Pediatric Orthopedic Services
There are many procedures performed by the Orthopedic Department for minimal access spine surgery, known as key-hole surgery. The surgery is perform though only small incisions using high-tech instrumentation which means that you will have a shorter stay in hospital, reduced post-operative pain and a quicker recovery/healing time.
Before considering spinal surgery, your Orthopedic Doctor will undertake a thorough examination of your spine, your posture and your range of movement. Your Doctor will consider the levels of pain you have, your mobility, your ability to undertake your daily activities and the quality of life you have with your condition. The Orthopedic Doctor may request an MRI scan to view the spine and confirm a diagnosis.
- Many surgical procedures are performed through a minimally invasive technique:-
Discectomy - A disc has two parts; a soft center and a surrounding tough outer ring. If the tough outer ring tears the soft inner can protrude or bulge out. This is a sign of wear and tear of the disc. When the disc protrudes or bulges out, it can cause significant symptoms in the form of pain, numbness and general weakness. The pain can be quite severe and debilitating making walking, standing and bending all quite uncomfortable. A discectomy is a procedure to remove an injured or herniated disc.
Dynamic stabilizationor Instrumented spinal fusion surgery is performed to reduce the pain in your back by reducing the mobility of the affected vertebrae. The vertebrae are fused together with an implant (a graft, a rod or special screws) that replaces the injured intervertebral discs.
Decompression or Percutaneous decompression surgery aims to manage pain by relieving the pressure on the nerves of the spine. The Orthopedic Surgeon will remove a small amount of bone (this procedure is known as a laminectomy) and/or disc to give more room within the spinal canal and to relieve the pressure over the nerve.
- Your Orthopedic Doctor might perform these types of surgery for conditions such as:-
- Spondylolysis, a fracture or defect of the vertebrae often as a result of a stress fracture. This type of injury is common for such as gymnasts, power weight lifters, sportsmen and women.
- Instability, with our natural aging process the intervertebral discs can lose some of the water content and become stiff and flattened. In this state they lose some of their shock absorbing qualities. With this change in the intervertebral discs the vertebrae become unstable and can begin to move slightly back and forth irritating the nerves associated with the spinal column.
- Spondylolisthesis is when one vertebrae moves forward to rest on top of another vertebrae and pinching the nerves. This condition can be as a result of wear and tear of the vertebrae or due to an injury.
- Spinal stenosis is a condition where there is a narrowing of the spinal canal. This may be as a result of a bony spur (a growth of bone) occurring and causing a narrowing, which puts pressure on the nerves. This condition may cause pain in the back that radiates down the legs.
Selective Nerve Block – when a nerve is inflamed or irritated it can cause pain in the back radiating down the legs. A nerve block is an injection to the affected nerve root to numb or anaesthetize the nerve and relieve the symptoms of back pain and leg pain. In most cases, this injection will provide a long term total relief from pain.
Caudal Epidural Injection - The epidural space runs along the outer covering of the spinal cord from the base of the skull down the entire length of the spinal canal. Nerve fibres carrying pain signals to the spinal cord and upto the brain pass along this canal. This treatment involves an injectionof medication to the bottom of the spine that will numb or anaesthetize the nerves. This treatment used in the management of low back pain due to inflammation caused by such as arthritis, injury, sciatica. The effect of this injection provides is a short term relief and allows the Orthopedic Doctor to diagnose more accurately your condition before considering a surgical option. This procedure is usually done as a day procedure and you will be able to leave the hospital the same day.
Facet Joint Injection – a facet joint is a small linking joint in the spine. The facet joints can become painful with arthritis, mechanical stress of the back or with an injury to the back. Your Orthopedic Surgeon will inject medication, usually under x-ray guidance, into the facet joint that will numb the joint and so relieve the pain. This treatment will provide short term relieve from pain. It is usually done as a day procedure and you will be able to leave the hospital the same day.
The effect of this injection provides is usually short term relief but this treatment allows the Orthopedic Doctor to diagnose more accurately your condition. If you respond well to this short term treatment you will be a good candidate for radiofrquency ablation.
Radiofrequency ablation is particularly used for those who have benefitted firstly from injection therapy, which provides only short term pain relief. Heat is applied to affected nerves to destroy the nerve and thus its ability to send signals to the brain. This is a very effective method of giving longer term pain relief to back pain sufferers. It is usually done as a day procedure and you will be able to leave the hospital the same day.
Back pain Management
Your Orthopedic Doctor will request an MRI scan be taken of your spine to give an internal picture of the bones, joints, discs and nerves of the spine. This will help in diagnosing the root of your pain. Procedures to help manage back pain:-