

It is performed under general anesthesia. Through an incision in the lumbar area, screws are introduced into the vertebral bodies to be fixed, through the pedicles of the vertebra. Some surgeons use bone graft to perform the fixation. Subsequently, the screws are assembled by means of metal plates, and the vertebrae are fixed in the desired position.

Endoscopic discectomy is an advanced method in disc herniation surgery, which allows a faster recovery and reduces postoperative pain, since the injury to the muscles and neighboring tissues is minimized.

It is performed through a small incision in the spine, through which a tube or endoscope is introduced, which has a camera at its end. The camera sends images to a video monitor that the surgeon follows to perform the surgical procedure.

Through the endoscope are also introduced instruments specifically designed to repair the disc and remove the fragments of the same that are causing compression of the nerve roots, achieving good results with minimal surgical aggression and respecting the anatomy.

Lumbar stenosis, or narrowing of the lumbar canal, is often due to a displacement of the vertebral bodies, which increases with the upright (standing) position and improves when the trunk is tilted forward.

This is because the diameter of the holes on each side of the vertebral bodies, or foramina, through which the spinal nerves exit, are severely compromised. This causes compression of the nerves themselves and accompanying structures such as blood vessels.

A method is now available to stabilize two or more vertebral levels of the lumbar spine without the need for complete fixation. This allows a certain mobility of the spine, but limiting as much as possible the movements that increase the narrowness of the foramina.

The procedure consists of making, under general anesthesia, an incision in the lumbar area, and implanting a small semi-rigid device between the posterior part of the vertebrae, also called spinous processes. This prevents the spine from moving backwards excessively and avoids the closure of the conjunction holes.

This implant can be complemented with a small incision in the ligaments that exist in the posterior part of the vertebral canal, thus increasing the free space for the neurological structures.

Kyphoplasty is a minimally invasive procedure indicated for painful acute vertebral fractures.

Although it is performed in the operating room, it is not necessary to use general anesthesia, and can only be performed under local anesthesia and sedation. It consists of the injection of a special cement inside the fractured vertebral body. By inserting a cannula in each side of the fractured vertebra, a small balloon is inflated inside the vertebral body, which helps to recover the height of the vertebra that was crushed.

Subsequently, the balloon is removed, and the gap that has been left is filled with cement, providing solidity to the vertebral body. Once the cement has solidified, the patient can be mobilized. In most cases, immediate pain relief is obtained. Thanks to the correction of vertebral subsidence, it is also possible to achieve a decrease in the curvature of the spine, also called kyphosis.

One or more levels can be treated in the same surgical procedure.

The patient will be hospitalized for 24 hours, although it is possible to be discharged the same day. Subsequently, the patient will be able to resume a normal life very soon. If the cause of the fractures is osteoporosis, it is essential to start appropriate pharmacological treatment as soon as possible to avoid new fractures.

Although spinal fusion or arthrodesis is the most commonly used treatment when all other methods have failed in the treatment of pain produced in the intervertebral disc, this is not always an infallible method, since sometimes the bone’s capacity to fuse or heal is not perfect. On the other hand, spinal fusion invariably results in immobilization of the treated segment, which can cause problems at neighboring vertebral levels, which will now be subjected to a greater degree of mechanical demand.

For this reason, artificial disc replacement has been used since the 1990s. The objectives of this surgical treatment are, on the one hand, to replace the degenerated disc causing pain and instability, and on the other hand, to continue to allow movement of the spine. Most of the studies on artificial discs have been carried out in Europe.

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Patient Reviews

After months of intense pain in my back and leg due to a hernia, and after being full of medications and rehabilitation sessions, finally a friend recommended this clinic and I was absolutely right. They visited me very quickly and Dr Ruiz performed a radiofrequency intervention that has solved the problem, it no longer hurts and I have regained my quality of life, which I had lost. I only have words of gratitude

Pedro L., See original review on Google

I had a rhizolysis two years ago and it is the best decision I ever made. I was advised to go to this clinic. Excellent staff and treatment. I would come back without hesitation. I am a different person since I don’t feel any pain.

Pepy A., See original review on Google

In a frankly desperate situation with my mother suffering from trigeminal neuralgia and with continuous and terrible pain during confinement and no public health doctor able to relieve her pain in any way, it was miraculous to find this center by surfing the internet. In just a couple of weeks after the initial visit, Dr. Ruiz operated on my mother in an outpatient and non-aggressive surgery and in just a few days she regained speech, mobility and finally began to sleep as she no longer suffered the tremendous pain. And if the treatment has been effective thanks to the hands of a great doctor, this does not mean that the whole team at the center is not deserving of credit. From the reception to the nurses, they are all exemplary professionals who make you feel safe and in good hands at all times. My mother is already another and just 4 months later we are aware that there is no better investment than health and Clínica Vértebra is a success. Totally recommendable. THANKS A MILLION.

icono pacientes 3Alicia R., See original review on Google

It has been a long time since I felt what it was like to live without pain. I only have words of gratitude for the whole team, from the reception staff to the operating room team. Thank you Dr. Squarcia for such a detailed explanation of my problem and for the accuracy of the treatment. I pray to God that this wellness lasts for a long time.

icono pacientes 4Alicia G., See original review on Google

I had a lumbar facet denervation (Rhizolysis) this morning and I have to say that «O» pain. It has been 10 hours since the intervention and I am still without any pain and without medication. Congratulations to the whole team. Viggo Adeler (Physician)

icono Viggo Adeler, See original review on Google

Good treatment and attention, I went with a horse sciatica and they left me like new, I only have words of thanks.

icono pacientes 2Antonio R., See original review on Google

It is a place that has improved my quality of life.

icono Markus O., See original review on Google

I only have words of thanks to Doctors Ricardo Ruiz and Dr. Matias, I have gone to them twice, and I only have words of thanks, they have solved my problem, first of Lumbar vertebrae and the second of a shoulder, and in both cases total success, I have not returned to have any kind of discomfort, I am totally grateful to them, they have changed my life. THANK YOU DOCTORS, you are fantastic.

Juan J., See original review on Google

First visit with Dr. Mattia Squarcia, finally a doctor who listens to me and looks at all my medical tests. I have already had a bad experience with another pain clinic where the doctor did not listen to me and did not even look at a single medical test.

Anabel R., See original review on Google

I have only words of thanks, thank you Doctor Ricardo Ruiz.

Carlos, See original review on Google