Spinal microsurgery gets patients back into action quickly
Not too long ago, outpatient surgical repair of herniated discs and other degenerative disc diseases through a one-inch incision was unimaginable to all but a few.
Among them was David A. Roth, MD, chief of neurosurgery at Melrose-Wakefield Hospital. A pioneer in the field, Dr. Roth was one of the first to perform spinal microsurgery.
Dr. Roth focuses on patients who do not get well with medical management, saying, "We usually wait six to 12 weeks to see if patients improve-and many do. For those who do not, surgical treatment can prevent permanent nerve damage."
The benefit of experienceForty-two-year-old Michael Good, an avid cyclist and mountain biker, is one of more than 9,600 patients to benefit from Dr. Roth's expertise. Good tolerated back pain for a number of years.
Riding off-road last October, he sustained a back injury with symptoms of radiating leg pain and numbness.
"There was no improvement after months of physical and other medical therapies. I still couldn't ride and continued to miss days at work," said Good. "I had heard a lot about Dr. Roth's great reputation and remarkable success rate, and when my wife and I asked about a hundred questions before the surgery, he took the time to answer every one."
Protecting the tissue, nerves during surgeryDuring Good's lumbar microdiscectomy, Dr. Roth made a one-inch incision over the lower spine, nudged the muscles to the side, and enlarged an existing spinal opening to the size of a nickel.
While protecting the trapped nerve, he removed the herniated disc fragments, scar tissue and calcification. After placing a small piece of fat over the opening to prevent future scar tissue, he bandaged the incision. Good walked out of the hospital two hours post-surgery.
"With magnification, a very powerful light source, and delicate instruments, we can resolve the problem without damaging other tissue," he explained. Dr. Roth performs more than 400 microspinal surgeries annually.
Applications for Spinal MicrosurgeryAs the body's "shock absorbers" which allow the spine to bend, intervertebral discs become herniated when a fragment of cartilage breaks loose and compresses a nerve root inside the spine.
Spinal microsurgery most commonly is used to treat herniated discs in the neck or lower back-which are generally the result of twisting, bending or lifting injuries. For many, disc problems can be treated with physical therapy and medication.