Minimally Invasive Surgery on the Spine
What you should know before deciding on intervention on the spine.
1.- What Is Disk Herniation and Canal Stenosis?
The spinal column is made up of a group of bone structures (vertebrae) which are articulated through vertebral discs and small posterior joints. Due to the displacement of the disc (disc herniation) or growth (hypertrophy) of these bone structures and ligaments in the region (stenosis canal) a set of painful symptoms may be produced. These are due to the compression within the nervous system (lumbar nerve roots in the case of disc herniation and stenosis in the lumbar column; cervical nerve roots and/or cervical medulla when the problem is in the cervical column).
2.-How Can I Be Sure of the Diagnosis?
Confirming the diagnosis is crucial and of great interest. Many painful symptoms can be confused with disc herniation since they produce similar symptoms. The magnetic resonance examination provides very useful information but does not allow us to rule out other processes which are not related to the spine, neither does it indicate patients who need intervention for disc conditions. A very careful evaluation is necessary from a clinical perspective, paying special attention to the NEUROLOGICAL EXAMINATION.
3.- Is It Always Necessary to Operate when Diagnosed with of Disc Herniation or Spinal Stenosis?
An operation is only necessary in a small number of cases affecting the cervical or lumbar areas. Both clinical and detailed radiology evaluations are vital to establish whether surgical intervention is necessary. A conservative attitude should prevail. In some cases when the nerves are affected and/or when there is intense pain, surgical intervention is unavoidable. In some cases, intermediary procedures can be chosen, such as certain types of infiltration and other specific techniques for the treatment of rachis pain.
4.- If I Need Surgical Intervention, What Is the Appropriate Technique?
Each case requires an individual decision. If the intervention is really necessary, we recommend minimally invasive techniques which are able to solve problems with nerve compression through Microsurgery. These techniques may be applied to disc herniation (lumbar Microdiscectomy), stenosis of the lumbar canal as well as certain types of disc and cervical herniation (discectomy microsurgical through posterior access). Such techniques do not require any kind of metal screws or plates nor inserts. The time the patient is hospitalized is considerably reduced. Metal instrumentation is sometimes necessary but should generally be avoided whenever possible.