Before an injured worker undergoes a neck or back surgery, he or she should be familiar with a few medical terms and what specific procedure the surgeon is recommending. Ask your doctor to write down the name of the surgery, and have him explain exactly what will be done. If you or your adjuster is requesting a second surgical opinion, make sure you understand whether the second surgeon is recommending a different approach. The following are a few medical terms and procedures courtesy of materials from the Mayfield Clinic and local neurosurgeon Aury Nagy, M.D. :
- Discectomy– surgery to remove herniated disc material that is protruding through the disc wall and irritating the surrounding nerves causing pain.
- Fusion– joining together two separate bones (vertebrae) to provide stability.
- ACDF (anterior cervical discectomy and fusion) – surgical procedure that removes a herniated or degenerative disc in the neck, and fusing the vertebrae above and below the disc space. The spine is approached from the front of the throat area. The removed disc space is filled with a bone graft and the the vertebrae are immobilized with metal plates and screws. Bone grafts may come from bone cells taken from your own hip, or from cadaver bone, or man-made substitutes. Artificial disc replacement is also an option for some patients. Both neurosurgeons and orthopedic surgeons do this surgery.
- Foraminotomy– surgical enlargement of the intervertebral foramen through which the spinal nerves pass. Bone spurs, called osteophytes, that may be pressing on nerves may also be removed during this procedure.
- Posterior lumbar discectomy– surgery to move a herniated or degenerative disc in the lower spine where the surgeon approaches the spine from the back. An open discectomy involves a 1-to 2-inch incision in the middle of the low back. A minimally invasive discectomy has a very small entry wound.
- PLIF- posterior lumbar interbody fusion.
- ALIF- anterior lumbar interbody fusion where the surgeon accesses the spine through the abdominal area.
- Laminectomy– this is the surgical procedure to drill a small hole through the lamina (a part of the bony vertebrae) so that the surgical can insert a surgical microscope to view and remove disc fragments. It may be necessary to do on both sides (bilateral laminectomies).
- OLIF- Oblique lumbar interbody fusion. This is a surgical procedure pioneered by local orthopedic surgeon Andrew Cash, M.D. where the surgeon enters the spine from the back, at an angle, near the pelvis and just above the iliac crest. Read more about this in the article on Dr. Cash by Brian Sodoma in Las Vegas Life magazine, Spring 2013.
–Written by Virginia Hunt, Hunt Law Office