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Spinal Decompression
Spinal decompression is the relief of pressure on the spinal cord or on one or more compressed nerve roots passing through or exiting the spinal column. Decompression of the spinal neural elements is a key component in treating spinal radiculopathy, myelopathy and claudication. Surgical methods Decompression of nerve roots When a single spinal nerve root is compressed, the resulting clinical outcome is termed radiculopathy, and is usually labeled according to the specific nerve root compressed (hence compression of the nerve root exiting the spinal column below the left-sided pedicle of the L5 vertebra will be diagnosed as "left L5 radiculopathy"). Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument. The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulpos ...
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Spinal Decompression
Spinal decompression is the relief of pressure on the spinal cord or on one or more compressed nerve roots passing through or exiting the spinal column. Decompression of the spinal neural elements is a key component in treating spinal radiculopathy, myelopathy and claudication. Surgical methods Decompression of nerve roots When a single spinal nerve root is compressed, the resulting clinical outcome is termed radiculopathy, and is usually labeled according to the specific nerve root compressed (hence compression of the nerve root exiting the spinal column below the left-sided pedicle of the L5 vertebra will be diagnosed as "left L5 radiculopathy"). Microdiscectomy (or microdecompression) is a minimally invasive surgical procedure in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument. The purpose of this procedure is to relieve the pressure and reduce the local inflammatory reaction around a nerve root, caused by the herniated nucleus pulpos ...
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Radiculopathy
Radiculopathy, also commonly referred to as pinched nerve, refers to a set of conditions in which one or more nerves are affected and do not work properly (a neuropathy). Radiculopathy can result in pain (radicular pain), weakness, altered sensation (paresthesia) or difficulty controlling specific muscles. Pinched nerves arise when surrounding bone or tissue, such as cartilage, muscles or tendons, put pressure on the nerve and disrupt its function. In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve. For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar-sacral spine can be manifested with symptoms in the foot. The radicular pain that results from a radiculopathy should not be confused with referred pain, which is different bo ...
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Myelopathy
Myelopathy describes any neurologic deficit related to the spinal cord. The most common form of myelopathy in humans, '' cervical spondylotic myelopathy (CSM)'', also called ''degenerative cervical myelopathy'', results from narrowing of the spinal canal (spinal stenosis) ultimately causing compression of the spinal cord. When due to trauma, myelopathy is known as (acute) spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy. In Asian populations, spinal cord compression often occurs due to a different, inflammatory process affecting the posterior longitudinal ligament. Presentation Clinical signs and symptoms depend on which spinal cord level (cervical, thoracic, or lumbar) is affected and the extent (anterior, posterior, or lateral) of the pathology, and may include: * Upper motor neuron signs—weakness, spasticity, clumsiness, altered tonus, hyperreflexia and pathological reflexes, including Hoffma ...
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Claudication
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. The perceived level of pain from claudication can be mild to extremely severe. Claudication is most common in the calves but it can also affect the feet, thighs, hips, buttocks, or arms. The word ''claudication'' comes from the Latin ''claudicare'' meaning 'to limp'. Claudication that appears after a short amount of walking may sometimes be described by US medical professionals by the number of typical city street blocks that the patient can walk before the onset of claudication. Thus, "one-block claudication" appears after walking one block, "two-block claudication" appears after walking two blocks, etc. The term ''block'' would be understood more exactly locally but is on the order of 100 metres. Types Intermittent vascular Intermittent vascular (or arterial) claudication (Latin: ' ...
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Discectomy
A discectomy (also called open discectomy, if done through a 1/2 inch or larger skin opening) is the surgical removal of abnormal disc material that presses on a nerve root or the spinal cord. The procedure involves removing a portion of an intervertebral disc, which causes pain, weakness or numbness by stressing the spinal cord or radiating nerves. The traditional open discectomy, or Love's technique, was published by Ross and Love in 1971. Advances have produced visualization improvements to traditional discectomy procedures (e.g. microdiscectomy, an open discectomy using an external microscope typically done through a 1-inch or larger skin opening), or endoscopic discectomy (the scope passes internally and typically done through a 2 mm skin opening or larger, up to 12 mm). In conjunction with the traditional discectomy or microdiscectomy, a laminotomy is often involved to permit access to the intervertebral disc. Laminotomy means a significant amount of typically nor ...
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Minimally Invasive Procedures
Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition is invasive and many operations requiring incisions of some size are referred to as ''open surgery''. Incisions made during open surgery can sometimes leave large wounds that may be painful and take a long time to heal. Advancements in medical technologies have enabled the development and regular use of minimally invasive procedures. For example, endovascular aneurysm repair, a minimally invasive surgery, has become the most common method of repairing abdominal aortic aneurysms in the US as of 2003. The procedure involves much smaller incisions than the corresponding open surgery procedure of open aortic surgery. Interventional radiologists were the forerunners of minimally invasive procedures. Using imaging techniques, radiologists wer ...
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Hernia Nucleus Pulposus
Spinal disc herniation is an injury to the cushioning and connective tissue between vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatment may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including posture. When a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings, the disc is said to be herniated. Disc herniation is frequently associated with age-related degeneration of the outer ring, known as the '' annulus fibrosus'', but is normally triggered by trauma or straining by lifting or twisting. Tears are almost always posterolateral (on the back sides) owing to relative narrowness of the posterior longitudinal liga ...
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Laminectomy
A laminectomy is a surgical procedure that removes a portion of a vertebra called the lamina, which is the roof of the spinal canal. It is a major spine operation with residual scar tissue and may result in postlaminectomy syndrome. Depending on the problem, more conservative treatments (e.g., small endoscopic procedures, without bone removal) may be viable. Method The lamina is a posterior arch of the vertebral bone lying between the spinous process (which juts out in the middle) and the more lateral pedicles and the transverse processes of each vertebra. The pair of laminae, along with the spinous process, make up the posterior wall of the bony spinal canal. Although the literal meaning of laminectomy is 'excision of the lamina', a conventional laminectomy in neurosurgery and orthopedics involves excision of the supraspinous ligament and some or all of the spinous process. Removal of these structures with an open technique requires disconnecting the many muscles of the back ...
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Physiotherapy
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries. In addition to clinical practice, other aspects of physical therapist practice include research, education, consultation, and health administration. Physical therapy is provided as a primary care treatment or alongside, or in conjunction with, other medical services. In some jurisdictions, such as the United Kingdom, physical therapists have the authority to prescribe medication. Overview Physical therapy addresses the illnesses or injuries that limit a person's abilities to move and perform functional activities in their daily lives. PTs use an individual's history and physic ...
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Microsurgical Lumbar Laminoplasty
Microsurgical lumbar laminoplasty is a minimally invasive technique for decompressing pinched nerves in the lumbar spine. Pinched or compressed nerves may result from herniated discs, lumbar spinal stenosis, or spondylolisthesis. The traditional technique for decompression of lumbar nerves is laminectomy, a surgical procedure developed in the early 1900s. In laminectomy, the paraspinal muscles are dissected off the spine bilaterally, that is on the left and right sides of the spinal column. The lamina and spinous process are then removed to gain access to the nerves contained within the spinal canal. The structures that are compressing the nerves (usually ligamentum flavum and herniated disc) are then trimmed until the nerves are free from compression. Laminectomy is an effective procedure for relieving pressure on spinal nerves, but during the procedure, many spinal stabilizing structures are destroyed even though they are not directly compressing the nerves (lamina, spinous pro ...
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