Spine surgery is a treatment the team at California Neurosurgical Institute uses to help patients when other forms of therapy aren’t providing relief from painful back and neck conditions.

Most people find that a treatment program that includes a combination of physical therapy, medication, and, in some cases, epidural steroid injections and nerve blocks, resolve their back and neck pain.

Some patients find these conservative approaches don’t work for them, in which case they might benefit from having an implantable device like a spinal cord stimulator or a pain pump.

In a minority of cases, patients either don’t respond to any other treatments, or their condition is one for which surgery is the only viable option. In these cases, the California Neurosurgical Institute can carry out a range of advanced spine surgeries.

Modern technologies play a key role in performing spine surgeries. One example is endoscopy. Endoscopic techniques use tiny cameras on the end of a flexible tube. Your surgeon makes one or several small incisions through which they pass the endoscope.

When it reaches the surgery site, the endoscope’s camera sends back images of your tissues, enabling your surgeon to carry out the operation without making any large incisions.

Other assistive technologies used in spine surgery include preoperative computed tomography (CT) and intraoperative fluoroscopy (a type of moving X-ray).

These are computer-assisted guidance systems that help the team at California Neurosurgical Institute carry out spine surgery safely and with great precision.

The team at California Neurosurgical Institute carries out many different types of spine surgery, including:

Anterior cervical discectomy and fusion
This procedure removes a herniated or slipped disc and fuses the vertebrae above and below.

Placement of cervical disk prosthesis
Similar to discectomy but using an artificial disc to replace the damaged one.

Corpectomy
This surgery replaces both bone and discs in patients who have extensive spinal cord compression problems.

Laminectomy and laminotomy
Laminectomy involves complete removal of a lamina, which are pieces of bone that form the spinal canal. Laminotomy removes only a part of the lamina.

Fusion
PLIF (posterior lumbar interbody fusion) is surgery on the back of your spine that fuses the vertebrae. ALIF (anterior lumbar interbody fusion) involves a frontal approach. Transforaminal lumbar interbody fusion and lateral interbody fusion are also options that could suit some patients.

Vertebral column resection
A vertebral column resection is an option for severe deformity in the spine caused by conditions such as scoliosis. It involves taking out one or more vertebrae and possibly laminae, transverse processes, and ribs.

Surgery is usually only considered when conservative treatments aren’t improving your symptoms after six months.

However, there are some cases in which the team at California Neurosurgical Institute might recommend surgery sooner:

Cauda equina syndrome
This is a medical emergency involving the bundle of nerves at the base of your spine called the cauda equina. Compression of these nerves leads to a loss of sensation and movement in your lower body.

Bilateral sciatica
Sciatica normally only affects one leg, but in some cases, it affects both. This can be due to a particularly bad herniated disc, a series of herniated discs, or central spinal stenosis.

Other reasons you might need sciatica surgery sooner rather than later include:

• Tumors
• Cysts
• Abscesses
• Severe lumbar fractures
• Pelvic infection

One of the main surgeries used to treat sciatica is lumbar disc microsurgery. This is a minimally invasive procedure for sciatica that’s due to a herniated spinal disc.

Your surgeon at California Neurosurgical Institute uses endoscopic instruments that fit inside very small incisions to remove pieces of the disc that are pressing on your sciatic nerve.

Other options that your surgeon might recommend, depending on the cause of your sciatica, include lumbar decompression surgeries such as:

• Laminectomy
• Foraminotomy
• Facetectomy