Department of Spine SurgeryWelcome to the Department of Spine Surgery at La Peer Health Systems. This particular department is a sub-specialty of the Department of Orthopedics & Sports Medicine - the department that treats conditions and diseases of the musculoskeletal system. At La Peer, patient care starts well before the day of the operation, with debriefings and pre-op appointments, and it extends long after the surgery is completed, with regular check ups and follow up consultations to ensure the site is healing as planned. The spine is susceptible to injury and misuse and many people suffer from spinal problems today. Despite the huge demand, it's estimated that around 650 orthopedic physicians complete residency training each year and go on to complete surgeries. La Peer Health Systems is very lucky to have 14 orthopedic surgeons on staff. At La Peer, we feel It is important to use surgery only as a last resort and to use minimally invasive techniques when possible. From musculoskeletal infections to injuries, tumors and congenital disorders, the number of conditions that can affect the spine is large. Lumbar spinal fusion, intervertebral disc surgery, lumbar partial discectomy and thoracic derotation are amongst just some of the spinal surgery procedures carried out by our surgeons when non-invasive or minimally invasive surgery is not possible. Conditions Treated:
Procedures:
ConditionsHerniated discs: A herniated disc is a condition where the outer ring of an intervertebral disc is torn and the softer, inner part of the disc is able to bulge out. The signs of a herniated disc is mild to severe pain, weakness in the limbs, and numbness in the limbs. This condition is typically brought on by heavy lifting, injury, or disc degeneration associated with the aging process. Fortunately, many people don’t require surgery. Many people can use over-the-counter pain medications, or prescription pain medication, and physical therapy can treat a herniated disc. If the physical therapy and pain medication does not fix the herniated disc, surgery may be required. The surgery may involved removing the bulging disc, a discectomy, or spinal fusion. Pinched nerve: A pinched nerve is a nerve that has pressure placed on it by surrounding tissue or bone. The symptoms of a pinched nerve are numbness, sharp pain, tingling, weakness, twitching, or the affected area “falling asleep.” Pinched nerves can be a side effect of other conditions such as a herniated disc, sciatica, or carpal tunnel syndrome. Obesity, osteoarthritis, and poor posture can also cause a pinched nerve. The treatment for pinched nerve is normally time to heal itself, physical therapy, and surgery. Surgery is reserved for cases that do not heal by itself. Spine Fracture: Like other bones in the body, the vertebrae in the spine can be broken through trauma. The treatment for a spine fracture is dependent on the severity of the fracture. If it is a small fracture, then it might just need rest and time to heal. If the fracture is more severe, surgery may be required to place rods, screws, and pins to realign the broken portions. Scoliosis: Scoliosis is when the spine has an abnormal curve. The spine does have a slight curve, but scoliosis is when there is a more pronounced curve. Scoliosis can affect children and adults. Scoliosis is common among children and will get worse when the child is going through a growth spurt. Girls are also more likely to have scoliosis than boys. Scoliosis can be caused by a congenital defect in the ribs or the spine, which cause the spine to grow in a different pattern. Another common cause of scoliosis is from the nervous system. Conditions that can cause scoliosis are spina bifida, polio, muscular dystrophy, and cerebral palsy. Many times, there are no symptoms of scoliosis, but people can experience back pain, uneven shoulders, uneven hips, spinal curvature, and an achy feeling in the spine after sitting or standing. The treatment for scoliosis depends on the age of the patient and the underlying cause. If the child is young and still growing, oftentimes, a back brace will be fitted to protect the spine from curving more. Surgery can be used to treat scoliosis. Those with congenital defects or neuromuscular scoliosis are harder to treat and may require multiple surgeries. ProceduresSpine Surgery Spine surgery is rarely an initial treatment for back pain but there are some emergencies that are likely to require surgical treatment. In majority of patients, such surgery is considered after a long course of traditional and conservative therapy. As back pain usually takes some time to resolve, rushing to spine surgery may not be the perfect idea. Usually, doctors recommend at least 3 to 6 months of conservative treatment before taking into account spine surgery. There are various types of spine surgery and these include:
