Spinal Surgery FAQ’s

CERVICAL (Neck)

LUMBAR (Low Back)

SCOLIOSIS

 


 

CERVICAL (NECK)

What Is Anterior Cervical Discectomy With Fusion?

Cervical refers to the 7 vertebrae of the neck. Discs are the spongy, cartilaginous pads between each vertebra, and ectomy means “to take out”. In a cervical discectomy, the surgeon accesses the cervical spine through a small incision in the neck and removes all or part of the disc – and/or in some cases bone material – that’s pressing on the nerves and causing pain.

Spinal fusion involves placing bone graft between two or more affected vertebrae to promote bone growth between the vertebral bodies. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.

Why Do I Need This Procedure?

If you have a herniated disc, this means that the nucleus pulposus – the soft, gel-like center of the disc – has pushed through the annulus fibrosus, the disc’s tough, outer ring. Bone spurs, also called osteophytes, can form when the joints of the spine calcify.

Pressure placed on nerve roots, ligaments or the spinal cord by a herniated disc or bone spur may cause:

  • Pain in the neck and/or arms
  • Lack of coordination
  • Numbness or weakness in the arms, forearms or fingers

Pressure placed on the spinal cord as it passes through the cervical spine can be serious, since most of the nerves for rest of the body (e.g., arms, chest, abdomen, legs) must pass through the neck from the brain. A cervical discectomy can ease pressure on the nerves, ultimately providing pain relief.

An anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.

How Is An Anterior Cervical Discectomy With Fusion Performed?

Through a small incision made near the front of the neck, the surgeon

  • Removes the intervertebral disc to access the compressed neural structures
  • Relieves the pressure by removing the source of the compression
  • Places a bone graft between the adjacent vertebrae and
  • In some cases, uses instrumentation – metal plates or pins that will provide extra support and stability to help ensure proper fusion

Pressure placed on the spinal cord as it passes through the cervical spine can be serious, since most of the nerves for rest of the body (e.g., arms, chest, abdomen, legs) must pass through the neck from the brain. A cervical discectomy can ease pressure on the nerves, ultimately providing pain relief.

An anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail. Your surgeon will take a number of factors into consideration before making this recommendation, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.

How Long Will It Take Me To Recover?

Your surgeon will have a specific post-operative recovery/exercise plan to help you return to your normal activity level as soon as possible. The amount of time that you have to stay in the hospital will depend on this treatment plan. You typically will be up and walking in the hospital by the end of the first day after the surgery. You may return to work in 3-6 weeks, depending on how well your body is healing and the type of work/activity level you plan to return to.

Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.

Are There Any Potential Risks Or Complications?

All treatment and outcome results are specific to the individual patient. Results may vary. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anesthesia, are some of the potential risks of spinal surgery. A potential risk inherent to spinal fusion is failure of the vertebral bone and graft to properly fuse, a condition that may require additional surgery.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to the anterior cervical discectomy with fusion procedure.

 

LUMBAR (LOW BACK)

Anterior Lumbar Interbody Fusion (ALIF)

Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front of the body to remove disc or bone material from in between two adjacent lumbar vertebrae. The procedure may be performed either as an open surgery or using minimally invasive techniques.

What Is An ALIF?

Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front (anterior) of the body to remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute.

The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to create an “internal cast” to support the vertebral structure during the healing process.

Depending on your condition and your surgeon’s training, experience and preferred methodology, an ALIF may be done alone or in conjunction with another spinal fusion approach. Please discuss your fusion approach options thoroughly with your doctor, and rely on his or her judgment about which is most appropriate for your particular condition.

Why Do I Need This Procedure?

There are a number of reasons your surgeon may recommend spinal fusion. This procedure is frequently used to treat:

  • One or more fractured (broken) vertebrae
  • Spondylolisthesis (slippage of one vertebral bone over another)
  • Abnormal curvatures of the spine, such as scoliosis or kyphosis
  • Protruding or degenerated discs (the cartilaginous “cushions” between vertebrae)
  • Instability of the spine (abnormal or excessive motion between two or more vertebrae)

Patients with low back and/or leg pain due to degenerative disc disease, spondylolysis/spondylolisthesis, scoliosis, or other spinal instability that have not responded to non-surgical treatment measures (rest, physical therapy or medications) may be suitable candidates for an ALIF.

