Spine Surgery

Overview

Your spinal cord is comprised of a bundle of nerves which carry messages back and forth from your brain to your muscles and other soft tissues. A stack of backbones called vertebrae surrounds these nerves to protect them. When injury or disease occurs, surgery is sometimes necessary.

 

Dr. Wirchansky is an expert in all types of spine surgery – from traditional open surgery to minimally invasive surgeries. Whenever possible – depending on the patient and the spine disorder – Dr. Wirchansky will recommend a minimally invasive procedure. He uses the most advanced minimally invasive technology, including microscopic surgery, percutaneous pedicle screws, Coflex® implants, and Varilift®-LX Interbody Fusion System

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Cervical Spine

Your cervical spine is made of seven bones, called vertebrae, located in the neck area.  These vertebrae are separated by discs filled with a gel-like substance that cushion and stabilize the vertebrae.  Click the arrow below to learn more about some of the most common types of cervical spine conditions Dr. Wirchansky treats:

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Cervical Stenosis

Stenosis occurs over a number of years and results in the thickening of ligaments, the formation of bone spurs, and the deterioration of the disc material. As a result, the spinal canal narrows and pinches the nerves. Bone spurs may also press on the spinal cord.

 

Cervical stenosis may cause neck or arm pain, numbness and weakness in both hands, loss of coordination when walking or during other activities, or muscle spasms in the legs

 

Although conservative treatment may be sufficient to alleviate symptoms of stenosis, surgery is recommended if there are signs that the spinal cord is compressed or there is significant risk that the spinal cord may become damaged. In cervical stenosis, discs and spurs can be removed from the front of the neck. Spinal fusion may be performed to stabilize the spine or if a disc is removed.

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Cervical Spinal Cord Compression

This occurs when pressure is put on the vertebrae in the neck area and can occur due to a number of different reasons – the most common of which is osteoarthritis.

 

Other causes can include:

  • Injury to the cervical spine
  • Scoliosis (abnormal spine alignment
  • Bone disease
  • Spinal tumor in the area
  • Certain bone diseases
  • Rheumatoid arthritis
  • Infection

 

Treatment depends on the underlying cause and symptoms you may be experiencing, but typically involves medication, physical therapy, injections, and/or surgery, or a combination of these.

 

When surgery is indicated, treatments may include removing bone spurs and widening the space between vertebrae. Other procedures may be performed to relieve pressure on the spine or repair fractured vertebrae. Your neck back may also be stabilized by fusing some of the vertebrae together.

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Cervical Degenerative Disc Disease

Your cervical discs both stabilize your neck and allow it to turn smoothly from side to side and bend forward to back. Over time, these natural shock absorbers become worn and can start to degenerate. This is known as cervical degenerative disc disease.

 

When this occurs, the space between the vertebrae narrows, often pinching the nerves and causing neck pain and stiffness. As the disease progresses, discs can also bulge out, putting even more pressure on the spinal cord and the nerves.

 

In most cases, cervical degenerative disc disease can be treated without surgery. Nonsteroidal anti-inflammatory medications can reduce pain and inflammation, while physical therapy can help increase your range of motion and reduce your pain and stiffness.

 

Surgery is an option if these treatments don’t offer relief.  Dr. Wirchansky will go over all options with you, and you will decide together which makes the most sense for you.

 

Surgical options include a microdiscectomy, a minimally invasive procedure, to remove the disc. Another option is implanting an artificial disc, made of metal and plastic, to maintain mobility of the spine. In the past couple of years, it has become more frequently utilized in cervical spinal surgery, but your spine surgeon will help you determine if that is the best option for you. Sometimes cervical spinal fusion is the best choice. New techniques in spinal fusion surgery make it less traumatic and recovery may be significantly shorter.

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Lumbar Spine

Your lumbar spine refers to your lower back, where your spine curves in toward your abdomen. It starts about five or six inches below your shoulder blades, where your thoracic spine ends and is comprised of five vertebrae that surround that section of the spinal column. In general, the lower the vertebrae, the more weight it must bear and are therefore the most prone to degradation and injury.

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Lumbar Decompression

Lumbar decompression surgery is typically performed in order to relieve pain from pinched nerves caused by a lumbar herniated disc or lumbar spinal stenosis.

 

Decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are:

  • Microdiscectomy – Removal of part of the disc that is compressing a nerve
  • Laminectomy – Removal of bone – called the lamina– to relieve pressure on the nerve.
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Lumbar Fusion

Lumbar fusion surgery is performed to stop pain and disability caused by lumbar degenerative disc disease or a spondylolisthesis by stopping the motion at the painful segment of the affected vertebrae. Once the motion stops, the pain decreases.

 

Spinal fusion surgery involves using a bone graft to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. Spine surgery instrumentation (medical devices), bone graft procedures, and a bone stimulator are sometimes used along with spinal fusion.

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Spine Trauma

Spine fractures caused by trauma from car accidents, falls, sports injuries, or blows to the vertebrae can occur anywhere along the spine – from the cervical spine (neck) to the lumbar spine (lower back) and sacrum (bottom of the spinal column).

 

The first sign of a spine fracture is usually pain. However, if the spinal cord itself has been injured, signs can also include weakness, paralysis, and lack of sensation.

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Treatment

The goal in treating spine trauma is to realign the fractures and keep them in alignment until the bones have healed.  Less traumatic fractures often respond well to external bracing. Other fractures may require surgical stabilization with implanted screws, hooks, connecting rods, or surgical fusion.

 

For patients who suffer neurologic injury, surgery is usually necessary in order to remove any bone or disc material that may be compressing the spinal cord and to stabilize the spine to minimize additional trauma.

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Spine Tumors

Although rare, spine tumors are a serious health risk and should be promptly treated.  They usually begin elsewhere in your body and spread to your spinal cord through the bloodstream.  Not all spine tumors are malignant (cancerous), but all need to be removed because they can compress your spinal cord and the nerves that carry messages to and from your brain.

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Symptoms & Treatment

Symptoms may include:

 

  • Pain or numbness in arms, legs, neck, or back
  • Loss of muscle strength
  • Loss of motor skills
  • Decreased feeling in the extremities
  • Decreased sensitivity to temperature changes
  • Loss of bladder and/or bowel control

 

Dr. Wirchansky typically treats spine tumors with surgery to remove and/or reduce the size of the tumor. If malignancy is indicated, he may also recommend the surgery be combined with radiation or chemotherapy.