At Camelback Spine care, we are one of the few medical centers that can offer same day outpatient procedures with the same quality and care provided to more advanced surgical treatments. With the innovations and modern techniques available to select surgeons today, Camelback Spine is proud to offer these treatments that allow the patient to go home the same day the treatment is done! This means getting back to enjoying the life and mobility you deserve. Call Camelback Spine Care today if you feel that these same day treatment options are right for you.
A laminectomy is typically performed to alleviate pain from lumbar spinal stenosis.
Spinal stenosis is caused by degenerative changes that lead to enlargement of the facet joints in the back of the vertebrae.
The enlarged joints and related degenerative changes place pressure on the nerve roots as they exit the spine.
Each vertebra has two portions of vertebral bone over the nerve roots in the back of the spine. These small flat bones are called the lamina.
The lamina functions as a protective covering of the spinal canal. In the lower back, they protect the cauda equina, the nerve roots that branch off of the spinal cord, as well as the nerve roots as they exit the spine.
Most people report measurable improvement in their symptoms after laminectomy, particularly a decrease in pain that radiates down the leg or arm. But this benefit may lessen over time if you have a particularly aggressive form of arthritis. Laminectomy is less likely to improve pain in the back itself.
A follow up appointment with Dr Bedi will lead to a better assessment of your procedure, as all results vary from patient to patient.
The coflexTM device can be used to treat LSS and is a single-piece titanium implant that is stable, strong, and flexible enough to give your spine the support it needs. It provides spinal stability without the invasiveness and loss of mobility associated with spinal fusion. If you or a loved one is recommended for the coflexTM procedure, the spine surgeon may choose to perform the procedure in an outpatient setting where patients can experience better outcomes, lower infection rates, cost savings, and more personalized service.
The coflexTM procedure can be performed in an outpatient setting. However, you should arrange for someone to drive you, and to help during the first few hours of your recovery after surgery.
Decompression surgery involves removing the pressure on the nerves that causes pain. After undergoing decompression surgery, Dr Bedi will insert the coflexTM device through the incision made for the decompression. The coflexTM device is positioned on your lamina, which is the strongest bone in the back of your spine. On average, the entire procedure, including decompression and the implantation of the coflexTM device, usually takes less than 2 hours.
When you wake from recovery, you may be encouraged to get up and walk almost immediately, taking into consideration your overall health at the time of surgery. Since there is no fusion, and therefore no healing bone to wait for, you’ll most likely be able to do this right after your procedure. You’ll notice that your pain has been significantly relieved, and your spine should feel stable and strong. Most patients do need to wait several days following the surgery for the incision wound to heal.
In the weeks and months following surgery, your recovery depends on a number of factors, including the degree of your stenosis and the extent of the decompression that was performed. Most patients are able to return to normal activity, and even expanded activity such as golf, cycling, or gardening, within weeks of the surgery. Some patients may require physical therapy to help with mobility and flexibility.
Typically performed for a herniated disc, a microdiscectomy relieves the pressure on a spinal nerve root by removing the material causing the pain.
A microdiscectomy is generally considered the gold standard for removing the herniated portion of a disc that is pressing on a nerve, as the procedure has a long history and many spine surgeons have extensive expertise in this approach. A microdiscectomy is generally considered a minimally invasive surgery, as there is minimal disruption of the tissues and structures in the lower back.
A microdiscectomy is performed through a 1 to 1½-inch incision in the midline of the low back.
First, the back muscles (erector spinae) are lifted off the bony arch (lamina) of the spine and moved to the side. Since these back muscles run vertically, they are held to the side with a retractor during the surgery; they do not need to be cut.
The nerve root is gently moved to the side.
Dr Bedi uses small instruments to go under the nerve root and remove the fragments of disc material that have extruded out of the disc.
In a microdiscectomy, only the small portion of the disc that has herniated—or leaked out of the disc—is removed; the majority of the disc is left as is.
The total procedure takes about 1 hour for Dr. Bedi to complete. Patients are generally permitted to go home that same day, but patients will be advised by physical and occupational therapists on proper in-home techniques before being discharged. Patients are generally instructed to avoid bending too much at the waist and to refrain from lifting heavy things for the first couple weeks. This, along with teaching of proper techniques of getting in an out of bed and using the restroom will avoid straining the injury. Patients should also avoid sitting for longer periods of time for the first couple of weeks after surgery.
Dr. Bedi may recommend a back brace after the procedure or a soft lumbar corset to provide additional lumbar support. The wound are is left clean and open without any surgical dressing or bandages required. Patients will be able to return to bathing within a day or two after the procedure and other routines such as driving and retiring to work are possible in just a few days or week after the procedure. Dr. Bedi will advise of a follow up procedure with the patient about 2 weeks after surgery to see how recovery is going.
