A lumbar microdiscectomy is a simple outpatient procedure designed to relieve leg pain, numbness or weakness from a herniated or bulging lumbar disc. It generally takes about an hour of actual surgery time. This operation is associated with low complication rates, high success rates and generally has a fairly rapid and tolerable recovery. However, because the operation is minimally invasive, it does have limitations. For example, it generally is not a very good treatment for low back pain - a symptom which often requires more involved surgical procedures.
Lumbar fusion surgery has become a mainstay in the treatment of disorders of the spine including, disc problems,arthritsis, scoliosis, stenosis, spondylolisthesis, fractures, tumors and infections. Lumbar spinal fusion surgery is more involved than microsurgery. Although there are many ways to do a fusion on the lumbar spine, our surgeons currently prefer a posterior lumbar interbody fusion. This is generally a longer procedure associated with a short hospital stay. This operation is very effective in treating back pain and sciatica. Patients are able to walk around just after surgery, but it does take time to heal. Our surgeons will explain your options.
Anterior cervical fusion
The anterior cervical fusion is the "gold standard" surgical option for treatment of herniated discs, arthritis and bone spurs in the neck. Generally, this is an outpatient surgery associated with a well-tolerated recovery. In this operation, an incision is made on the front of the neck and the disc and bone spurs are removed with the surgeon looking through a microscope. The disc is replaced with a bone graft, and a titanium plate and screws are applied to hold the bones together. The operation is very effective for pinched nerves causing arm pain and sometimes effective for neck pains. Patients have a sore throat and stiff neck muscles for a while after the surgery.
Artificial cervical disc (cervical disc replacement)
The first artificial cervical disc was recently approved by the FDA for general use. The operation to implant these devices is just like an anterior cervical fusion, but instead of a bone graft and a metal plate, the artificial disc is implanted. Currently we have evidence that these devices help patients at least as well as fusions. The surgery to implant these devices is only indicated in certain specific clinical situations. To find out if you are a candidate for this operation, you must consult with a qualified surgeon. Our surgeons were the first to implant these devices in Montana. We have been involved in multiple FDA clinical trials, which evaluate the safety and efficacy of these devices. This is an exciting technology but it is not for everyone.
The cervical laminectomy and its microsurgical cousin, the posterior cervical foramenotomy, are surgeries designed to decompress pinched nerves and the spinal cord. Small cervical disc herniations may also be removed this way. These operations are done from the back side of the neck. Although these used to be the mainstays of treatment for spinal problems in the neck, the recent trend has been toward operation done from the front of the neck. These are still very good operations, and just the right answer for certain specific situations. They can be inpatient or outpatient surgeries. Patients tend to have sore neck muscles for a while after surgery.
Carpal tunnel release
The carpal tunnel release is a common, simple, outpatient surgery which helps patients with carpal tunnel syndrome. Patients with this syndrome have numbness in one or both hands which often bothers them while sleeping, driving, using a computer or using hand tools. The numbness is caused by pinching of the median nerve on the front of the wrist. The surgery is performed to snip the thickened ligaments which are pinching the nerve.
This is the classic "brain surgery" operation. Craniotomies are done for removal of benign tumors, aneurysms, infections and hematomas. Some are very minor operations; some are quite involved. Thanks to modern techniques of computer-aided image-guided surgery, these operations are much better tolerated by the patient than in the past. Often, only minimal hair removal is required. These operations are serious and thus, they should be discussed with a qualified surgeon.
This operation requires a small craniectomy, just behind the ear. It is typically used to treat refractory trigeminal neuralgia or Tic Doloreaux. The hole in the back of the skull is used to access the cranial nerves. In the case of Tic pain, a small Teflon sponge is used to separate the fifth cranial nerve from an artery compressing it. This operation is effective, but should only be used after medical treatments have failed.