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Minimally Invasive Spine Surgery
For many patients considering spinal surgery, the fear of a large incision, hospital stays and a long recovery period was enough to scare them away from surgery. However, innovative new technology now allows for Spinal Surgery to be performed through an incision as small as an inch in what is known as a Minimally Invasive fashion.With this Minimally Invasive approach, small surgical instruments and a tiny camera are slipped between tissue and muscle fibers to access the spine.
Once these instruments have been inserted, the surgeon will use real-time imaging, known as fluoroscopy, to navigate the structures of the spine and remove herniated portions of the spinal discs or bone spurs causing nerve irritation. Once the procedure is completed, only small stitches and a bandage is required and most patients are able to return home the same day.
Minimally Invasive Lumbar Fusion
The goal of Minimally Invasive Spinal Fusion Procedure (and open Spinal Fusion) is to remove portions of, or the entire, spinal disc and/or any bone material that may be causing spinal nerve compression to reduce impingement on the targeted nerve roots.
Once the disc(s) have been partially or completely removed, an implant is placed into the space where the spinal disc once was in an effort to restore the normal height of the spinal disc space. This implant will also contain bone graft that triggers a biological response, which, over time, will knit together with the vertebrae above and below and form one continuous stable vertebrae. Additional plates, rods or screws may also be used to ensure stability of the spine.
Depending upon the area of the spinal condition and the best option for the patient, Lumbar Spinal Fusions can have several different approaches, including:
- ALIF (Anterior Lumbar Interbody Fusion)
- TLIF (Transforaminal Lumbar Interbody Fusion)
- PLIF (Posterior Lumbar Interbody Fusion)
- XLIF (Extreme Lateral Interbody Fusion)
Many of these procedures can be performed on an outpatient basis and utilize Minimally Invasive approaches that minimizes disruption to surrounding muscle and tissue.
Minimally Invasive Cervical Fusion
Cervical instrumentation and fusion is used to treat conditions of the spine which cause spinal instability such as Degenerative Disc Disease or spinal arthritis.
During this procedure, a small incision (usually 1inch) is made toward the front of the cervical spine. Through this incision, small surgical tools are used to remove the damaged spinal disc(s) as well as any bone spurs that may be causing irritation to the surrounding nerves. Once the disc space has been cleared, a small implant that is filled with bone graft material is inserted. This bone graft material will eventually fuse into one complete vertebrae and restore stability to the spine.
To further stabilize the spine, instrumentation such as plates, small rods or screws are attached the the vertebrae above and below.
A Microdiscectomy is a procedure that requires a small (1-2 inch) incision and is used to treat pain caused as a result of disc herniations by removing only the herniated portions of the spinal disc while leaving the remaining portions of the disc intact. This procedure is commonly performed for those who are experiencing pain that radiates into the buttocks and legs (Sciatica) but can also be performed for patients with cervical or thoracic radiculopathy. By removing the herniated portions of the disc, and any bone spurs, the spinal nerves that are causing pain and numbness are no longer impinged.
In most cases, a Microdiscectomy can be performed on an outpatient basis due to the reduced trauma to the spine and muscular structures. In fact, most patients are up and walking shortly after this procedure and physical therapy will begin within a few days of the procedure if needed.
Artificial Disc Replacement (Cervical)
The purpose of the artificial disc used in the surgery is to eliminate nerve root, spinal canal or spinal cord compression and preserve motion of the cervical spine. This procedure requires a small (1 inch) incision and is an alternate to anterior cervical discectomy (and) fusion (ACDF). The CADR procedure involves the surgical replacement of the cervical disc implant that allows mobility of the neck. This procedure is a similar principle to a knee or hip replacement procedure.
This new procedure of CADR is minimally invasive and approved by the Food and Drug Administration (FDA). Cervical Artificial Disc Replacement may be preferred over traditional cervical disc surgery because it allows more movement and reduces stress on the neck.
Minimally Invasive Laminectomy
Laser Spine Surgery
The term “laser spine surgery” has become increasingly popular over the years and many patients often ask their doctor if they are candidates for this type of surgery. The truth is that “laser” spine surgery is term used to make what is already known as Minimally Invasive Spine Surgery sound fancier. Despite what you may have been told, lasers can not correct the issue within your spine and a surgeon still needs to decompress the spinal nerves or stabilize the spine in order to relieve your pain. However, modern advancements in Minimally Invasive Spine Surgery now use incisions as small as an inch and many patients are able to return home the same day. At Virella Spine Surgery, we have been at the forefront of Minimally Invasive Spine Surgery and Dr. Anthony Virella is considered a pioneer in this field.
Nervous or Apprehensive about taking the first step?
People all over the world delay their treatments due to long-term anxieties and fears surrounding spine surgery and treatments in general. Our practice has worked with many patients over the years and we understand these valid concerns. If you have these general concerns, please click below to read “A Letter To Patients From Dr. Virella“.
Read: A Letter To Patients From Dr. Virella
Relieving your pain should not be a cause for anxiety, and we take every step possible to make sure our patients are comfortable, secure and relaxed from their first visit to their last. Remember, there is nothing scary about taking back control of your life and relieving your pain. Our practice is highly organized and provides step-by-step guided help the entire way to keep you relaxed with your focus where it should be- on you.
You’ve already taken the first step by searching for the right doctor and can soon be on a path to a pain-free life. Call our practice today (805-270-2038) or request a callback to come and visit with me. We will sit down together and discuss your concerns. Then, I will provide you with a thorough analysis and review of a suggested care path and treatment options.
I pride myself in being extremely attentive to my patients, using extreme caution and putting to work my experience (of nearly two decades) in conservative treatments and minimally invasive procedures that have given thousands of patient their lives back. I have spent my life designing a new approach to spine treatments that reduce any anxieties of my patients by providing them with a comprehensive strategy that makes sense and is proven.
Don’t let your pain get worse by delaying getting the help you need. Neglecting needed treatment will (almost certainly) make your situation worse. We hope you decide to take control of your pain and your life. We welcome and look forward to meeting you and having the opportunity to shares our skills and successes with you. Thank you for taking the time to read and we hope to see you soon.
ANTHONY A. VIRELLA M.D., F.A.C.S