Degenerative Spinal Conditions
Cervical Stenosis
- Laminectomy and fusion
A laminectomy involves removing the posterior bony roof of the spinal canal to provide more room the the spinal cord. A fusion is also performed to maintain optimal spinal alignment.
- Laminoplasty
Laminoplasty involves hinging open the bony roof of the spinal canal. This creates more space for the spinal cord and allows motion between the spinal segments.
Cervical Disc Disease
- Cervical Discectomy and Fusion (ACDF)
ACDF involves approaching the spine from the front of the neck. The disc material at the affected level(s) is removed to release pressure on the spinal cord and/or nerve roots. The disc is replaced with bone graft to create a bony bridge between the vertebral bodies. A plate is often placed on the anterior spine to maintain alignment.
- Cervical Disc Arthroplasty
Disc arthroplasty involves the removal of disc material from the front of the spine and replacement of the natural disk with a manufactured disc made out of metal and plastic. This theoretically allows the disc space to continue to move in a more physiologic manner.
Lumbar Stenosis
- Lumbar Decompression
Lumbar decompression involves the removal of bone and soft tissue from the posterior aspect of the lumbar spine to make more space for the compressed nerves. This can be done in isolation when the decompression does not compromise spinal stability.
- Lumbar Fusion
This is often combined with a decompression. Fusion involves creating a bony bridge between spinal segments using bone graft to prevent motion at that level. Sometimes this is done with bone graft alone, but frequently requires the placement of screws and rods into the spine.
Lumbar Disc Disease
- Lumbar Microdiscectomy
This involves making a incision in the back at the level of the herniated disc. After a small muscular dissection, a window in the bone is made in order retract the compressed nerve and access the herniated disc material. This disc material is then removed in order to decompress the nerve.
- Posterior Lumbar Fusion (PLF)
Fusion involves creating a bony bridge between spinal segments using bone graft to prevent motion at that level. Sometimes this is done with bone graft alone, but frequently also requires the placement of screws and rods in the spine.
- Lumbar Disc Arthroplasty
Disc arthroplasty involves the removal of disc material from the front of the spine and replacement of the natural disk with a manufactured disc made out of metal and plastic. This theoretically allows the disc space to continue to move in a more physiologic manner.
- Lumbar Interbody Fusion (ALIF, DLIF, TLIF, PLIF)
Interbody fusion can be achieved through several different approaches. This involves the removal of disc material and replacement with bone graft to create a bony bridge between the two vertebral bodies.
Spinal Deformity Correction
Spondylolisthesis / Spondylolysis
Spondylolisthesis is the slippage of one vertebra on another. Spondylolysis is the presence of breakage in the bone in the posterior part of the spine. Sometimes, but not always, these conditions require surgical management to help with back and leg pain or progressive deformity.
Scoliosis Correction
Scoliosis is a rotational curvature of the spine causing a lateral bend on X-rays. Scoliosis correction involves straightening this curvature and decreasing spine malrotation.
Kyphosis Correction
Kyphosis causes the spine to ‘hunch’ forward. Correction of kyphosis brings the spine back into alignment to help centre the head and shoulders over the pelvis.
Spinal Osteotomies
This involves breaking the spine and then repositioning it to correct the deformity. This type of procedure is usually reserved for more severe spinal deformities or those that are very rigid.
Spinal Trauma
Management of fractures and ligamentous spine injuries
Spinal Tumors
Management of primary and metastatic spine tumours
General Orthopaedic Trauma Management
Management of acute fractures and acute tendon/ligament injuries
