BACK SURGERY: CLOSING THE GAP
REPORT: MB #3054
BACKGROUND: Herniated discs -- also referred to as slipped or ruptured discs -- are a common cause of pain in the neck, lower back, arms or legs. A disc is a cushion between the bones of the spine. When a disc collapses down on a nerve, that is called herniation. "When there is a weakness in the wall of the disc, then that soft inner material can push out and push up against a nerve, and that's what gives you radiating leg pain," Eugene Bonaroti, M.D., a neurosurgeon at West Penn Allegheny Health System in Pittsburgh, Penn., told Ivanhoe.
TREATMENTS: The American Academy of Orthopaedic Surgeons says in more than 90 percent of cases, herniated discs can be treated effectively with nonsurgical treatments. These treatments include rest, over-the-counter pain medications, muscles relaxers, anti-inflammatory medications, cold compresses and heat treatments. If a patient doesn't respond to such treatment, surgery may be recommended.
SURGERY: The most common procedure performed to treat herniated disc is a discectomy, or more recently, the micro-discectomy, which involves removing the portion of the disc that is applying pressure to the nerves. Surgeons can now perform the procedure through one small incision in the back. "There have been a lot of attempts to improve upon [the micro-discectomy] with new technology, but most of those things haven’t panned out to be better than the standard micro-disc-ectomy," Dr. Bonaroti said. This standard procedure involves working with an operating microscope through the small incision to trim back the portion of the disc that's coming in contact with a nerve. While effective, this procedure leaves an opening in the disc that sometimes leads to re-injury following surgery. About 30 percent of patients experience pain following a lumbar discectomy and 15 percent require a second surgery (Source: Orthopedics Magazine).
PREVENTING SECOND SURGERIES: A new implant protects a patient from re-herniation by closing the hole left behind after discectomy. The Xclose Tissue Repair System is made of a sterile, braided material made of polyester. The umbrella-like implant is inserted through the opening in the disc and opened up to act as a seal against any material that might try to pass through the opening. Experts hope the procedure will not only reduce the risk of re-injury, but quicken recovery times for patients. "Our hope is that by suturing that disc wall back together, we can get people back to regular activities much sooner," Dr. Bonaroti said.
FOR MORE INFORMATION, PLEASE CONTACT:
Dan Laurent
Public Relations
Allegheny General Hospital
(412) 359-8602
