My last blog discussed common back problems. Sometimes conservative treatment fails and you are faced with the difficult decision of having spine surgery. Such a decision can be daunting because there are a wide variety of surgical procedures. They range from minimally invasive to major surgery. The technical names for the surgery do not always give you a good picture of what the surgeon is recommending. This bolg will define some of the common surgical procedures so that you can make an informed decision, with your surgeon’s guidance, before undergoing surgery.
Intradiscal Electrothermal therapy (IDET) is a minimally invasive non-surgical procedure that is done using fluoroscopy. The surgeon threads a catheter into the disc material. A coil within the catheter is heated which causes a contraction or tightening of the disc fibers. This procedure generally has better success rate in patients under 55 years old, with at least 6 months of back pain which has not responded to conservative treatment and where the pain is localized in the back (without pain going into the legs). Recovery averages 4 months.
A laminectomy also commonly called a laminotomy is a surgery that is designed to relieve pressure on the nerve due to a herniated disc. While these terms are often used interchangeably, they are slightly different. In a laminotomy, part of the lamina or bony arch in the spine is removed. In a laminectomy, most of the lamina is removed. This procedure is used in instances where back pain has not responded to conservative treatment.
A foraminotomy is also designed to relieve pressure on the nerves due to a herniated disc where the nerve root exits the spinal column. It opens up or hallows out a path allowing more room for the nerves to pass through the spinal column. This surgical procedure is often recommended when the pain is in the buttocks or legs.
Discectomy, sometimes referred to as a micro-discectomy, is the removal of all or part of a herniated disc which is touching the nerve. Often times a laminectomy is performed simultaneously. The removal of the bony arch often times allows the surgeon to see the area better. Microdiscectomy, or laser discectomy, also removes the herniated disc material, but the surgeon can make a smaller incision and utilizes a special microscope for a better view. This procedure is used where there is both back pain and pain radiating into the buttocks or legs.
A spinal fusion, or arthrodesis, involves the use of hardware and bone grafts to stabilize the spine. A fusion is indicated when the source of the pain can be identified. A discogram is a diagnostic tool used by surgeons to try to identify where the pain is coming from. Severe degenerative changes, herniated discs and spondylolothesis are conditions that could warrant this drastic procedure. The surgeon uses metal rods and screws and bone grafts to stabilize the spine. This procedure is used where the back and radiating pain are disabling. This link shows what the spine looks like post-operatively.
Articifical disc replacement surgery involves removing the disc that is causing the problem and replacing it with an artificial disc. This type of procedure is relatively new in the United States. It is FDA approved, but some insurance companies still consider this type of surgery experimental and therefore will not cover the procedure. It is generally not recommended for older patients. This link is an example of what the prosthetic device looks like.
Knowing the technical terms for common back surgeries should help you when discussing your options with your surgeon. Some of these procedures are more invasive than others and it is important that you understand what the specific procedure recommended for you is designed to do. Recovery times will vary significantly depending on the procedure, and your overall health and fitness level. Only a well qualified spinal surgeon can help you make the decision that is right for you.
If your back injury is a result of a work related accident, an experienced workers’ compensation attorney will be able to help you obtain all the benefits you are entitled to under the New Jersey workers’ compensation statute, including a monetary award to the extent the injury has a permanent impact on your life. It is important to note that even with an excellent recovery; the spine will never be the same as it was before the accident, which means that you too may be eligible for the monetary award.
At Stark & Stark, we have experienced attorneys ready to help you. Please call us today for a free, no obligation consultation.
Vicki Beyer is a Shareholder in Stark & Stark’s Lawrenceville, New Jersey office, specializing in Workers' Compensation Law. For more information, please contact Ms. Beyer.