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Compression of nerves or spinal cord is usually caused by disc material or bony spurs.
In an anterior cervical decompression and fusion procedure the approach is from the front of the neck . The procedure involves removal of disc and/or bone mass. The resulting cavity is then filled with a bone graft from the hip. Sometimes screws and plates are used to hold the structure in place.
Posterior cervical decompression is done if there is significant compression on the spinal cord from bone spurs from the joints in the back of the neck or because of thickening of ligaments that are found on the back of the spine. Normally, this procedure is combined with a fusion and/or an anterior approach.
Lumbar laminectomy is a surgical incision into the backbone to obtain access to the spinal cord. It is used to treat herniated intervertebral discs, or to relieve pressure on a spinal nerve, which occurs when spinal nerves are pinched by a narrowing of the spinal canal.
A small incision is made in the lower back in order for the surgeon to see the pinched spinal nerves and/or the compressed cauda equina. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves. This procedure is also used to remove tumours.
Spinal fusion is a procedure which joins or ‘fuses’ one or more of the vertebrae of the spine in order to prevent any motion between them. Bone grafts are placed around the spine during the fusion procedure. The grafts, after several months of healing and growth in the surgery site, weld the vertebrae together.
Fusion is considered in the following situations: fractured vertebra associated with spinal cord or nerve injury, deformities of the spine (scoliosis or spondylolisthesis), friction & pain caused by movement, cervical disc herniations and abnormal or excessive motion between two or more vertebrae
A spinal tumor is a cancerous or non-cancerous growth within or near the spinal cord or in the bones of the spine. The physical mass of the growth can impinge on nerves in the spinal region causing pain, neurological problems and even paralysis, in extreme cases.
Diagnosis is done on the basis of medical history and physical examination followed by MRI, CT , myelogram, positron emission tomography (PET scans) and nuclear medicine bone scans A biopsy will be done to determine if the growth is malignant and will also help in staging the cancer if the tumour is malignant.
Surgery is a good option in treating: - Tumors that can be removed with a minimal risk of nerve damage. - Intramedullary and intradural-extramedullary tumors - Benign tumors in the vertebrae
When a tumor has metastasized to the spine, radiation is usually the treatment of choice
Surgical stabilization of the spine may be required to correct any instability caused either by the tumor or by the surgery to remove it. The surgical approach may be the neck, chest or abdomen.
Recovery from surgery depends on the nature and extent of surgery. In most cases, hospital stay would be in the range of 7-12 days, with recuperation over several weeks.
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