Decompression is a surgical procedure that aims to free up space for a spinal nerve that is pinched as a result of a herniated disc, spinal stenosis or spondylolisthesis. A decompression surgery involves removing a portion of bone that is putting pressure on the nerve, with the goal of providing more room for the nerve to heal and function.
Spinal fusion is a surgical procedure that aims to decrease back pain or neck pain that is generated by the joints as a result of conditions like degenerative disc disease or spondylolisthesis. During a spinal fusion surgery, bone is grafted to grow between two vertebrae to stop motion at that painful vertebral segment and thus reduce severe pain and functional limitations.
A laminectomy is a surgical procedure that aims to alleviate leg pain and lower back pain as a result of neural impingement caused by lumbar spinal stenosis. A laminectomy involves removing a small portion of bone over the nerve root and/or disc material from under the nerve root to provide more space and a better healing environment for the nerve.
Fracture Repair: Vertebroplasty and Kyphoplasty
Vertebroplasty and kyphoplasty are minimally invasive procedures for treatment of vertebral fractures that are causing severe pain that has not improved after a number of weeks of non-surgical care like pain medications and braces. Both vertebroplasty and kyphoplasty involve a small incision and the injection of bone cement in the fractured vertebra to provide stability; prior to the injection of the bone cement, kyphoplasty involves the use of an inflated balloon to restore fractured vertebrae that have collapsed and become wedged.
Artificial Disc Replacement
Artificial disc replacement surgery is a spinal fusion alternative that aims to replace a painful disc that is causing back pain or neck pain. Artificial disc replacement surgery involves removing the painful, natural disc and inserting an artificial disc that can preserve some of the motion of that spinal element. Closely related, nucleoplasty surgery replaces only the center of the disc (nucleus) while leaving the disc's outer portion (annulus) intact.
Motion Preservation Surgeries
A wide variety of motion preservation devices may be used as alternatives or adjuncts to spinal fusion surgery when treating symptoms of lumbar spinal stenosis, degenerative disc disease or facet pain from osteoarthritis. These devices may include interspinous process spacers (such as the X-STOP) that distract or open the central canal and foramen; posterior dynamic stabilization devices (comprised of screws, cords, rods and/or spacers) that allow for controlled motion and more movement of the spine; and facet replacement or total element replacement devices that respectively replace the facet joints or all of the elements in the back of the spine with the goal of limiting or controlling motion. Many of the motion preservation devices are still under investigation and not yet commercially available.