About spinal infections In most cases, spinal infection is caused when an illness or infection somewhere in the body is carried to a disc in the spinal column. Even when the illness has passed, the infection stays in the disc and spreads to the vertebra bones, causing pain and deformity. ALIF: Anterior Lumbar Interbody Fusion ALIF is generally used to treat back or leg pain caused by degenerative disc disease. The surgeon will stabilize the spine by fusing vertebrae together with bone graft material. Anterior Cervical Discectomy This surgery removes a herniated or diseased disc, and relieves neck and radiating arm pain caused by parts of the disc pressing on nerve roots. The surgeon performs this procedure through an incision on the front of the neck. Anterior Cervical Corpectomy This surgery removes damaged or diseased vertebral bone and surrounding discs, and relieves neck, arm and leg symptoms caused by pressure on the spinal cord and spinal nerves. The surgeon performs this procedure through an incision on the front of the neck. Artificial disc One goal of this procedure is to relieve the pain caused by pinched nerves or discogenic pain in the lumbar spine by replacing a diseased disc with a specialized metal and polyethylene implants. Where back pain begins How herniated discs cause pain. STEP 1 The fibers in the disc wall or annula begin to crack and weaken. STEP 2 The cracks cause radial tears in and around sensitive nerve fibers in the disc wall. STEP 3 The soft nucleus center of the disc pushes through to the outer wall of the annula along the tear. This causes local back pain at the disc level. STEP 4 As the herniated disc pushes through the disc wall, it presses on the large nerve roots creating radiating pain down one or both legs. About Spinal Stenosis Spinal stenosis results from new bone and soft tissue growth on the vertebra, which reduces the space in the spinal canal. When the nerve roots are pinched, a pain, burning, tingling and/or a numbing sensation is felt from the lower back area, down the legs, and sometimes all the way to the feet. Bone Fusion OVERVIEW This procedure corrects the spinal condition caused by spondylolisthesis, or diseased bone. STEP 1 First, the surgeon removes the lamina or the portion of the vertebra that covers the spinal cord. Removing the lamina relieves the spine of some pressure which causes nerve pain. Caudal steroid injection This injection procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. Positioning the patient In this procedure, the patient lays face down. A cushion is placed under the stomach area for comfort and to arch the back. The physician uses a fluoroscope to find the small opening at the base of the sacrum called the sacral hiatus. Cervical Epidural Steroid Injection This injection is administered to relieve pain in the neck, shoulders, and arms caused by pinched nerve(s) in the cervical spine. Conditions such as herniated discs, spinal stenosis, or radiculopathy can compress nerves, causing inflammation and pain. The medication injected helps decrease swelling of the affected nerve(s). Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief. Cervical Laminaplasty For patients with painfully restricted spinal canals in their necks, this procedure immediately relives pressure by creating more space for the spinal cord and roots. The technique is often referred to as an “open door laminaplasty,” because the back of the vertebrae is made to swing open like a door. Cervical Radiculopathy The spinal cord branches out to all parts of the body. The part of a nerve that connects to the spinal cord is called a nerve root. If one of these roots is injured or pinched, pain, weakness, numbness or tingling may be felt in the part of the body served by that nerve. Cervical Posterior Foraminotomy This surgery removes bone and/or portions of a herniated or diseased disc to relieve neck and radiating arm pain caused by parts of the disc pressing on nerve roots. About Degenerative Disc Disease OVERVIEW While disc degeneration is a natural part of the aging process, it may also result from continued injury to the back. These injuries generally develop over a long period of time from activities that push the disc space together. Disc Microsurgery The most common and effective microsurgical technique for the removal of a disc herniation is called a microdiscectomy. The procedure is up to 95% to 98% effective in eliminating leg pain (sciatica) caused by nerve root compression from a disc herniation. This procedure is performed through a small incision on the back. Facet Joint Block Injection Each vertebra in the spine is connected by two facet joints – one on each side of the spine. For back or neck pain believed to originate in these joints, a facet joint block can be both diagnostic and therapeutic. This injection can confirm whether the facet joints are indeed the source of pain and can help relieve the pain and inflammation. Facet Joint Syndrome (Arthritis) The facet joints are bony structures that connect the vertebrae in the spine. Each facet joint is lined with cartilage and surrounded by a lubricating capsule that enables the vertebrae to move freely. Herniated Discs OVERVIEW The nerves leaving the lumbar region join together and travel through the hip as the sciatic nerve. When this nerve is pinched by a herniated disc, a pain, burning, tingling and/or a numbing sensation is felt from the low back area to the foot. Intrathecal Pump Implant Overview An intrathecal pump is used to relieve chronic pain. It uses small amounts of medicine applied directly to the intrathecal space (area surrounding the spinal cord) to prevent pain signals from being perceived by the brain. Pump candidates include people for whom conservative treatments have failed and surgery is not likely to help. Trial procedure Under local anesthetic a catheter is inserted into the intrathecal space by a needle or through a small incision. This is connected to a temporary pump. It will be used for several days to determine if the system will help the patient. If pain decreases during the trial period, Lumbar epidural steroid injection This injection procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However many patients get significant relief from only one or two injections. Lumbar Inter-Body Fusion (IBF) Overview Designed to be a less invasive way to fuse the spine, IBF is generally used for the treatment of back pain caused by degenerative disc disease. When the procedure is performed from the front (anterior) of the spine, a minimally-invasive endoscopic technique may be used. The surgery in the following animation is performed through an anterior approach. Lumbar Radiofrequency Neurotomy OVERVIEW Also called radiofrequency (RF) rhizotomy, this procedure is done to reduce or stop pain in the spinal facets. A slight electric current is used to cut the nerves serving the painful facet joints. This short, minimally invasive procedure is done with local anesthetic. Spine Medial Branch Block This diagnostic procedure is done to determine if a specific facet joint is the source of a patient’s pain. During the procedure, an injection is used to block the nerves serving the painful facet joints. Sacroiliac Joint Steroid Injection This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce the swelling and inflammation. About Scoliosis About two percent of people are affected by a deformation of the spine called scoliosis. Causes While scoliosis can run in families, in most cases the cause is idiopathic, meaning unknown. It often develops before puberty and goes unnoticed because there may be no pain. In adults, scoliosis may develop due to worsening of a slight curvature from childhood, or it could be caused by degenerative diseases of the spine such as kyphosis or osteoperosis. Understanding Spondylolisthesis OVERVIEW Here is a look at the two types of spondylolisthesis conditions known as degenerative and isthmic. DEGENERATIVE STEP 1 In this condition, the joints weaken and become arthritic allowing the vertebra to slip forward. Transforaminal epidural steroid injection This procedure is performed to relieve low back and radiating leg pain. The steroid medication can reduce the swelling and inflammation caused by spinal conditions, such as spinal stenosis, radiculopathy, sciatica and herniated discs. In some cases it may be necessary to repeat the procedure. However many patients get significant relief from only one or two injections. Vertebroplasty Vertebroplasty, a minimally invasive treatment for spine fractures caused by Osteoporosis or cancer, was designed to provide rapid back pain relief and help prevent further weakening of the spine. By stabilizing the fracture, Vertebroplasty quickly resolves pain and restores quality of life. XLIF: Lateral Lumbar Interbody Fusion Unlike traditional back surgery, XLIF is done through the patient’s side. By entering this way, major muscles of the back are avoided. This minimally invasive procedure generally treats leg or back pain caused by degenerative disc disease. It can be done on an outpatient basis.