Other Treatments

Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure that removes damaged, degenerated or herniated discs from the neck. Once the affected disc is removed, the adjacent vertebrae are fused to ensure spinal stability. It’s an “anterior” procedure because the surgeon creates an incision on the front of the neck to access the cervical disc.

The ACDF procedure is conducted under general anesthesia. The front of the neck is cleansed and prepared for surgery. Dr. McHugh creates an incision on the front of the neck, either the left or the right side. After creating the incision, the surgeon moves the muscles and tissues aside to access the affected intervertebral disc, visible through fluoroscopy.

Dr. McHugh uses specialized surgical instruments to remove the affected or ruptured disc or its fragments, including the bone spurs and herniated disc fragments causing nerve compression. Removing the bone spurs and herniation fragments take the pressure off the spinal nerve roots. Next, the surgeon plants bone grafting material into the cavity to encourage bone growth.

Bone grafting material can be derived from the patient’s own body, a donor bank, or other synthetic materials. The bone grafting material is attached to a metal plate and placed within the cavity. Over time, your bone grows around the bone grafting material, fusing the two vertebrae for optimal stability.

man with neck pain

Anterior Lumbar Interbody Fusion

Anterior lumbar interbody fusion (ALIF) is minimally invasive spine surgery used to treat lumbar (lower back) spine disorders, such as degenerative disc disease and spondylolisthesis, i.e., spinal problems that cause spinal nerve compression and instability. The compression of the spinal nerves in the lumbar region leads to radiating pains in the lower back, buttocks, and leg pain, often accompanied by numbness, tingling, and muscle weakness. The ALIF procedure’s primary goal is to decompress the nerve roots and stabilize the lumbar spine to relieve the symptoms.

ALIF is a spine surgery wherein the surgeon accesses the lumbar spine via an incision on the abdomen, either on the left or right side. After accessing the lumbar spine, the surgeon inserts bone grafting material and specialized instruments into the empty space between two vertebrae, stabilizing the lower back. The implant devices, such as the cages, plates, and screws, temporarily immobilize the lower back. The bone grafting material encourages natural bone growth in and around the implants, leading to long-term spinal fusion and recovery.

Kyphoplasty

Kyphoplasty is a minimally invasive spine surgery used to treat vertebral compression fractures. Popularly called spinal fractures, VCFs occur because of osteoporosis, cancer, and other conditions that weaken your bones, increasing the likelihood of fractures. A single fracture on the spinal column can destabilize the entire spinal structure, leading to additional spinal fractures.

Balloon kyphoplasty is a cutting-edge minimally invasive spine surgery that restores optimal spinal alignment without open surgeries or external hardware. The specific details of the procedure differ for each individual, but they always involve inflating a balloon within a vertebra to create space for the bone cement. The procedure restores spinal height while also addressing abnormal curvatures.

During the kyphoplasty surgery, Dr. McHugh creates two incisions on either side of the spine to insert a hollow tube into the affected spinal bone under fluoroscopic guidance. Small orthopedic balloons are transferred through the tubes and inflated within the vertebra. Inflating the orthopedic balloons lifts the vertebral body, restoring natural spinal anatomy.

The balloons are deflated and removed once the vertebra is restored. Finally, the surgeon fills the empty void with bone cement that quickly hardens in place, creating an internal cast for spinal stability. Depending on the level of spinal fractures, the procedure may conclude within an hour, and you can return home either the same or the next day.

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Laminoforaminotomy

Laminoforaminotomy is a spine surgery that treats cervical radiculopathy, i.e., neck pain radiating into the upper back, shoulders, and arms. The laminoforaminotomy procedure involves creating a small window in the lamina, a thin plate of bone at the back of the neck, removing the disc and fractured bone spurs responsible for nerve compression. Removing the disc and bone spurs enhances the neuroforamen, i.e., the space on either side of a disc, and decompresses the nerve roots. Dr. McHugh may recommend laminoforaminotomy if non-operative treatments fail to yield the desired results.

Dr. McHugh performs laminoforaminotomy under general anesthesia. Your neck is shaved, cleansed, and prepared for the surgery while you lie face-down on the surgical table. Your head is held firmly, and a specialized instrument is used to immobilize your neck. A computerized system is used to monitor your nerves and spinal cord throughout the procedure to ensure optimal safety. Dr. McHugh creates an incision on the back of the neck while using fluoroscopic images to monitor your anatomy. A part of the lamina is removed to access the underlying tissues causing nerve compression. Dr. McHugh removes all the tissues crowding or compressing the nerve roots, and the wound is finally closed.

