About Spine Surgery
Overview of the Procedure
As a patient considering spine surgery, you probably have many questions.This information will help prepare you for what to expect during your hospitalization.
The spine is made up of a series of vertebra. There are seven cervical (neck), 12 thoracic (chest) and five lumber vertebrae.The verte- bra is composed of a solid section called the body that sits anteriorly and a ring of bone posteriorly (shown in Figure 1). The ring of bone creates a canal through which the spinal column and nerve roots run.
The bony arch consists of the pedicle, paired transverse process, facet joints, lamina and spinous process (shown in Figure 2).
Between each vertebra is a disc that serves as a shock absorber and provides height between two vertebrae. The disc has circular bands of cartilage called the annulus, which encases a gelatinous center called the nucleus (shown in Figure 3).
The disks between the vertebrae allow the back to flex or bend. Disks also act as shock absorbers. Disks in the lumbar spine (low back) are composed of a thick outer ring of cartilage (annulus) and an inner gel-like substance (nucleus). In the cervical spine (neck), the disks are similar but smaller in size.
With aging and the wear and tear we put on our backs, degenerative changes in the spine can occur. The disks between the vertebrae (bones) may become degenerate and lose some of their water content causing the annulus to weaken allowing the disc to protrude or become herniated (shown in Figure 4).
The facet joints may develop overgrowth due to arthritis. These changes can also lead to narrowing, or stenosis, of the spinal canal. Spinal stenosis can cause the nerves to be pinched as they pass through the canal and foramina (shown in Figure 5). The nerves become inglamed, causing pain in the buttocks and/pr legs. These changes can occur anywhere along the spine. We frequently see pathologies develop in the neck (cervical) or lower back (lumbar) spine.
About the Procedures
A Laminectomy or decompression of the spine is done to eliminate pressure on the nerves from bone or soft tissue (often discs). A portion of the lamina is removed, this is often done with a spinal fusion (shown in Figure 5 and 6).
Spinal fusion surgery permanently fuses together bone segments (shown in Figure 7) and eliminates motion between vertebral segments using bone graft. Bone graft may be laid down between the vertebrae or along the posterior portion of the bertebrae. In addition, rods, screws, and cages are used to immobilize the spine in the area while the bone fusion is healing. Spinal fusion will take away some spinal flexibility. However, most spinal fusions involve only small segments of the spine and therefore, do not limit motion very much.
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