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Surgery

Spine Center > Surgery

Microscope decompression and Interspinous Soft Stabilization (ISS)

Indications

  • Patients with spinal stenosis
  • Patients suffering from lumbar disc herniation along with spinal instabilities
  • Aged patients suffering from spinal stenosis
  • Patients with spinal or foraminal stenosis
  • Patients with recurrent lumbar disc herniation
  • Patients with spondylolisthesis (G1 or below)

Procedure

  • General anesthesia administered
  • Incise the skin for about 4.5cm in the middle of the lower back. Exfoliate the muscle partially and remove the ligament to decompress the nerves.
  • Remove the interspinous ligaments and insert a locker which strengthens spinal structure. Then, tie it with artificial ligaments.

Advantages

  • Reduction of complications caused by conventional spinal stenosis surgery (transfusion-free surgery)
  • Normal spinal structures are kept intact as much as possible.
  • No bone transplantation or screw fixation required
  • Applicable to elderly people
  • Normal lower back movement through rehab after surgery
  • About 1-hour surgery / 4-day hospital stay required

Before and after pictures

In the photo before the surgery, nerves in the lumbar vertebrae 4-5 are compressed. In the post-surgery picture, nerves look normal through the elimination of the ligament which caused spinal stenosis.

In the photo before the surgery, nerves in the lumbar vertebrae 4-5 are thin because of thick ligament. In the post-surgery picture, nerves look normal through the elimination of the ligament which caused spinal stenosis.

To make up for the weak spinal structure after removing the thick ligament, a locker was inserted.

Anterior and posterior spinal fusion

Indications

  • Patients with spondylolisthesis in which bones are not in line
  • Patient with degenerative disc which causes chronic back pain because of narrow disc space
  • Patients with recurrent lumbar disc herniation
  • Patients with foraminal stenosis along with narrow intervertebral space
  • Patients with discitis
  • Aged patients with spondylolisthesis

Procedure

  • General anesthesia administered
  • Incise the skin in the abdomen for about 5cm and approach the posterior abdominal cavity. Then, expose the disc to be operated.
  • Remove all damaged discs and align the bones in normal position. Transplant the artificial bone.
  • Make the patient lying face-down. Incise the skin for about 1cm in four spots and fix the spine with screws.

Advantages

  • Approach the disc from the front (abdomen)→easy to align the discs
  • Minimum scars on the abdomen and on the back→no transfusion needed
  • Indirect decompression of nerves without touching them → no damage on the nerves and reduction of possibility of nerve adherence → less postsurgical pain
  • About 1-week hospital stay required
  • Screws are fixed without incising spinal muscle tissues → spinal muscles kept intact as much as possible

Before and after pictures

In the X-ray image before the surgery, the 4th and 5th lumbar vertebrae are not in line. According to X-ray picture after the surgery, the 4th and 5th lumbar vertebrae are in normal position with artificial bones and screws.

Artificial disc replacement for lumbar degenerative disc disease

Indications

  • Patients with recurrent lumbar disc herniation
  • Patients with degenerative disc which causes chronic pain

Procedure

  • General anesthesia administered
  • Incise the skin in the abdomen for about 5cm and approach the posterior abdominal cavity. Then, expose the disc to be operated.
  • Remove all damaged discs and inject artificial disc between vertebrae. Finish the surgery.

Advantages

  • Removal of the disc by approaching it from the front (abdomen)  tissues on the lower back kept intact
  • The damaged disc replaced with an artificial one → lower back joint stays soft
  • About 1 hour and 30 minute surgery / a patient can walk on the following day / 4-day hospital stay required / fast return back to daily routine
  • Almost no bleeding / no transfusion required
  • Minimization of degenerative changes in the adjacent parts, which can occur in the event of fusion
  • No recurrence

Before and after pictures

Degenerative disc was found in lumbar vertebrae 4-5 and between the 5th lumbar vertebrae and 1st sacral vertebra. The degenerative disc was replaced with an artificial one.

Cervical ADR

Indications

  • Patients with cervical disc herniation

Procedure

  • General anesthesia administered
  • Incise the skin in the front neck for 5cm and exfoliate the muscle.
  • Eliminate all damaged discs using the microscope.
  • Insert the artificial disc into the disc-removed space and finish the surgery.