Minimally Invasive Spine Surgery Minimally invasive spine surgery is an endoscopic operation that utilizes specialized instruments that are entered into the abdomen or chest through tiny incisions in order to reach the spine and do the required surgery. This procedure involves the use of a specialized video camera as well. For decades, endoscopic methods have been utilized but to diagnosis certain conditions only. In the later part of the 1970 and early part of the 1980s, there were advancements made to endoscopic techniques which allowed a diagnosis to be made and the disorder could be remedied. These techniques that are adopted in other surgical requirements have been developed to treat spine disorders. However, a minimally invasive spine surgery is not perfect for everyone. A surgeon must completely assess each patient to identify their qualification for the surgery. In some cases of scoliosis, degenerative discs, kyphosis, herniated discs, fractures and infections, minimally invasive surgeries may accelerate recovery, alleviate post-operative pain and enhance the final result. The different types of minimally invasive spine surgeries are:
Benefits of Minimally Invasive SurgeryCompared to the conventional spine surgery that needs long incision and recovery period, minimally invasive surgery utilizes an endoscope that is inserted into a tiny incision. The endoscope is attached to a small video camera that projects the inner view of the body onto the operating room's television screens. After the procedure, sutures are used to close the tiny incisions which will be covered with surgical tape. They will be almost invisible after a few months. The fact that minimally invasive spine surgery holds a minimized risk of complications and alleviates the need for a longer stay in the hospital indicates that there could be cases that such surgical procedure can be performed on an outpatient basis. Obviously, this demonstrates substantial advantage for both patient and doctor in terms of cost effectiveness and safety. These procedures have become popular due to these mentioned advantages. Minimally invasive spine surgery techniques use cutting-edge technology to make corrections to chronic spinal conditions without triggering undue injury to the soft tissues that surround it. Because of these highly specialized instrumentation and tools, guided by enhanced features like nerve monitoring and computerized navigation, spine surgeons are able to perform the surgery safely and effectively. Compared to posterior lumbar fusion (PLF), a minimally invasive spine surgery like transforaminal lumbar interbody fusion (TLIF) provides the same postoperative fusion rates and alleviates the quantity of spinal muscle iatrogenic injury. The benefits of minimally invasive spine surgery include:
Spine Surgery Risks and Complications Complications of spine surgery are always a risk and this must be considered carefully before deciding to have a surgical procedure.
Failed Back or Spine Surgery Information
Postsurgical Pain Predictability
This makes it important to stick to highly successful operations to ensure preoperative identification of an anatomic lesion that is to be corrected during the surgery. Surgical Surgery Rehabilitation
Risks and Complications of Minimally Invasive Spine Surgery
Procedure-specific risks:
Surgeons who are performing minimally invasive surgery usually would say that there is a limited opportunity to learn this technique. Post-operative and intra-operative problems are higher when the surgeon is obtaining experience. The technical challenges may be overcome with practice and training but it needs time. Minimally invasive spine surgery requires advanced techniques, demands specialized equipment, offers decreased visualization and is linked to a limited learning curve. Compared to conventional surgical methods, this type of procedure is also related to minimized fusion rates and insufficient decompression. The procedure does not need the utilization of fluoroscopy. This means a low chance of exposure to fluoroscopy. Actually, the risk is more for the part of the surgeon and staff in the operating room who are exposed to every patient. In minimally, invasive spine surgery, there is usually a risk of bone fracture, nerve damage, screw malfunction and blood clot formation. Postoperative Care for Minimally Invasive Spine Surgery Recovery in preoperative symptoms is attained in 80% of patients. Back pain and function improvement continues up to a couple of years following the minimally invasive spine surgery. The basis for the improvement would be:
Recovery after a minimally invasive spine surgery can be affected by smoking. Nicotine is like a bone poison that inhibits bone fusion. According to a study on bone mass fusion with spinal fusion patients depicts that there is lower nonunion rate to patients who do not smoke than those patients who smoke. The nonunion rate for those who quit smoking is slightly higher. Occupational therapy, exercise and physical therapy may be needed to aid patients in regaining strength and function. This could start in the hospital or be suggested at a later time Like other forms of back pain treatment, the more effort exerted by the patient, the better the whole result of minimally invasive spine surgery. If you are suffering from a spinal injury, ongoing condition, infection or degenerative disease then we at the Department of Spine Surgery are always ready to book you in for a consultation and get your treatment started. Please don't hesitate to call us La Peer Surgery Center: (310) 360-9119 today. La Peer Health Systems- Department of Spine Surgery |