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Surgical Terms
Annuloplasty: A relatively new procedure where an
electrode is introduced into a lumbar disc via a needle and the
skin (annulus) of the disc is heated to purportedly realign the
collagen fibers in the annulus and thereby reduce back pain.
Early results with this treatment are encouraging but long-term
benefit has yet to be documented.
Laminectomy: A lamina is the arch of bone attached to the
backside of the vertebra which creates a canal for the nerves to
pass through. Think of the Arc de Triomphe in Paris
creating an opening through which all that traffic passes. A
laminectomy is a removal of the upper one half of that arch to
gain access to the spine canal to remove tumors or the causes of
spinal stenosis (thick joints and ligaments). It is commonly
used as a term for any operation on the low back designed to
remove the herniated portion of a disc but is a misnomer as disc
hernia removal requires such a minimal laminectomy it is called
a laminotomy.
Foramenotomy: Surgery where the opening (foramen) through
which a nerve passes to leave the spine and go to the arm or leg
is enlarged usually by removing some of the joint in that region
(since the joint bones form the roof of the foramen).
Open Discectomy (also called Laminotomy-Discectomy): The
term used to describe the removal of the herniated (bulging)
portion of the skin of the disc and/or a ruptured piece of disc
pulp. The entire disc is rarely removed in any low back
operation.
Micro-discectomy: A discectomy performed using an
operating microscope or special magnifying glasses which allows
the surgeon to make a smaller incision and see better.
Suction-discectomy: Procedure in which a needle is
introduced into the disc under local anesthesia and a very
strong suction is applied to the needle to remove a small amount
of the center of the disc pulp in the hope that such a reduction
in pulp volume will allow a disc hernia to recede or shrink down
away from a nerve. It’s like letting some air out of an inner
tube to reduce the size of a weak spot that is pooching out.
Laser-discectomy: Same procedure as the suction
discectomy but instead of suctioning out some pulp, some of the
pulp is vaporized with the laser thus reducing pulp volume.
Endoscopic discectomy: Same maneuver as the micro-discectomy
but done by introducing a needle into the back of sufficient
size to pass an endoscope and instruments to see the herniated
disc and remove disc material by grasping with small forceps.
Cervical discectomy and fusion: Operation where the spine
is approached from the throat side and one or more discs are
removed and replaced with a graft which usually results in the
vertebrae on either side of the graft fusing into one bony unit.
Usually performed to relieve neck pain accompanied by
significant arm symptoms of pain, numbness or weakness.
Lumbar Fusion: Operation where one vertebra is connected
or "fused" to the next vertebra so that no motion
between them can occur in the future. It is accomplished by
placing pieces of bone (the graft) between the vertebrae so that
new bone cells travel through the graft and unite or fuse the
two vertebrae into one solid unit of bone. The operation usually
involves placing some metal screws, plates, rods or cages to
hold the vertebrae immobile (like an internal cast) while the
new bone growth occurs. This operation is usually done for very
chronic back pain (when the pain is due to a degenerated disc)
or for spondylolithesis to prevent further slippage/misalignment
of the spine.
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