Type of Surgery
Information
Last updated: 11/24/2009
The surgery is performed under general anesthesia. The surgeon cuts an opening into the vertebral canal, and moves the dura and the bundle of nerves called the "cauda equina" (horse's tail) aside, which exposes the disk. If a portion of the disk has...
moved out from between the vertebrae and into the nerve canal, it is simply
removed. If the disk itself has become fragmented and partially displaced, or is not fragmented but bulges extensively, the surgeon removes the damaged part of the disk and the part that lies in the space between the vertebrae.
There are minimally invasive surgical techniques for disk removal, including microdiskectomy. In this procedure, the surgeon uses a magnifying instrument or special microscope to view the disk. Magnification makes it possible to remove a herniated disk with a smaller incision, causing less damage to nearby tissue. Video-assisted arthroscopic microdiskectomy has exhibited good results with less use of narcotics and a shortened period of disability. Newer forms of diskectomy are still in the research stage, and are not yet widely available. These include laser diskectomy and automated percutaneous diskectomy.
Total disk replacement research in the United States is underway. Products under investigation include the ProDisc (made by Spine Solutions, Inc.), and the SB Charite III (made by Link Spine Group, Inc.). In these clinical studies, a significant number of patients who received artificial disk implants report a reduction in back and leg pain; 92.7% state they are satisfied or extremely satisfied with the procedure.
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This animation shows the steps involved in an anterior cervical disc replacement. The cervical spine is the spinal area that supports the head while the disks of the spine are the relatively soft areas between individual vertebra (spinal bones). As the animation shows, this cervical disc replacement involves the removal of the natural, diseased cervical disk and the replacement with an artifical joint.
In the anterior cervical disk removal, an incision is made into the patient's neck (B). The cervical disk, which may be herniated, is visualized (C). It is removed completely (D and E). (Illustration by GGS Inc.)
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Definition
One of the most common types of back surgery is disk removal (diskectomy), the removal of an intervertebral disk, the flexible plate that connects any two adjacent vertebrae in the spine. Intervertebral disks act as shock absorbers, protecting the brain and spinal cord from the impact produced by the body's movements.
Description
The surgery is done under general anaesthesia, which puts the patient to sleep and affects the whole body. Operating on the patient's back, the neurosurgeon or orthopedic surgeon makes an opening into the vertebral canal, and then moves the dura and the bundle of nerves called the "cauda equina" (horse's tail) aside, which exposes the disk. If a portion of the disk has moved from between the vertebrae out into the nerve canal, it is simply removed. If the disk itself has become fragmented and partially displaced, or not fragmented but bulging extensively, the surgeon will remove the bulging or displaced part of the disk and the part that lies in the space between the vertebrae.
— Carol A. Turkington
Other Information
New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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