MINIMALLY INVASIVE APPROACH AND MORE OPPORTUNITY OF CARE AND QUICKER HEALINGS

By the ageing of population the persons suffering from spinal column disorders have increased. After the 45 years-old, the 50% of Italian people suffer from back pain many times a year. The backaches, disc herniation lumbosciatics or degenerative stenosis lumbosciatics carrying pain also to lower limbs because of sciatic nerve involvement are very common. The degenerative process compromises the stability of lumbar column, producing a hypermobility condition causing chronic inflammation and pain.

The spinal surgery had got an extraordinary development during the last years. The breakthroughs in implant and instruments technology, the minimally invasive surgery, the computer-assisted surgery are the cornerstones of this development. The possibilities of care of disc herniation, vertebral fractures, scoliosis, kyphosis, spondylolisthesis, multiple discopathies and spinal canal stenosis have multiplied.

Thanks to the long neurosurgical experience of Spinal Surgery Unit in spine disorders treatment, now at Clinica San Francesco is possible to undergo specific treatments for every spinal column compartment, from cervical tract to lumbosacral segment.

The diseases more frequently treated are:

• disc herniation lumbosciatics
• lumbar stenosis
• lumbar spondylolisthesis
• lumbar degenerative discopathies backache
• osteoporotic and vertebral traumatic fractures
• cervical disc herniation cervicobrachialgia
• cervical myelopathies with suffering of spinal corde
• adult lumbar scoliosis

The surgical percutaneous and minimally invasive approaches, spinal microsurgery with operating microscope and the most advanced and innovative materials of vertebral osteosynthesis permit a greater respect and conservation of tissues, translating into more reduced hospitalization and rehabilitation times for the patient.      

Laser Discectomy for lumbar disc herniation

Minimally invasive percutaneous procedure for treatment of contained lumbar disc herniations. It can reach the ill intervertebral disk through the placement of a thin needle, under radiologic control and in local anesthesia. Therefore a state of the art pulsed laser vaporizes the disc herniation component. It is a day hospital procedure and allows a rapid return to the normal job activities in few days.

Microsurgical discectomy for lumbar disc herniation

Specific treatment for extruded disc herniations. It removes the migrated disc herniation through a small cutaneous incision by the operative microscope, and carries out, when it is appropriate, the selective discectomy with removal of ruined disk contents. The procedure is carried out also in local anesthesia and permits an early mobilization with discharge at own home two days after the operation and the return to the normal job activities within 20-30 days.

Vertebral stabilization – Arthrodesis with open or minimally invasive procedure

Surgical procedure for the treatment of serious spinal column problems as degenerative spondylolisthesis, canal stenosis, adult scoliosis, multiple lumbar discopathies. It shows, under a strict intraoperative radiologic control, the placement of titanium screws at every interested vertebra level connected to bars conveniently molded in order to stabilize the pathologic tract of column responsible of chronic pain. The need of nervous structures liberation through the removal of most posterior vertebra part (lamina) or removal of ruined ligaments and thickened between contiguous vertebrae (laminectomy), when it is necessary, can be associated with this procedure.

The most modern technology and the most innovative techniques allow in selected cases to carry out these procedures by minimally invasive way through small cutaneous incisions respecting the cutaneous and muscle soft tissues.

Microsurgical discectomy for cervical disc herniation

Specific treatment for cervical disc herniations determining persistent cervicobrachialgia and refractory to conservative treatment or selective myelopathies of spinal cord compression. It completely removes the cervical disk and the disc herniation through a small cutaneous and right anterior lateral cervical incision and by a high enlargement operative microscope, and substitutes the disk with cervical prosthesis or graft between the vertebral bodies of bone graft named “cage” to preserve the correct height of ruined disk.

The procedure is carried out in general anesthesia and permits an early mobilization with discharge at own home two days after the operation and the return to the normal job activities within 20-30 days.

Postoperative antalgic treatment

In postsurgical phase the patient is followed by an anesthetist who takes care of prevention and treatment of prosthetic painful symptomatology, turning to the most innovative procedures (selective block of nervous branch, peridural tubes, continuous administration of analgesic minidoses, et cetera) and the use of state of the art drugs.