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Spine Surgery
Spine Surgery
Spine Surgery in Atlanta
Spine surgery is always complex, and the vital importance of the neurological system makes precision and experience important assets for any orthopaedic spine surgeon. Douglas A. Linville, MD has decades of experience in spinal surgery. His unique background and time in the field performing cutting-edge techniques such as robotic-assisted spine surgeries have made him a sought-after teacher for training new surgeons in the delicate art of spine surgery.
He’s also one of the spinal surgeons people throughout Georgia and the surrounding states turn to when in need of revision of failed spine surgeries.
Endoscopic Spine Surgery
Endoscopic spine surgery is one of the latest advancements in orthopaedic spinal surgery. Using very small microincisions and an endoscope – a small camera – a spine surgeon can visualize disc and vertebrae damage or conditions and utilize small instruments to perform complex surgeries to treat them.
These minimally invasive surgeries cause significantly less damage to the body and in most cases allow orthopaedic spine surgeons avoid spinal fusion, which may reduce spine mobility. There are many types of spine endoscopic, including:
- Endoscopic Discectomy
- Endoscopic Foraminotomy
- Endoscopic Facet Rhizotomy
- Endoscopic Laminotomy
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Cervical and Lumbar Disc Replacement
Cervical or lumbar disc replacement, also known as total disc arthroplasty, entails removing the damaged disc or discs and replacing them with artificial discs. The procedure is similar to the previously explained discectomy, with the difference being the implantation of artificial discs to replace the cervical or lumbar intervertebral disc that was removed.
The replacement disc is technically composed of two metal discs, one of which is attached to the upper vertebrae while the other is attached to the bottom vertebrae. A sheet of medical grade plastic goes between these two metal pieces so they can slide and mimic natural movement as possible. The ideal goal of cervical or lumbar disc replacement is to prevent the need for spinal fusion.
Kyphoplasty
Spinal compression fractures can result in reduced mobility, chronic pain and reduced quality of life. During a kyphoplasty, a minimally invasive spine surgery that treats spinal compression fractures, a spine surgeon will stabilize the fractured vertebra and restore it back to its normal, healthy state.
They do this by inserting a narrow tube into the pedicle (vertebral arch). This tube contains a miniscule balloon, which is inflated until the compressed vertebrae is restored to its proper height. The balloon is then removed, and the resulting cavity is filled with specialized bone cement. The procedure, which requires only a very small incision, may be performed multiple times to ensure proper restoration and stability of the damaged vertebrae.
Annuloplasty and Nucleoplasty
Annuloplasty and nucleoplasty are other potential treatment option for patients with a herniated or bulging disc. These procedures are usually reserved for patients who have not responded well to alternative herniated disc treatments. During the procedure, an orthopaedic specialist uses X-ray guidance to maneuver a specialized needle to the offending bulging disc. The specialized needle delivers a carefully controlled plasma field to remove a portion of the bulging disc.
Annuloplasty is targeted at the collagen fibers on the outer disc wall, while nucleoplasty is targeted at the interior of the herniated disc’s wall. The procedure should close the torn or damaged disc walls and reduce or eliminate the pain caused by the bulging disc.
The same plasma field is then used to cauterize the channel that was made by the annuloplasty/nucleoplasty needle.
Transforaminal Lumbar Interbody Fusion (TLIF)
The TLIF procedure decompresses the spinal cord and its nerves while re-stabilizing the spine. The procedure helps prevent future movement and damage to the affected lumbar joints.
During this fusion surgery, your orthopaedic spine surgeon will fuse the targeted joints together using a bone graft, which is taken from donor tissue in a bone bank or transplanted from elsewhere in the patient’s own body.
The spine surgeons at Barbour Orthopaedics can perform a minimally invasive form of TLIF to reduce post-operative pain and healing time.
Lumbar Microdiscectomy
Herniated or ruptured disks can be incredibly painful and complicate a lot of back issues. These disks are meant to cushion the vertebrae they sit between, so when they are compromised, they can’t effective provide that cushioning and may compress sensitive nerves in the process.
One of the treatment options for fixing a herniated lumbar disc in the lower back is a microdiscectomy. During both a regular discectomy and a microdiscectomy the herniated disc is removed. The main difference is the size of the incision and the surgical tools that are used.
A much smaller incision can be used to perform a microdiscectomy, which results in less surgical trauma and accelerated recovery. The procedure is performed with arthroscopic or endoscopic tools, including a thin tube camera for visualizing the herniated disc during surgery.
Anterior Cervical Discectomy and Fusion (ACDF)
ACDF is a surgical option for the removal of a herniated cervical disc. The cervical vertebrae are in the neck, which is why a slightly different approach is taken with herniated cervical discs as opposed to herniated lumbar discs.
During the procedure, small incisions are made in the throat, through which the herniated disc is removed. A bone graft is then used to fuse the vertebrae above and below the herniated disc together.
Cervical and Lumbar Disk Herniation Repair
Vertebrae in the spine are separated by intervertebral discs, which are composed of spongy connective tissue. Some of the most commonly damaged vertebrae and discs are the cervical vertebrae and the lumbar vertebrae.
A herniated disc occurs when the intervertebral disc tears or ruptures, causing the soft, gelatinous core of the disc to ooze out. In addition to risking vertebrae-on-vertebrae abrasions, a herniated disc can also pinch nearby nerves, resulting in severe chronic pain.
In many cases surgical intervention isn’t required to treat herniated discs. However, some patients, especially those with degenerated discs between their lumbar vertebrae, may not experience relief with less invasive treatment options such as physical therapy, injections and medication. In these cases, a surgeon may recommend:
- Discectomy – Partial or total removal of the damaged intervertebral disc.
- Laminectomy – Removal of the lamina, or the bony arch, of the vertebrae.
- Spinal Fusion – Fusion of two or more vertebrae utilizing bone grafts on the spine and in some cases screws, rods or other devices to improve spinal stability.
Spinal Deformity Surgeries for Adults and Children
Scoliosis, kyphosis and spondylolisthesis are some of the common spinal deformities treated by Dr. Linville.
Scoliosis and kyphosis are both spine deformities that affect the shape of the spine. For patients with scoliosis, the spine is generally s-shaped horizontally along their back. Patients with kyphosis, commonly known as hunchback, have an abnormally curved spine. Although the condition is sometimes associated with osteoporosis, it can also manifest in children, and is especially common during adolescence.
Spondylolisthesis occurs when a vertebra slips, most commonly at the base of the spine. Although spondylolisthesis can result from trauma, it can also manifest as a birth defect, which is why many patients treated for spondylolisthesis are children and adolescents.
Scoliosis, kyphosis and spondylolisthesis can sometimes be treated with a combination of chiropractic care, physical therapy and other non-invasive treatment methods. In extreme cases, the condition may be best addressed with spinal fusion.
