|
Minimally Invasive Spinal Surgery
Spinal surgery has been performed in the modern era for almost 100 years, but
remains one of the most confusing or misunderstood and, in some instances,
frightening areas of medicine by the general public. The old saying "never have
back surgery", while an enduring motto for most, is rarely followed by someone
with excruciating back pain, and in a variety of instances for good reason. The
reality is that in many well defined circumstances back surgery can be extremely
gratifying for patients, allowing them to return to a very active and full
lifestyle. The "proof" is in the tremendous growth in the number of spinal
operations performed worldwide over the past 15 years. The reason for such an
increase has been the technological boom in spinal instrumentation, techniques,
devices and medications.
The most important of these factors currently and going forward into the future
is the use of minimally invasive techniques to perform spinal surgery (MIS).
Smaller incisions using tubular "arthroscopic" retractors that split, rather
than cut muscles from their attachment to bone. This preserves the ligaments
and tendons of the adjacent spinal joints, as well as the nerve and blood supply
to these muscles and joints. The result is less tissue damage during surgery,
less scar tissue, much less blood loss and much less pain than using "open"
surgical techniques.
Neurosurgeons at Lyerly Neurosurgery are leaders in minimally invasive spinal
surgery in the state of Florida and nationally, having performed the first
endoscopic removal of a herniated thoracic disc in Florida (1998), one of the
first endoscopic removal of a lumbar and cervical disc herniation in Florida
(the first in Jacksonville) in 1999 and the first minimally invasive lumbar
fusion in Jacksonville 2001 (one of the first in the United States), including
the first 2, 3, and 4 level minimally invasive fusions. We have performed
thousands of minimally invasive cervical and lumber operations of all varieties
(fusion and non-fusion) over the past 7 years and are the undisputed leader in
experience within the region. Members of Lyerly neurosurgery have developed
instruments and techniques used nationally and internationally in MIS. We
likely perform more minimally invasive surgery annually in our group than the
remainder of the spinal surgeons at all hospitals in Jacksonville combined.
The following procedures are the most routine minimally invasive spinal
procedures. Please select one or more to learn more about these techniques.
There are other minimally invasive and non-invasive treatment options used for
other neurological problems. Please click on the procedures below and inquire
about these possibilities during your next visit with the doctor.
-
Lyerly Neurosurgery and MIS. Please click on this link to learn about
the role of Lyerly neurosurgeons and the development of MIS surgery in the
spine.
-
MED: Microendoscopic discectomy. This is the most common MIS procedure
and is typically performed for a ruptured (herniated) lumbar or cervical disc.
-
MELD: Microendoscopic Lumbar Decompression. This typically refers to a
decompresson that is performed bilaterally from a unilateral approach (one
incision on one side) for lumbar stenosis (narrowing of the spinal canal).
-
EFD: Extra-Foraminal Decompression. Occassionally, a disc ruptures
outside the spinal canal and the surgical approach to decompression requires
removing the ruptured fragment from under a spinal nerve after it has left the
spinal canal. This is also called a far-lateral discectomy and is ideally
suited for MIS
-
MIS TLIF: Minimally Invasive Surgical Transforaminal Lumbar Interbody
Fusion. This is a lumbar fusion technique that allows for a unilateral or
bilateral decompression from a unilateral (one-sided) approach with placement of
the interbody stabilizing implant from the same side. TLIF is often performed
with stabilizing screws placed from the same side. A postero-lateral or facet
fusion is typically performed on the contra-lateral side through a 2/3rds inch
incision, although not always (no incision on other side).
-
MIS PLIF: Minimally Invasive Surgical Posterior Lumbar Interbody
Fusion. This is another lumbar fusion technique that allows for bilateral
decompression from bilateral approaches (incisions on both sides of the spine).
PLIF is usually considered when there is nerve compression or spinal canal
narrowing on both sides of the spinal canal. The decompression and fusion
involves the use of rods, screws and intervertebral implants to stabilize the
spine.
-
MIS XLIF: Minimally Invasive Surgical Extreme Lateral Interbody Fusion.
This procedure is one that allows the surgeon to remove the disc and perform a
fusion from a direct lateral, or side approach, It is not necessary to enter
the spinal canal and, therefore, there is less chance of nerve injury or leaving
scar tissue near the nerve(s).
-
Common Conditions treated with MIS procedures.
Questions or Comments?
email: Lyerly Neurosurgery
or call us at (904) 388-6518
|
|
