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Arthroscopic back surgery refers to a minimally invasive type of back surgery that is accomplished through smaller incisions than those usually seen in traditional operations. This is possible with the use of an arthroscope, a thin flexible tool about the diameter of a drinking straw, through which the surgeon can see and work. The use of arthroscopic techniques minimizes the patient's discomfort and usually speeds the recovery process. There are several different types of back surgeries that can be performed using arthroscopic techniques, though arthroscopy is not suitable for all types of back surgery.
In many cases, the techniques of arthroscopic back surgery are used during a discectomy surgery, which is performed to treat a herniated, or bulging, disc in the spine. During a discectomy, the surgeon will remove the portion of the disc that is compressing spinal nerves. Arthroscopic discectomy procedures are quite common and generally are performed with few surgical complications.
A foramenotomy surgery using arthroscopic methods also might be considered if both bone and disc tissues are compressing spinal nerves. This procedure removes the bone and disc tissue to alleviate pain and numbness. A foramenotomy might be performed as arthroscopic back surgery, but this usually depends on the amount of bone and tissue that must be removed.
When the bone and discs have deteriorated so that the spinal cord itself is being compressed, as in conditions such as spinal stenosis or spondylolisthesis, a laminectomy is usually performed, but this type of surgery isn't usually suitable for arthroscopic techniques. A laminectomy removes bone and disc tissue, much like a foramenotomy, but it is considered more serious because of the involvement of the spinal cord. For this reason, it is less common to see a laminectomy performed arthroscopically.
A spinal fusion is usually performed along with a laminectomy, but fusions can also be performed alone to correct spondylolisthesis. The extensive nature of this procedure usually precludes it from being performed during an arthroscopic back surgery, although new surgical methods may allow for less invasive methods in the future. The purpose of a spinal fusion is to prevent vertical motion of the spine so that nerves in the immediate area are not compressed. A spinal fusion often involves the use of bone grafts harvested from another part of the body, usually the hip, and the implantation of titanium rods, screws, or brackets for added stability.
A relatively new type of spinal surgery that allows the entire vertebral disc to be replaced with an artificial disc can be performed using arthroscopic techniques involving lasers. This procedure might be performed for a variety of purposes, including a disc that has herniated multiple times or in cases of severe degenerative disc disease (DDD). Though this type of surgery is relatively cutting-edge, it is becoming more common around the world.
The type of back surgery performed will depend largely on the underlying condition. The severity of the condition being treated will also determine whether or not an arthroscopic back surgery is possible. More severe conditions may necessitate more invasive traditional surgical techniques in which larger incisions are required.
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