Patients without an excessive amount of spinal instability or slippage, and who have little to no spinal stenosis or nerve compression in the back of the spine, are generally the best candidates for an ALIF alone. However, ALIF as a stand-alone technique is usually not recommended for people whose bones have become very soft due to osteoporosis, or in patients with instability or arthritis.

Your surgeon will take a number of factors into consideration before recommending an ALIF, including the condition to be treated, your age, health and lifestyle and your anticipated level of activity following surgery. Please discuss this treatment option thoroughly with your spinal care provider.

How Is An ALIF Performed?

For an ALIF procedure, the patient is positioned on his or her back and sedated under general anesthesia. The surgeon then

  • Makes an incision in the abdomen and retracts the abdominal muscles, organs and vascular structures – including such major blood vessels as the aorta and vena cava – for a clear view of the front of the spine and access to the vertebrae. (This part of the procedure may be performed by a general surgeon or vascular specialist.)
  • Removes all or part of the degenerated disc(s) from the affected disc space, and inserts bone graft or bone graft substitute into the disc space between the vertebral bodies, to support the disc space and promote bone healing
  • Returns the abdominal organs, blood vessels and muscles to their normal place, and closes the incision

Surgeons typically perform an ALIF as a traditional, open procedure as described above; however, another option is to access the spine using minimally invasive (endoscopic) technologies that allow surgeons to reach the affected vertebrae through small incisions and intramuscular tunnels created to accommodate special guidance, illumination and surgical tools.

How Long Will It Take Me To Recover?

The recovery period for a spinal fusion procedure such as an ALIF will vary, depending on the procedure and your body’s ability to heal and firmly fuse the vertebrae together. One advantage of an ALIF is that the back muscles and nerves are undisturbed.

Patients typically stay in the hospital for several days, longer if necessary for more extensive surgery. This may also include time in a rehabilitation unit. Your surgeon will prescribe pain medication as needed, and may recommend a brace and follow-up physical therapy.

The length of time you will be off work will depend on a number of factors: your particular procedure and the physician’s approach to your spine, the size of your incision, and whether or not you experienced any significant tissue damage or complications. Another consideration is the type of work you plan to return to. Typically, you can expect to be on medical leave for 3 to 6 weeks; however, many innovations and advancements have been developed in the last few years that allow for improved fusion rates, shorter hospital stays and a more active and rapid recovery period.

Work closely with your spinal surgeon to determine the appropriate recovery protocol for you, and follow his or her instructions to optimize the healing process.

Are There Any Potential Risks Or Complications?

All treatment and outcome results are specific to the individual patient. Results may vary. Complications such as infection, nerve damage, blood clots, blood loss and bowel and bladder problems, along with complications associated with anesthesia, are some of the potential risks of spinal surgery. A potential risk inherent to spinal fusion is failure of the vertebral bone and graft to properly fuse, a condition that may require additional surgery.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to the ALIF procedure.

The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your health care professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your health care professional for diagnosis and treatment.

 

SCOLIOSIS

What is it?

There are several different approaches that a surgeon will use to correct spinal deformity such as scoliosis and kyphosis, including the traditional posterior approach, an anterior approach, or both. The anterior approach to scoliosis means that the surgeon will approach the spinal column from the front of the spine rather than through the back.

Technically speaking, the actual surgical incision and approach to the spine is through the side of the chest or abdomen (stomach area) rather than down the front of your body, as many patients would envision it. The anterior approach allows surgeons to remove discs from the front of the spine, place corrective spinal instrumentation and perform a spinal fusion.

Why is it done?

The choice of an open anterior approach to the spine is based on a number of different factors including the type of scoliosis, location of the curvature of spine, ease of approach to the area of the curve, and the preference of the surgeon. There are certain types of scoliosis curves, such as those involving the thoracolumbar spine, that are especially amenable to the anterior approach. The surgeon may be able to fuse a shorter segment of the spine using the anterior approach, preserving more motion in the spinal column.

Anterior instrumentation techniques can produce very powerful correction of spinal deformities. However, this approach is more difficult than the standard posterior approach.