The spine is made up of bones, muscles and other important structures (7 cervical vertebrae -neck, 12 thoracic vertebrae –thorax, 5 lumbar vertebrae, the sacrum and the coccyx). The bony part supports the body and protects the spinal cord which in turn controls muscle movement and facilitates the detection of sensations. Spinal pain can be variable and may come in a variety of intensities and forms, depending on its origin. Some of the causes are: disc injuries, spasms, muscle tension, injuries caused by sprains, fractures, accidents, falls, pregnancy, scoliosis, arthritis, infections, tumors, or stress, among others.
Symptoms of lumbar spine problems that may require surgery at some point include: pain that extends from the back to the buttocks or back of the thigh, leg or feet weakness, numbness in the legs, feet or toes and loss of bowel or bladder control.
Traditional lumbar spine surgery is performed under general anesthesia with an incision to remove the bone that surrounds and covers the spinal cord and the tissue, which are putting pressure on the nerve or the spinal cord. The orifice through which the nerve passes can be enlarged to prevent further pressure.
Today, surgeons perform more functional surgeries with better results for their patients through minimally invasive spine surgery, which represents a standard in modern neurosurgery. This type of surgery uses smaller incisions and allows to protect and preserve important structures of the spine, bringing greater benefit to the patient by restoring his capacity and physical performance in less time. In other words, minimally invasive surgery is the achievement of maximum efficiency with the least possible impact on healthy anatomy. One of the most widely used minimally invasive surgery techniques is tubular access using technologies such as the surgical microscope which allows the neurosurgeon to perform complex tasks within the column, via small 2.5 cm long incisions, which contributes to a much faster and much less painful patient recovery.
The spine consists of 23 discs that serve as buffer between each vertebra. The discs get damaged and sometimes misaligned, causing pain and discomfort; this is known as herniated disc. Although most patients with a herniated disc respond well to non-surgical treatments, some require surgery. The most common surgery is a discectomy. This is a surgical procedure that removes all or part of the damaged intervertebral disc. If the problem is in the neck, the procedure is done from below and is called anterior discectomy. Sometimes the surgeon can “create space” for the disc and nerve removing part of the bone covering the nerve. This is called laminectomy.
Recently, surgeons are using less invasive techniques known as “minimally invasive” or “percutaneous” or “micro discectomy”. In these techniques, surgeons perform the entire operation with a small incision or through a tube that allows the insertion of a tiny camera and special surgical instruments. Sometimes the disc is replaced with an artificial disc, although it is more common in the neck than in the lumbar region.