Arthritis of the Spine Surgery

Arthritis of the spine surgery — surgical methods for treating spinal osteoarthritis

Surgical treatment for spinal arthritis is typically recommended in cases where one or more conservative, nonsurgical methods were attempted over the course of several weeks or months, but the patient is still experiencing chronic or acute pain and limited mobility. Nevertheless, a patient’s decision to undergo surgery is almost always elective. Depending on the severity of the condition, the most appropriate surgical treatment may involve decompressing a nerve structure, treating an arthritic spinal joint or possibly performing a spinal fusion.

Open spine surgery for arthritis of the spine

Decompression surgery is a broad term that is often used to describe a number of procedures designed to relieve symptoms caused by pressure on a nerve root or the spinal cord. During a decompression procedure, a surgeon generally removes the bone tissue, disc material or other debris that is exerting pressure in order to relieve nerve compression symptoms, such as pain, tingling, numbness or weakness in the neck, back or extremities.

When performed utilizing an open spine approach, which requires a large incisions, decompression surgery can sometimes render the spine less stable or structurally sound. If this occurs, the patient may require further surgery in the form of a spinal fusion. During a spinal fusion, a surgeon inserts bone grafts or implants into the spine to provide support and allow two or more vertebrae to grow together as a single, strengthened unit.

While they can be effective, open spine decompression and fusion surgeries have several disadvantages. For instance, these highly invasive procedures are usually performed in a hospital setting and require overnight hospitalization. In order to view and access the spinal components, a surgeon must create large incisions and disrupt the surrounding musculature. As a result, a patient’s recovery and rehabilitation can be painful and lengthy.

Minimally invasive decompression surgery

For certain patients, minimally invasive spine surgery can be a more effective alternative to traditional open spine surgery for treating arthritis of the spine, mainly because this advanced technique involves much smaller incisions. As a result, many patients report that they experience less pain, fewer complications, minimal scarring and faster recoveries.

When performing a minimally invasive spine procedure, a surgeon generally makes a small incision and then inserts a series of telescoping tubes, one over another, of gradually increasing sizes. In this way, the surgeon can create an opening to view and access the spinal components with minimal disruption to the surrounding musculature and neural tissue. The surgeon then inserts a tiny camera, along with specialized suction, irrigation and other surgical instruments, to remove the bone or tissue that is creating the excess pressure. After completing the procedure, the surgeon slowly removes the tubes to allow the muscles to slide back into place and then carefully closes the incision.

Minimally invasive decompression surgeries performed at Laser Spine Institute include:

  • Foraminotomy — This approach may be utilized if bony matter, displaced disc material, scar tissue or excessive ligament development is blocking the spinal foramen. Formed by the spaces in between adjacent vertebrae, the foramina are canals – hollow archways through which sensitive nerve roots pass as they exit the spinal cord.
  • Laminotomy — This procedure can relieve the symptoms of nerve root compression or spinal cord impingement through the surgical removal of a portion of the lamina, the bony vertebral arch that surrounds and protects the spinal cord. The goal is to create more space within the spinal canal, which can reduce the pressure on neural tissue that is being encroached by the presence of displaced herniated disc material, bone spurs or inflamed facet joints within this limited area.
  • Discectomy — The technique involves the removal of herniated or bulging disc material that is pressing on the spinal cord or a nerve root. Using a specialized laser and other small surgical tools, a surgeon can vaporize and remove the displaced disc material to alleviate painful pressure.
  • Facet thermal ablation — Similar in theory to a dental root canal procedure, facet thermal ablation is performed to debride a degenerated spinal facet joint and desensitize the associated nerve to relieve pain.

Minimally invasive stabilization (MIS) surgery

If spinal fusion surgery is recommended to address arthritis of the spine, minimally invasive stabilization surgery may be an option. Common techniques performed at Laser Spine Institute include:

  • Decompression with Interlaminar Stabilization™ device — A surgeon removes the source of the pressure, then inserts a coflex® device to help stabilize the spine and maintain the decompression without limiting the patient’s range of motion.
  • Anterior cervical discectomy fusion (ACDF) — With the aid of a fluoroscope (a special X-ray), a surgeon removes a degenerated disc, then prepares the remaining space for the placement of an artificial disc or a bone graft stabilization and a small titanium plate.
  • Cervical disc replacement — A surgeon replaces an unhealthy intervertebral disc with an artificial disc.
  • Transforaminal lumbar interbody fusion (TLIF) — Accessing the spine slightly laterally (from the side) to minimize the movement of sensitive nerve roots, a surgeon inserts a bone graft and spacer into a natural disc space that has become unstable to encourage the formation of a solid bridge of bone between two or more vertebrae.
  • Lateral lumbar interbody fusion (LLIF) — Accessing the spine laterally, a surgeon removes a portion of a degenerated disc, inserts a spacer to restore proper disc height and inserts bone grafts to help the adjacent vertebrae heal together for enhanced stability.
  • SI joint fusion — With the guidance of a fluoroscope, a surgeon accesses the SI joint (where the sacral bone joins the pelvis bone) and places a specialized implant designed to stabilize this heavily loaded joint.
  • Posterior cervical fusion — A surgeon accesses the spine from the back of the neck and inserts bone grafts or implants to provide stabilization and encourage two or more vertebrae to grow together into one stronger unit.

Next steps…

Laser Spine Institute is the leader in minimally invasive spine surgery. Our skilled surgeons perform more of these procedures to address spinal arthritis and other degenerative neck and back problems than any other spine surgery provider in the nation, and this has resulted in an unparalleled level of expertise. Our minimally invasive surgical treatments for spinal arthritis are performed in an outpatient environment and can directly treat an arthritic joint to relieve pain. The state-of-the-art technology used during these procedures allows for much smaller incisions than traditional open-back surgery.

If you’ve been advised to consider surgery to treat arthritis of the spine, contact Laser Spine Institute today to learn more about our minimally invasive procedures or to arrange for a review of your recent MRI scan.