Spinal cord stimulation is used most often after nonsurgical pain treatment options have failed to provide sufficient relief. Spinal cord stimulators may be used to treat or manage different types of chronic pain, including:
Spinal cord stimulation can improve overall quality of life and sleep, and reduce the need for pain medicines. It is typically used along with other pain management treatments, including medications, exercise, physical therapy and relaxation methods. Several kinds of spinal cord stimulation systems are available. The units that are more commonly used are fully implanted and have a pulse generator, which is like a battery. Most of the newer devices feature a rechargeable pulse generator system that can be easily charged through the skin. There are also some pulse generators that are fully implanted that do not require recharging, but last a shorter time before they need to get replaced. Another system includes an antenna, transmitter, and a receiver that relies upon radio frequency to power the device. In these systems, the antenna and transmitter are carried outside the body, while the receiver is implanted inside the body. Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed. Spinal cord stimulation, also called neurostimulation, directs mild electrical pulses to interfere with pain messages reaching the brain. A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.
During spinal cord stimulation, a device that delivers the electrical signals is implanted in the body through a needle placed in the back near the spinal cord. A small incision is then made to place the pulse generator in the upper buttock. The patient may turn the current off and on or adjust the intensity of the signals. Some devices cause what’s described as a pleasant, tingling sensation while others do not. Research shows that newer devices may change the sensation of pain by potentially altering the balance of cells that deliver pain in the spinal cord. During the permanent implantation procedure, the generator is placed underneath the skin and the trial electrodes are replaced with sterile electrodes. Unlike the trial electrodes, these will be anchored by sutures to minimize movement. The implantation can take about 1-2 hours and is typically performed as an outpatient procedure.
After the local anesthesia has been administered, your surgeon will make one incision (typically along your lower abdomen or buttocks) to hold the generator and another incision (along your spine) to insert the permanent electrodes. The incisions are about the length of a credit card. Once the electrodes and generator are connected and running, Dr Bedi will close the incisions.
Generally, the pain relief provided by spinal cord stimulators allows patients to do much more than they could before surgery, but there are certain restrictions to be mindful of.
MRIs are not always safe for those with spinal cord stimulation devices!! Some newer devices are compatible with certain MRI machine models and scan locations, but your doctor will need to evaluate the specifics of your stimulator first. If your device is not MRI compatible, MRIs can cause serious injury. You should power off your stimulator when you’re driving or operating heavy machinery, as sudden changes in stimulation levels could cause distraction. Swimming is fine with a permanent, implanted generator, but you cannot get your temporary stimulator wet. You will need to avoid baths and showers during that short trial period. A spinal cord stimulator can be removed safely if you are unsatisfied with the level of pain relief it provides or if there is an infection or mechanical problem with your system
The natural cervical intervertebral disc is a remarkable mechanical structure from an engineering perspective. It has the ability to absorb a large compressive load while still providing an impressive range of motion between the bones in the neck. Duplicating the natural disc's form and function with an artificial disc is challenging. However, several artificial cervical discs have been developed and are available as a surgical option to treat cervical disc problems that cause chronic neck pain and other symptoms, such as arm pain or weakness.
Before having cervical disc replacement surgery, the surgeon typically requests the following of the patient in the weeks leading up to the procedure:
A single-level cervical ADR surgery commonly involves the following steps:
After cervical artificial disc replacement surgery, most patients go home the same day whereas others spend a night in the hospital. During this short stay in the hospital, the patient receives:
A Kyphoplasty procedure is an outpatient surgical procedure that treats small breaks and fractures in the vertebra that make up the spine. Without treatment or surgical procedures, these fractures can curve and shorten the spine.
With Dr. Bedi and his advanced team, they are able to complete this complex procedure that is designed to stop the pain caused by a spinal fracture, without the need for a hospital setting. Besides stopping the pain, Dr. Bedi will stabilize the bone and restore some of the lost vertebral body height due to compression and spinal fractures. This minimally invasive surgery is performed through a small skin puncture rather than an incision and typically can be performed within 1-2 hours.
During the kyphoplasty procedure, the back is cleaned and prepped for where Dr. Bedi will place the needle to puncture the skin. Local anesthesia and mild sedation is applied although the patient will remain awake during the procedure. Once the small incision is made in the back, the tube is placed cloth the path through the vertebra, and into the fractured area.
A specialized ballon will then be inserted throughthe tube and into the fractured vertebra to be inflated. The inflating ballon creates a soft inner bone support for the fractured vertebra allowing it to return to normal height. Once the ballon is removed, the cavity of the damaged vertebra will be willed with a cement like material that will quickly harden and mimic the natural bone structure.
After a Kyphoplasty procedure, Dr. Bedi will monitor the patient in the recovery area for a couple of hours. If there are no complications during this time period, then the patient is typically allowed to go home with the assistance of someone. Patients are not recommended to drive home themselves. Although relief for most patients may be immediate, others may feel a gradual reduction in pain through time.
This type of out patient procedure allows for patients to return to their normal routines almost immediately, but are limited to non strenuous activities for 4-6 weeks. Dr. Bedi will follow up with the patient through virtual or in person setting a few weeks after the procedure is done, to see how the patient is recovering.
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