Unlike open spine surgery which requires an incision, removal of bone and frequently a hospitalization, new technological advances have miniaturized the tools needed for spine surgery.
Now, trained pain management physicians are performing these procedures. There are 4 methods of removing a disc herniation. ” Nucleoplasty”, uses a special wand which carries electrical energy into the disc creating a plasma field which melts the disc which contacts the wand turning it into a gas thus removing or decompressing the disc.
The” Dekompressor” is a device which drills into the disc grabbing disc material along the way and removing it thru repeated entries. “Hydrocision”, also known as Hydrodiscectomy, uses a high pressure water jet which cuts through the disc and then sucks out the disc fragments thru a suction port. In effect, vacuuming out the disc. All of these procedures are done under real time fluoroscopic guidance using a 360*view into the spine. The newest technique is called Laser Assisted Endoscopic Discectomy. This technique is similar to Arthroscopy of the knee only the tools have been miniaturized to be used in the spine. The spinal scope, which has a working channel, is placed into the disc and is attached to a large video monitor allowing us to look inside the disc on the big screen. Thru this can we place either a laser, or radiofrequency heating device to vaporize it or we use a grabbing device to pull out the disc. You have the added advantage of being able to remove scar tissue and disc pressing on the nerve and remove bone spurs in the way if they are narrowing the canal where the nerve passes.
This is the future of spine surgery, and when Dr. Magaziner performs this technique he has a spine surgeon he works together with. In his team he also uses another physician or technologist who performs real time spinal electophysiologic monitoring for added safety. All of these procedures are done as same day surgery at the Middlesex Surgical Center, and you get to go home afterwards. Typically, you are back to work in 1-2 weeks.