Cervical Spondylotic Myelopathy and Cervical Stenosis
Cervical spondylotic myelopathy (CSM) is a condition in which the spinal cord malfunctions due to compression. It commonly presents as a gait disturbance or loss of coordination of the hands. The cause is cervical spondylosis/ arthritis and secondary stenosis or squeezing of the spinal cord. Common procedures to correct this condition include posterior cervical laminectomy, cervical laminoplasty (with and without fusion), and/or anterior cervical discectomies and fusion. These procedures are aimed at expanding the spinal canal and decompressing the spinal cord. These can often be performed in a minimally-invasive fashion.
Cervical Radiculopathy and Cervical Disc Herniations
Radiculopathy is a common process of malfunction of a cervical nerve root due to mechanical impingement (i.e. disc or bony spur). The disease process generally has a benign natural history. Certain patients who have failed conservative treatment or have shown a progressive neurologic deficiency may be candidates for surgery. The surgical options include anterior cervical disc fusion, as well as posterior foraminotomy. These procedures are quite reliable and result in greater than ninety-five percent of patients having complete relief of their symptoms.
Lumbar Disc Herniations
Sciatica, or radiating leg pain, is a very common symptom complex that is usually caused by mechanical compression on a lumbar nerve root. It is most commonly caused by a disc herniation. In some patients, nonoperative treatments yield excellent short-and long-term results. For patients who have failed all conservative treatments or have developed a progressive neurologic condition, decompressive procedures such as hemi-laminectomy have proven to be successful. Occasionally, a fusion may be required in patients with associated spondylolisthesis or scoliosis. These procedures are only indicated after failure of conservative treatment.
Inflammatory and Cancerous Conditions
These include rheumatoid arthritis, infections, ankylosis, spondylitis and neoplastic diseases including epidural tumors. These diseases cause spinal instability, spinal cord compression, kyphosis and a bony disruption. Treatments are primarily aimed at spinal cord decompression, realignment of the spine and reconstruction of the bony structures to restore stability.
Fractures
Spinal fractures commonly present with spinal cord injury and spinal instability. The Service is on call 24 hours a day for referral of spinal fractures or any level I trauma. Treatment of these injuries commonly involves decompressive and extensive stabilization procedures.
Spondylolisthesis
This is a condition in which two bones are misaligned. This often causes pain from compression of nerves or back pain from abnormal movement of the vertebrae. These are generally treated with decompression and stabilization procedures such as laminectomy and fusion.
