There are several Minimally Invasive Procedures that Dr. Guy Fogel of San Antonio, TX can perform to target specific pinched nerve symptoms and back pain conditions. Using a tubular retractor that separates bluntly rather than cutting muscle allows us to approach the posterior lamina and facet joint with very little trauma to the muscle and ligaments.
LAMINOTOMY
Spine and back surgeon Dr. Guy Fogel of San Antonio, TX and SpinepainBegone has minimally invasive, outpatient surgery procedures that can correct the causes of many back pain issues and leave the patient free of painful symptoms often times in the same day.
Saggital and axial views of an MRI that demonstrates large L5-S1 herniated disc causing severe central stenSpine Pain Be Gones and compresses the S1and the L5 nerve root causing severe pinched nerve leg pain.
A laminectomy is a procedure used in traditional open back surgeries that involves removing the lamina to increase the amount of space available for the neural tissue. The term laminectomy is derived from the Latin words lamina (thin plate, sheet, or layer), and -ectomy (removal).
A laminotomy is also a procedure used to remove the ligamentum flavum. The ligamentum flavum is a ligament in the Spinal canal that can thicken to the point where it is actually compressing on the Spinal cord, attributing to Spinal stenSpine Pain Be Gones. Through a laminotomy, the ligament can be removed, therefore opening up the Spinal canal and releasing the nerve(s).
At the Spine Pain Be Gone in San Antonio, Texas, we perform approach through a tubular retractor separating the muscle and performing laminotomy and removing only the scar tissue, bony obstructions, ligamentum flavum and/or herniated/bulging discs that are causing the nerve impingement, leaving most of the lamina intact. This is done through an tubular retractor separating the muscle bluntly rather than cutting it to make an opening in the lamina to allow access to the spinal canal. This is generally done in an outpatient surgical setting. See below to view an animation of this procedure performed at Spine Pain Be Gone.
After an anesthetic is administered, a small incision is made and a tubular retractor is put into the incision. A series of tubes of increasing size are placed over this first tube, one at a time, bluntly separating the muscles to slowly create a small opening to the spine. That allows us to perform laminotomies with minimal damage to the surrounding muscles. The muscles are pushed out of the way and are not torn or cut. The last tube is about 18 millimeters in diameter (about as big as a small marker) and through this working tube we insert suction, irrigation and other surgical instruments. Once everything is in place, the surgeon can begin the procedure. Some patients feel immediate relief during the laminotomy as the nerve(s) are released.
When the procedure is complete, the tube is slowly removed, allowing the muscles to move back into place. Occasionally, a stitch or two is needed for the incision.
After 1 - 2 hours of monitoring, the patient (with a companion) is free to go. We generally encourage patients to take a long walk the afternoon or evening of their laminotomy procedure.
The patient will generally experience relief of back pain during these procedures and after a short post-operative period most patients walk out of the Spine Pain Be Gone free of the pain caused by back conditions.
DISCECTOMY
This procedure is performed in an outpatient surgical setting. After an anesthetic is administered, a small incision is made and a small tubular retractor is put into the incision. This tube allows us to perform microscopic discectomies without damage to the surrounding muscles. The muscles are pushed out of the way and are not torn or cut. Through this 15-18 mm working tube we insert our surgical instruments. Once at the disc level, the surgeon removes the herniated disc material, therefore diminishing the pressure on the Spinal nerves.
When the procedure is complete, the tube is slowly removed, allowing the muscles to move back into place. A discectomy is a relatively short procedure, only taking ½ hour to 45 minutes to perform with a quick recovery ensured afterwards. After 1 - 2 hours of monitoring, the patient (with a companion) is free to go. We generally encourage patients to take a long walk the afternoon or evening of their discectomy procedure.
FORAMINOTOMY
At Spine Pain Be Gone we use a microscopic approach to open up the foramen or window that the nerve exits through, in an outpatient. LAMINOTOMY MINIMALLY INVASIVE PROCEDURES - DR. GUY FOGEL surgical setting. A small incision is made and a small dilator is put into the incision. A series of dilators of increasing size are placed over this first one, one at a time, to slowly create a small opening to the spine. That allows us to perform foraminotomies with minimal damage to the surrounding muscles. The muscles are pushed out of the way and are not torn or cut. The last tube is about 18 millimeters in diameter (about as big as a small marker) and through this working tube we insert the surgical instruments. Once everything is in place, the surgeon can begin removing the bone and tissue that is compressing the nerve without distress to the patient. Some patients feel immediate relief from back pain during the procedure as the nerve is released.
When the procedure is complete, the tube is slowly removed, allowing the muscles to move back into place. Occasionally, a stitch or two is needed for the incision. After 1 - 2 hours of monitoring, the patient (with a companion) is free to go.
We generally encourage patients to take a long walk the afternoon or evening of their foraminotomy procedure.
