Spinal Fusion Alternatives?
Artificial Disc Replacement
Artificial Disc Replacement in the neck is a groundbreaking procedure, and Dr. Bindal's group was among the first to pioneer this type of surgery as a Spinal Fusion surgery alternative in Houston, Texas. Many surgeons are more comfortable performing Anterior Cervical Fusion, so that is their first, and possibly their only, option. But at The Texas Center for Spine Surgery, surgeons are highly skilled at multiple techniques to offer the best possible solution for their patients. Having performed the first artificial cervical disc replacement in Fort Bend County, Dr. Bindal’s group offers this surgery as an alternative to avoid fusion.
An Artificial Disc Replacement, otherwise known as Cervical Disc Arthroplasty, allows for the removal of the patient's disc and the associated bone spurs or herniation, and repairs decompression of the pinched nerves. The difference from a fusion surgery is that the disc is replaced, instead of the bones being fused together to provide stability in the spine. With a fusion, limited mobility at the surgical site, reducing the potential for chronic pain and adjacent segment disease. There is one caveat, and that is the FDA has only approved this procedure for single-level disc replacement and is more appropriate for younger patients.
Cervical laminoplasty is a second excellent technique to avoid fusion. This procedure involves the reconstruction of the posterior cervical spinal bones, which dramatically increases the size of the spinal canal. A spacer is inserted to give the nerves more room, eliminating the “pinching”, which is frequently the root cause of severe nerve pain. When multilevel conditions of the spine are present, especially spinal compression paired with associated chronic neck discomfort and reduced range of motion, this surgery is a viable option. Cervical laminoplasty can offer better short and long term results, in many cases.
In the lumbar region, spinal fusion can also be avoided with procedures such as a lumbar laminectomy. One of the most common reasons that causes patients to undergo lumbar fusion is lumbar stenosis with degenerative spondylolisthesis. If open surgery is performed, lumbar fusion is a necessity to restabilize the spine because of damage to the spinal elements. In lumbar laminectomy open surgery, weakening of the spine is caused by the destruction of both lamina, spinous process, interspinous ligament, bilateral partial facetectomy and stripping of the muscles.
Dr. Bindal and his team have published groundbreaking research on their innovative surgical techniques. Because the surgeons at The Texas Center for Spine Surgery are highly skilled at minimally invasive spinal surgery, damage during surgery can be avoided. This enables the lumbar laminectomy to be performed without spinal fusion. Other advantages to minimally invasive surgery are less blood loss and postoperative pain, faster recovery, smaller incisions, and reduced tissue destruction.
Minimally invasive bilateral (two sides) laminectomy can now be performed with a unilateral approach (surgery is approached from only one side of the spine). With a unilateral approach, only one spinal lamina is opened. The spinous process and insterspinous ligament are left intact; the procedure is performed without compromising the dorsal lamina, muscles, and facet joints.
The outcome of a minimally invasive, simple laminectomy is no destabilization of the spine. Therefore, in most cases, spinal fusion is not necessary. Dramatically successful surgeries for degenerative spondylolisthesis result in patients recovering faster, with less pain and lower complication rates, than with an open laminectomy and fusion.