Other Spinal Treatments

Jenkins NeuroSpine is nationally known for being a leader in providing pain relief by tailoring spinal treatment to each patient.

At Jenkins NeuroSpine, we are well-versed in a variety of other spinal treatments that provide relief to patients experiencing pain.

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Jenkins NeuroSpine is led by nationally recognized neurosurgeon Dr. Jenkins who specializes in providing relief to patients who are experiencing acute or chronic neck and back pain.

Additional spinal treatments we provide include:

ANTERIOR KEYHOLE FORAMINOTOMY

For those patients whose spinal stenosis is caused by a single off-centered disk herniation or bone spur from the disk space (anterior osteophyte), a small procedure with a similar approach as the discectomy can remove the compression without complete removal of the disk, and without a fusion. This procedure involves less disruption of the rest of the disk space, so the majority of the native disk material is left untouched, and the patient can maintain their pre-operative range of motion. The restrictions are slightly less after an anterior foraminotomy for discectomy for decompression, and so consequently the procedure is slightly easier to recover from.

However, this procedure does have a significant recurrence rate (precisely because it does not involve the removal of the entire disk material, which typically requires a fusion or total disk replacement) and does result in some damage to the disk. Although most surgeons who perform this procedure will not completely immobilize the patient after surgery in a collar, strenuous activity is typically curtailed initially.

CORPECTOMY

Sometimes, more complete removal of the vertebral body is required. This is called a vertebrectomy or a corpectomy.

Corpectomies are typically required when:

Compression is more than just disk material or bone spurs at the disk level
A major deformity is involved
Removal of the entire vertebral body is necessary because of tumors or other diseases involving the bone.

Whenever a corpectomy is performed, either a fusion or instrumentation is usually performed. This is to maintain a more ideal position. The corpectomy is more destructive than a discectomy and fusion and may have a higher nonunion rate, and multilevel procedures are more likely to require a second procedure to provide supplemental instrumentation from the posterior approach to ensure a solid fusion.

POSTERIOR CERVICAL PROCEDURES

LAMINECTOMY

Laminectomy has been performed for more than 80 years to take the back of the spinal canal off, like opening a convertible roof or a can of sardines. By removing the back of the canal (an “ectomy,” or removal of the lamina or back of the spine), the contents of the spinal canal (the spinal sac, with its column of spinal fluid and the spinal cord and nerve roots) can expand backward and be less compressed. This usually alleviates or improves the neurological symptoms caused by the compression and gives the best environment to recover.

However, there are many circumstances where the removal of the bone in the back results in delayed kyphosis or forward tipping. This forward tipping essentially bends and stretches the spinal cord over the disk spaces and bone spurs, and over time this can result in more neurological symptoms. For this reason, most spine surgeons will perform instrumentation and fusion with a laminectomy when done for spinal canal stenosis, especially if there is already forward or kyphotic tipping of the spine, or if there is a significant weakness to suggests that the muscles of the neck will be too weak to hold the neck in position over time.

LAMINECTOMY WITH FUSION

Fusion, when performed as part of a laminectomy procedure, will eliminate movement in the levels fused. This is usually achieved with some form of instrumentation to hold the bones rigidly until the bone heals and adds stability to the neck (assuming the fusion heals properly). Most skilled practitioners believe that getting the spinal alignment to fuse in as close to the normal neutral lordosis will keep the remaining levels from degenerating as quickly. There are various competing forces and issues (difficulty in getting the alignment of the spine corrected, risks of being more aggressive, among others). We try, where possible, to restore or maintain a 20-degree or more curve within the entire cervical spine (normal is generally considered 20 to 40 degrees).

The consequences of the procedures include:

Reduced range of motion in the neck. (The range of motion depends on the levels fused.)
Slightly increased risks associated with screws, cables, and other forms of instrumentation placed into the spine.
The need to observe the patient for a year or so after the operation to make sure the fusion doesn’t develop into a pseudoarthrosis [failed fusion – see REVISION SPINAL SURGERY].

LAMINOTOMY OR FORAMINOTOMY

When the area of stenosis is less extensive or off to one side, a smaller procedure can be performed. Some disk herniations can also be treated by a small procedure from the back of the neck, which doesn’t require a fusion to achieve the goal of decompression of the nerves or spinal cord. The indications for a “keyhole” foraminotomy may be different than that of a discectomy or a laminectomy, and in some cases, either procedure may be appropriate.

LASER SPINE SURGERY

Laser endoscopic spine surgery is a minimally invasive surgical approach that uses highly focused lasers to remove tissue and perform other techniques used in treating an array of spine-related issues and conditions.

Laser spine treatment or surgery is used in patients who experience a broad array of spine conditions, including:

Bone Spurs
Spinal Stenosis
Sciatica
Facet Joint Disease
Herniated Discs

Laser endoscopic spine surgery is usually performed using sedation or a local anesthetic, so patients avoid the risks associated with deep general anesthesia. The specific technique used during a laser spine surgical procedure varies based on the condition being treated. In general, laser spine treatment or surgery uses a very small incision to admit a long, flexible tube to access the area of the spine that requires treatment. The tube can be used to visualize the treatment areas as well as serve as a conduit for the laser device, avoiding the need to cut through muscle tissue and limiting tissue damage for quick recovery. After the tissue is removed and repairs are made, the tube and instruments are withdrawn, and the incision is closed.

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