SPINE SURGERIES

🧠🦴 SPINE SURGERIES – OVERVIEW

Spine surgeries are performed to treat a wide range of spinal conditions including degenerative diseases, trauma, deformities, tumors, and infections affecting the cervical, thoracic, or lumbar spine.

🔹 Common Indications for Spine Surgery

Condition Examples

Degenerative Disc herniation, spinal stenosis, spondylolisthesis

Trauma Vertebral fractures, dislocations

Deformity Scoliosis, kyphosis

Infection Tuberculosis (Pott's spine), discitis

Tumors Primary or metastatic spinal tumors

Instability Due to degeneration, trauma, or surgery

🔹 Goals of Spine Surgery

Relieve nerve compression (e.g. sciatica, radiculopathy)

Stabilize the spine (internal fixation, fusion)

Correct deformities

Remove pathological tissue (e.g. tumor, abscess)

Restore spinal alignment and function

🔹 Types of Spine Surgeries

1. Discectomy / Microdiscectomy

Indication: Herniated disc compressing nerve root (sciatica, radiculopathy)

Microdiscectomy: Minimally invasive, less muscle damage

Most common in: Lumbar spine

2. Laminectomy / Laminotomy

Laminectomy: Removes lamina to decompress spinal canal (for spinal stenosis)

Laminotomy: Partial removal (more conservative)

Common in lumbar and cervical stenosis

3. Spinal Fusion

Indication: Instability (e.g., spondylolisthesis, fractures, severe degeneration)

Joins two or more vertebrae using bone grafts + hardware (screws/rods/plates)

Can be:

PLIF (Posterior Lumbar Interbody Fusion)

TLIF (Transforaminal Lumbar Interbody Fusion)

ALIF (Anterior Lumbar Interbody Fusion)

ACDF (Anterior Cervical Discectomy and Fusion)

4. Vertebroplasty / Kyphoplasty

Indication: Osteoporotic vertebral compression fractures

Vertebroplasty: Injection of bone cement into vertebral body

Kyphoplasty: Balloon inflation before cement injection to restore height

5. Deformity Correction

For scoliosis or kyphosis

Involves long-segment instrumentation and fusion

May use pedicle screws, rods, osteotomies

6. Spinal Tumor Surgery

Decompression ± excision of tumor

May involve spinal stabilization or reconstruction

Requires multidisciplinary planning (oncology, radiology)

7. Endoscopic Spine Surgery (MISS)

Minimally invasive alternative for discectomy, decompression

Uses tubular retractors and cameras

Reduced pain and quicker recovery

🔹 Spinal Levels & Surgeries

Region Common Surgeries

Cervical ACDF, cervical laminectomy, posterior fixation

Thoracic Discectomy, corpectomy (e.g. for TB/tumor), deformity correction

Lumbar Discectomy, TLIF, laminectomy, vertebroplasty

🔹 Risks and Complications

Infection

Nerve injury

Dural tear → CSF leak

Implant failure

Adjacent segment degeneration

Nonunion (in fusion cases)

Persistent pain (Failed Back Surgery Syndrome)

🔹 Rehabilitation & Recovery

Early mobilization (especially after MISS)

Bracing if needed

Physiotherapy: core strengthening, posture correction

Gradual return to activity

🔹 Advances in Spine Surgery

✅ Minimally Invasive Spine Surgery (MISS)

✅ Robotic-assisted spine surgery

✅ Intraoperative navigation & neuromonitoring

✅ Biologics for fusion (e.g. BMPs)

✅ Artificial disc replacement (motion-preserving alternative)

🔹 Summary Chart

Surgery Indication Approach Invasiveness

Discectomy Herniated disc Posterior Conventional or minimally invasive

Laminectomy Spinal stenosis Posterior Open or minimal

Fusion (e.g. TLIF) Instability, degeneration Anterior/Posterior Moderate–high

Vertebroplasty Compression fracture Percutaneous Minimally invasive

Tumor excision Spinal tumors Any Variable