Back and Spinal Surgery
Your spine is one of the most complex areas in your body. It comprises of more than 30 small bones called vertebrae. The vertebrae are held together by muscles, tendons and ligaments and are cushioned by intervertebral discs. Nerves branch out from the spinal cord through openings in the vertebrae and carry messages between the brain and muscles. All these components of your spine can be stressed, injured or affected by disease and result in back pain.
The back and spinal surgery service at Duchy Hospital offers an integrated, multi-disciplinary approach to treating spinal conditions. Our team consists of consultant orthopaedic surgeons, consultant neurosurgeons, consultant anaesthetists, specialist spinal nurses and clinical physiotherapists who provide complete care, from diagnosis to treatment and rehabilitation.
We perform spinal surgeries including: facet joint injections, nerve root decompressions surgery, kyphoplasty and vertebroplasty.
The range of spinal surgeries we offer
Nerve root decompression surgery
Nerve root compression can occur when your vertebral bone or disc put pressure on your nerve root which in turn causes pain. Nerve root decompression surgery or lumbar decompression surgery aims to prevent neural impingement by removing the tissue pressing on the nerve and also to create more room for the nerve to move freely.
Depending upon the source of the impingement your spinal surgeon may decide to perform one or more of the following procedures together:
- laminectomy - removal of the bony roof (vertebral bone called the lamina) covering the nerve root and widening of the spinal canal.
- discectomy - removal of bulging/ruptured disc material pressing on the nerve root.
- spinal fusion – fusing two or more vertebrae together using a graft to prevent the bones pressing on the nerve root.
Discectomy is a type of decompression surgery to relieve neural impingement. It involves removing the damaged part of a bulging or ruptured disc in your spine that is pressing on your spinal nerves.
You have twenty-three vertebral discs in your spinal column. If a disc becomes damaged the soft inside leaks out and can compress the surrounding nerve or nerves or even put pressure on your whole spinal cord. This leads to pain, tingling, numbness and weakness in your back, neck and legs.
Discectomy can be performed as a minimally invasive operation or as open surgery. Normally it’s recommended if non-surgical treatments haven’t reduced your pain.
Vertebral body fractures are cracks in the front part of the vertebrae whilst the back part remains intact. They are often due to osteoporosis. Vertebral body fractures can cause your spine to collapse, compress, shorten and curve forward and you may develop a kyphotic (hunched-over) deformity.
Kyphoplasty is used to treat vertebral body fractures by inserting and inflating a balloon into your vertebra to expand your compressed vertebra to its normal height and then bone cement fills the space created and stabilises your vertebra.
This procedure restores the height of your vertebra and so straightens your spine. This relieves your pain and it will also prevent further fractures.
Vertebroplasty is a minimally invasive technique to treat vertebral compression fractures, often due to osteoporosis. It will stabilise the fracture and in doing so take your pain away.
Using x-ray guidance your spinal surgeon will insert bone cement into your partially compressed vertebra. It’s a similar procedure to kyphoplasty but it doesn’t involve the use of a balloon.
Facet joint injections
The facet joints are on both sides of your spine, in between vertebrae that are next to each other. They offer stability and allow movement in your spine.
Your facet joints may become damaged due to osteoporosis and cause chronic spine pain. Facet joint injections contain a local anaesthetic to numb your pain and steroids to help reduce inflammation and irritation in these joints.
Facet joint injections can also be used diagnostically to determine if your back pain is coming from your facet joints and if you so which one. Once this is established your surgeon will then be able to advise on the best course of treatment.
The following Consultant specialises in back and spinal surgery