Surgical Procedures


From treatment for sprains and strains to minimally invasive spinal surgery or more comprehensive surgical procedures, the Orthopaedic & Spine Center of New Jersey provides a gamut of services.

Our approach is both comprehensive and customized for each individual patient, with the goal of exhausting all non-surgical options, before selecting from our state-of-the-art surgical procedures.

When necessary, the Orthopaedic & Spine Center of New Jersey performs a wide range of surgical treatments including the latest, state-of-the-art non-invasive surgical solutions.

Complex Revision Spine Surgery

Complex Revision Spine Surgery/Deformity/Scoliosis:  A spine deformity is when there is an abnormal curvature of spine which can cause an abnormal appearance, severe pain and/or a poor quality of life. Some of these conditions that cause spinal deformity are scoliosis or kyphosis ("hunched" spine), the result of previous spine fractures/tumors, severe degeneration or occasionally, after prior spine surgery.

Deformity Surgery are done to straighten & balance a severely curved spine and prevent the curve from worsening. This is done with the use of spinal hardware (rods, screws or hooks). This can be performed through the back ("posterior"), front ("anterior") or both. Occasionally this can be performed through a minimally invasive approach (MIS) - thus decreasing blood loss, hospital stay & postoperative pain.

Some surgical procedures (complex spine revision surgery, severe fixed/rigid deformities, etc.) are more complicated and require special expertise & training in spinal surgery.

Anterior & Posterior Fusion

Anterior/posterior fusion, in which both the front and the back of the spine are fused, stabilizes both the front and back of the spine. It is a procedure used to correct a great degree of spinal instability, such as results from a fracture, disc degeneration, a high degree of spondylosis or abnormal curvatures of the spine (such as with scoliosis). This surgery stabilizes the bones (vertebrae) and also includes removing discs or bone spurs that are the cause of back problems.

The anterior portion of the surgery is performed first, followed by the posterior. Bone graft material is used from another part of the patient’s body (autograft), or from a bone bank (called allograft). Vertebrae are also repaired with artificial materials, such as screws and metal plates. This surgery requires several days of a hospital stay.

Complex Revisions

Some surgical procedures (which are called “complex revisions”) are more complicated and require special expertise in spinal surgery. There are several conditions which require complex revisions. These include failed back surgery syndrome (FBSS), which is either due to misdiagnosis of the exact cause of pain, or failure to correct the problem; flatback syndrome, surgery required to correct the alignment of the spine; pseudoarthrosis which occurs when a fracture does not heal properly so that it creates a false (pseudo) joint (arthrosis); and hardware failure, which is the malfunction of any surgical devices, such as implants for spinal procedures, that require surgical correction or removal.

Discectomy & Microdiscectomy

Discectomy is surgery to remove a herniated lumbar disc that is pressing on a nerve root or the spinal cord. Microdiscectomy uses a special microscope to view the disc and nerves. This procedure allows the surgeon to use a smaller cut (an inch to 1 ½ inches) in the midline of the low back, thus facilitating a less invasive procedure, less damage to surrounding tissue and more rapid recovery. Both procedures are designed to relieve symptoms such as severe leg pain, numbness or weakness caused by impingement (compression) on the nerve root.

Fusion

Fusion is the growing or joining of bone which leads to a decrease in the pain caused by a diseased or injured joint. Spinal fusion surgery joins vertebrae (bones in the spine), so there is no movement between them. This is done for degenerative conditions but also includes treating instability or weakness of the spine, scoliosis or fractures.

Interspinous Devices

Interspinous devices (spacers) are small devices composed of a plastic-like polymer. They are implanted between the spinous processes of the symptomatic lumbar levels. Spinous processes are the thin projections from the back of the spinal bones to which muscle and ligaments are attached. After implantation, the device is expanded to open and separate the spinal canal. This serves as a form of decompression (such as on the facet and discs) and pain relief by providing more room for the structures and alleviating the pressure on the nerves, and thus also enabling normal motion. Interspinous devices are utilized for spinal stenosis and other causes of low back pain. These spacers allow the anatomy of the spine to remain uncompromised and thus are less invasive than other procedures.

Kyphoplasty & Vertebroplasty

Both of these minimally invasive, non-surgical procedures are used to treat severe spinal fractures that occur as a result of osteoporosis. Kyphoplasty is the newer of the two treatments. It is a minimally invasive procedure that stabilizes the fracture, restores height and corrects deformity. It can alleviate up to 90% of the pain due to compression fractures.

Vertebroplasty is also designed to relieve the pain of compression fractures. Vertebroplasty, which means ‘fixing the vertebral body,’ relieves pain and also strengthens vertebrae that are weakened but not yet fractured.

In both procedures, a cement-like material is injected directly into the weakened or fractured bone. The difference is that kyphoplasty makes use of a balloon to create the space before injecting the cement-like material. There is no bracing following either procedure, and most patients are able to make a relatively quick return to normal activity.

Laminotomy & Laminectomy

Laminotomy and laminectomy are surgical procedures related to the lamina, which is the protective layer of bone covering the spine. Laminotomy is the partial removal of this layer, while a laminectomy is the full removal. These are both decompression procedures, designed to alleviate the pressure on the spinal cord and spinal nerves. These surgical procedures allow access to the spinal canal and are used to treat such conditions as spinal stenosis or to facilitate removal of a herniated disc that is impacting the spinal nerve. In addition to herniated discs, these procedures also facilitate removal of any bone spurs, tumors or compromised (swollen) ligaments—all of which are causes of arm or leg pain.

These procedures, which can be performed at any location along the spine, do not compromise protection of the spine or spinal nerves. That’s because the spinal canal is well protected by muscles and the spinal joint.

Minimally Invasive Spinal Surgery

Minimally invasive spine surgery (MISS) treats a variety of spinal disorders using small incisions and advanced technology through specialized (endoscopic) devices. MISS alleviates the pain and other symptoms with less involved procedures and lessens recovery time. Procedures in this category treat conditions such as degenerative or herniated discs, fracture repair and spinal stenosis.

Scoliosis Surgery

This surgery is designed to treat severe scoliosis (curvature of the spine), to balance the spine and prevent the curve from worsening. It is done by permanently joining the vertebrae, and with the use of spinal rods. These rods are also used with or without the use of fusion. There is both a posterior (back) and anterior (front) approach to the spine in this surgery, depending on the nature and location of the spinal curve. The bone fusion continues to take place following the surgery and can do so for up to a year.

Total Disc Replacement

Total disc replacement replaces a severely degenerated disc with one made of a prosthetic, or artificial one. The artificial version is designed to duplicate the function of a normal disc. In this procedure, the replacement device is placed into the space between vertebrae once all or most of the defective disc tissue is removed.

While traditional surgical treatment for pain caused by damaged discs is spinal fusion, in which bone is placed between involved vertebrae, when artificial discs are indicated, they are designed to facilitate motion following surgery that is as natural as possible.

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