Surgical Approach to Stabilize Spine & Relieve Compressed Nerve
Which surgical approach is best for stabilizing your spine and relieving your compressed nerve?
Spine surgery is intended to either stabilize the segments of the spine and / or take pressure off of a compressed nerve. Depending on the type and location of the problem, a posterior (back side), anterior (front side), or lateral (flank side) approach may be recommended to you. Regardless of the approach, the purpose of the surgery is to stabilize and decompress with the least amount of muscle and ligament injury as possible.
Questions to ask?
- Can the surgery be completed through one incision, either anterior, posterior, or lateral?
- If two incisions are being recommended, why can this not be done through another approach with a single incision? (It may be necessary to do two incisions in some cases)
The posterior approach is very similar in the neck (cervical), mid back (thoracic), or low back (lumbar) spine with the patient face down on a well-padded support. The spine is approached by through an incision and then a division of the muscle to allow visualization of the spine. Minimally invasive approaches differ here, where some take the supporting muscle (multifidus) off the spine and others leave the muscle attached and work between the fibers.
In the thoracic and lumbar spine stabilization and decompression to relieve the compressed nerve can usually be completed through this approach. In the cervical spine, the posterior approach allows decompression of the nerve in some cases, but no access to the disc that lies in front of the spinal cord.
The anterior approach to the cervical spine is often needed as the spinal cord cannot be moved and this approach allows a near full view of the disc and nerve roots, so that either an artificial disc or fusion combined with nerve decompression can be performed. This approach is usually much less painful after surgery when compared to the posterior cervical approach.
The anterior approach to the lumbar spine allows a complete view of the disc and is necessary for artificial disc replacement surgery and can be the best choice for a fusion surgery. From this anterior approach it is not possible to completely take pressure off of the compressed nerve in the posterior (back) portion of the lumbar spine.
The far lateral approach is possible in the lumbar spine, sometimes in the thoracic spine, and is not used in the cervical spine. With the patient on their side, the spine is approached behind the abdominal contents, with a minimally invasive incision and allows for removal of the disc and fusion of the spine. The technique can help with decompressing the nerves by stretching the vertebral bodies apart, and making more room. Oftentimes, after the lateral approach fusion is complete a second posterior surgery is needed to complete stabilizing the spine.
Dr. Keenen at Pacific Spine Specialists can help you determine the best surgical approach for your spine care, request an appointment today.