Advantages

  • Herniated disc replaced with an artificial one → lower back joint stays soft
  • About 1 hour and 30 minute surgery / a patient can walk on the following day / 2 to 3-day hospital stay required / fast return back to daily routine
  • Almost no bleeding → no transfusion-related side effects
  • Minimization of degenerative changes in the adjacent parts, which can occur in the event of fusion

X-ray pictures after surgery

The discs between the 5th and 6th cervical vertebrae are all removed, and artificial discs are injected.

Cervical microforaminotomy

Indications

  • Patients with cervical disc herniation
  • Patients with cervical foraminal stenosis caused by excessive hypertrophy of neck joints or ligament
  • Patients suffering from nerve compression caused by ossification of posterior ligament

Procedure

  • General anesthesia administered
  • Incise the skin on the beck for about 4m and exfoliate the muscle.
  • Remove all damaged discs using the microscope.
  • Inject the artificial bone into the disc-removed space and finish the surgery.

Advantages and disadvantages

  • All damaged discs removed → no possibility of recurrence
  • Bone fusion after the surgery → a frame should be put on for a while
  • About 1 hour and 30 minute surgery / a patient can walk on the day of surgery / 2 to 3-day hospital stay required
  • Almost no bleeding → no transfusion-related side effects

Before and after pictures

According to the 1st picture, spinal cord compression caused by ruptured disc is observed between the 5th and 6th cervical vertebrae. However, the spinal cord is sufficiently decompressed after surgery. In the 3rd picture, discs between the 5th and 6th cervical vertebrae are removed and filled with artificial bone.

Open laser-assisted micro discectomy

Indications

  • Patients suffering lumbar disc herniation with pain in the legs and in the lower back
  • Patients suffering from lumbar disc herniation along with spinal stenosis
  • Patients suffering from lumbar disc herniation with neurologic abnormalities such as numb legs, abnormal sense and elimination disorder
  • Patients with disc ruptures
  • Patients with recurrence of lumbar disc herniation
  • Patients with intervertebral disc calcification

Procedure

  • General anesthesia administered
  • A patient lies face down.
  • Incise the skin for about 1.5cm in the middle of the lower back. Exfoliate the muscle partially and remove the herniated disc using laser.

Advantages

  • Using the surgical microscope, the structure around the nerves can be identified in detail.
  • Little scar (1.5cm)→minor damage on normal tissues
  • Reduction of recurrence rates by treating the degenerative discs with laser
  • Almost no bleeding
  • Less than 1-hour surgery / a patient can walk in four (4) hours after the surgery / 2 to 3-day hospital stay required

Before and after pictures

According to the 1st picture, spinal cord compression caused by ruptured disc is observed between the 5th and 6th cervical vertebrae. However, the spinal cord is sufficiently decompressed after surgery. In the 3rd picture, discs between the 5th and 6th cervical vertebrae are removed and filled with artificial bone.

In the 1st picture, the nerves in the middle have a crescent shape due to the herniated disk. In the picture after surgery, however, they have a normal round shape.

Spine correction for LDK patients

Indications

  • Leaning forward when walking → need to carry a stick or push a stroller
  • Hard to walk up the stairs without holding the rail
  • When washing the dishes, elbow is rested on the sink.
  • A callus forms in the elbow.
  • When carrying something in my hands, it is hard to walk.

Procedure

  • General anesthesia administered
  • In general, surgery is performed in two stages.
  • In the first stage, approach the damaged disc from the abdomen and remove it. Then, fill the space with the artificial bone.
  • The 2nd surgery is performed in 3-5 days depending on the patient's conditions.
  • During the 2nd stage, fix the spine with screws in the back.
  • If necessary, nerve decompression is performed during the 2nd surgery.

Advantages

  • Surgery is performed in two stages, approaching the disc from the abdomen and from the back each → mitigation of risk from the long operation
  • When walking, the body does not lean forward.
  • Even though a patient is suffering from osteoporosis, the surgery can be performed because a hazard-free cement mixture is used.

Before and after photos

In the 1st photo, narrow disc space caused by degenerative changes is found in the lumbar vertebrae 3-4 and between the 5th lumbar vertebra and 1st sacral vertebra. In addition, no normal curve is observed in the lumbar area.

In the 2nd photo, a normal curve is formed in the lumbar area through screw fixation using artificial bone and cement.