Laminoplasty

Laminoplasty is a minimally invasive spine surgery that treats spinal problems occurring due to spinal cord compression, such as myelopathy, spinal dysfunction, etc. The procedure is performed on the cervical spine, i.e., the vertebrae on the neck region. It involves creating a hinge on the lamina, the uppermost plate over the spinal column, to create space within the spinal canal. Specialized instruments are then planted within the opened section to bridge the gap and ensure optimal spinal stability. It’s different from other similar surgeries because the lamina isn’t removed, either completely or partially.

Dr. McHugh performs laminoplasty under general anesthesia. After cleaning and preparing the neck and back, a specializing computer is used to monitor your spinal cord and nerves throughout the procedure, minimizing the risk of cord injury. The surgeon creates a small incision on the back of the neck, either on the right or left side of the lamina. The lamina is then scored, cut, and pulled back to create a small hinge on both sides. Disc material, bone spurs, and other components placing pressure on the nerve roots are removed. The surgeon prepares an implant made of metal or bone, which is then secured in the correct position to ensure spinal alignment. The wound is sutured and allowed to heal.

Selective Endoscopic Discectomy

Selective endoscopic discectomy is a minimally invasive spine surgery that relieves pain caused by nerve root compression due to herniated discs. The procedure is performed via a small tubular device (endoscope) under local or epidural anesthesia. What makes this procedure unique is that it’s performed through a keyhole incision, using the visual feed from a small camera in the endoscope for guidance. Selective endoscopic discectomy is one of the best treatments to remove a herniated disc because it involves tiny incisions, minimal tissue disruption, and minimal loss of blood.

After delivering local or epidural anesthesia, your back is cleansed and prepared for the surgery. Dr. McHugh inserts a small needle into the affected disc under fluoroscopic guidance. He creates a small incision, through which he inserts a dilation tube and an endoscope. Tiny, specialized instruments are moved through the endoscope to perform the surgery. Dr. McHugh may also use a laser probe to remove or shrink the disc, decompressing the nerve roots. It takes 30 to 60 minutes to work on a single disc, so the entire procedure concludes within a few hours, depending on the number of affected discs. Once the procedure is done, the incision is dressed and closed.

Spondylolisthesis Surgery

Spondylolisthesis is a condition wherein one of the vertebrae dislocates, slipping forward or over the next vertebra. If left untreated, spondylolisthesis leads to severe pain and spinal problems. Spondylolisthesis surgery is a procedure that treats spondylolisthesis, but the exact steps of the procedure may differ from one situation to the next. The procedure always involves decompressing the affected nerves, but whether the slipped vertebra needs realignment depends on the individual case. Dr. McHugh curates a highly-personalized treatment plan based on your specific situation, as determined through various diagnostic tests.

Spondylolisthesis surgery is often combined with other procedures to achieve nerve decompression. The surgeon may perform a laminectomy to remove parts of the lamina (the root of the spinal column) to decompress the nerve roots and relieve the symptoms of pinched nerves. Next, he may recommend spinal fusion to permanently join the two vertebrae, ensuring long-term spinal stability. In this case, the surgeon may plant specialized instruments and bone grafting material to seal the distance between the two vertebrae, eliminating intervertebral movement.

“Getting an appointment was quick and easy. The ladies I spoke with were all very professional, friendly, and helpful, whether it was a phone call or in-person visits. Being able to complete paperwork online before going to the office was convenient as well. Dr. McHugh was very professional and gave a clear and honest opinion and plan moving forward.”

Transforaminal Lumbar Interbody Fusion

Transforaminal lumbar interbody fusion (TLIF) is an advanced and cutting-edge approach to spinal fusion surgery. The procedure is performed in the lumbar (lower back) spine to remove a degenerated intervertebral disc and fuse the two surrounding vertebrae. The procedure involves the decompression of the nerve roots, removal of the facet joint, removal of the affected disc, insertion of screws into the vertebrae, and fusion of the two vertebrae with an implant. The greatest advantage of the TLIF procedure is that the surgeon can access the lumbar spine through a small incision in the back without cutting the muscles and soft tissues.

During the procedure, Dr. McHugh accesses the affected vertebrae and discs from the side of the spinal canal via a small incision measuring less than an inch. He removes a small portion of the vertebral bone to access the disc, removes the damaged disc, and fills the empty space with bone grafting material. Finally, he plants specialized instruments, like screws and rods, to ensure spinal support. Over time, natural bone tissues grow in and around the implants to fuse the two vertebrae, ensuring long-term spinal stability. However, recovery from spinal fusion is a long process, and it may take over a year for the bones to fuse completely.

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