- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Surgical Interventions
Surgical Interventions
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Surgical Interventions
Facetectomy:
Similar to the foraminotomy a facetectomy involves trimming bone, more specifically trimming the edges of the facet joints and removing portions of the bone in order to enlarge the lateral or central spinal canal. This procedure may be considered in the presence of bony enlargement and bone spur development around the spinal joints (facet joints). Excessive bony enlargement of the facet can lead to compromise of the lateral aspect of the spinal canal referred to as the lateral recess. This can result in nerve compromise. This procedure may be performed along with a surgical foraminotomy in order to make more room for the nerve within the central spinal canal and at the lateral opening of the spine. If too much of bone is trimmed off the facet joint complex, there may be subsequent destabilization of the spinal level requiring fusion at the time of the initial surgery or a return later for a second surgical procedure in order to stabilize the spine.
Vertebrectomy:
Vertebrectomy refers to surgical removal of all or most of the vertebral body. The vertebral body refers to the cylindrically shaped front portion of a vertebra. Most of the weight borne by the spine is placed on the vertebral body. This procedure may be used when there has been a significant amount of compromise of the vertebral body secondary to infection, fracture, tumor invasion, or when large amount of access is required to the spinal canal or spinal cord region. When the vertebral body is surgically removed, replacement instrumentation and/or tissue must be placed into the space to provide spinal and segmental stabilization. This often requires placement of an autograft or allograft with bone to restore the capacity to accept axial loading and to restore supportive strength. Removal of the vertebral body may prompt replacement by man made materials such as titanium cages or meshes, which are used to hold bone-generating materials. This is done to provide an infrastructure, which provides guidance and support for the development of bone to bridge to develop across the adjacent vertebral sites.
Allograft
An allograft is a bone or ligament tissue taken from another person, and used for surgical repair or reconstruction. The tissue may require a longer time to incorporate into the surgical area, but there is no second surgical site (for autograft) to heal. Also, the overall surgical time and hospital stay is often reduced when allograft tissue is used. Allograft tissue transplants are not rejected by the body as with organ transplants, so that it is not necessary to use drugs to suppress the body’s immune response.
Autograft
Bone used to fuse the spine is taken from a different location to be used in reconstruction or fusion. A piece or pieces of bone can be taken from the large bone you can feel at the sides of your waist (iliac crest bone graft), from a bone of the lower leg (fibular graft) or pieces of bone removed while doing a laminectomy. This autograft tissue incorporates faster than allograft tissues, however the surgical donor site may be painful to touch for years after the surgery.
Interbody Fusion
After removal of a disc, a piece of bone is placed in the space that was occupied by the disc. It serves as a spacer; it preserves the space between the bones (vertebrae) of the spine. Over time the bone from the bone above and the bone from the bone below will grow through the bone graft and permanently join the bones (vertebrae) together.
Similar to the foraminotomy a facetectomy involves trimming bone, more specifically trimming the edges of the facet joints and removing portions of the bone in order to enlarge the lateral or central spinal canal. This procedure may be considered in the presence of bony enlargement and bone spur development around the spinal joints (facet joints). Excessive bony enlargement of the facet can lead to compromise of the lateral aspect of the spinal canal referred to as the lateral recess. This can result in nerve compromise. This procedure may be performed along with a surgical foraminotomy in order to make more room for the nerve within the central spinal canal and at the lateral opening of the spine. If too much of bone is trimmed off the facet joint complex, there may be subsequent destabilization of the spinal level requiring fusion at the time of the initial surgery or a return later for a second surgical procedure in order to stabilize the spine.
Vertebrectomy:
Vertebrectomy refers to surgical removal of all or most of the vertebral body. The vertebral body refers to the cylindrically shaped front portion of a vertebra. Most of the weight borne by the spine is placed on the vertebral body. This procedure may be used when there has been a significant amount of compromise of the vertebral body secondary to infection, fracture, tumor invasion, or when large amount of access is required to the spinal canal or spinal cord region. When the vertebral body is surgically removed, replacement instrumentation and/or tissue must be placed into the space to provide spinal and segmental stabilization. This often requires placement of an autograft or allograft with bone to restore the capacity to accept axial loading and to restore supportive strength. Removal of the vertebral body may prompt replacement by man made materials such as titanium cages or meshes, which are used to hold bone-generating materials. This is done to provide an infrastructure, which provides guidance and support for the development of bone to bridge to develop across the adjacent vertebral sites.
Allograft
An allograft is a bone or ligament tissue taken from another person, and used for surgical repair or reconstruction. The tissue may require a longer time to incorporate into the surgical area, but there is no second surgical site (for autograft) to heal. Also, the overall surgical time and hospital stay is often reduced when allograft tissue is used. Allograft tissue transplants are not rejected by the body as with organ transplants, so that it is not necessary to use drugs to suppress the body’s immune response.
Autograft
Bone used to fuse the spine is taken from a different location to be used in reconstruction or fusion. A piece or pieces of bone can be taken from the large bone you can feel at the sides of your waist (iliac crest bone graft), from a bone of the lower leg (fibular graft) or pieces of bone removed while doing a laminectomy. This autograft tissue incorporates faster than allograft tissues, however the surgical donor site may be painful to touch for years after the surgery.
Interbody Fusion
After removal of a disc, a piece of bone is placed in the space that was occupied by the disc. It serves as a spacer; it preserves the space between the bones (vertebrae) of the spine. Over time the bone from the bone above and the bone from the bone below will grow through the bone graft and permanently join the bones (vertebrae) together.
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