A Primer of Spinal Orthopedic Procedures

Both orthopedic surgeons and neurosurgeons are trained to do spinal surgery, and many doctors from both disciplines specialize in spinal surgery. The only difference between what they can do is that only neurosurgeons are trained to do procedures that involve the spinal cord, and only orthopedic surgeons are trained to do procedures to correct deformities like scoliosis.

Spinal orthopedic procedures may involve the cervical spine (neck), thoracic spine (mid and upper back) or lumbar spine (low back). Different techniques are needed in each area, but the spinal orthopedic procedures themselves are very similar.

Some spinal orthopedic procedures involve open surgery, where the surgeon cuts through the muscles along the spinal cord and does surgery on the spine. The surgeon is usually able to approach the spine through your back (posterior spinal orthopedic procedures), but sometimes he must go through your body from the front (anterior spinal orthopedic procedures) to get at the injured area.

Some spinal orthopedic procedures can be done with minimally invasive endoscopic surgery. Endoscopic surgery causes less trauma to surrounding tissues and gives the surgeon better visualization of the damage.

To understand the different types of spinal orthopedic procedures, we need to understand a little terminology. The corpus or body of a vertebra is large, round bony part that gives the spine its stability. Between each pair of vertebrae is a disc, a gel-filled cushion that keeps the discs apart so that the spine can move freely and to provide space for the nerve roots to leave the spinal cord. The facets are the joints between vertebrae. The laminae are part of the bone that surrounds the spinal canal and protects the spinal cord.

· Corpectomy usually involves the cervical spine. The surgeon goes through the neck from the front and removes the body of one or more vertebra to relieve pressure on the spinal cord or nerve roots. · Laminectomy involves removing part of the lamina to relieve pressure on a nerve root. The vertebrae may or may not be fused. · Discectomy is the removal of an intervertebral disc that is bulging out and putting pressure on a nerve root. The spine may be fused to keep the vertebrae apart, or an artificial disc can be inserted. · Vertebroplasty means that the surgeon repairs the vertebra. This is often done as a minimally invasive surgery. · Facetectomy is the removal of the facet joint to relieve pressure on a nerve root. Artificial facet joints may be available in the near future, similar to artificial knee or hip joints.

Your surgeon will tell you which spinal orthopedic procedure you need and explain exactly what he will do. This primer only explains the basics; your surgeon will give you information that is specific to you and the spinal orthopedic procedure you need.

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