Tired of Living With Back Pain? These 4 Minimally Invasive Procedures Could Be Your Answer

Many Philadelphians suffering from back and neck pain are reluctant to seek help, perhaps worried that the only two fixes are bed rest or major surgery. But advances in surgical techniques are providing patients with relief through minimally invasive procedures that simultaneously deliver more patient-centered care. 

At Premier Orthopaedics, with 30 locations across the region, spinal experts specialize in minimally invasive procedures that restore function and improve quality of life for patients suffering from spinal conditions. These surgeries employ innovative, targeted techniques to minimize downtime and offer a faster recovery than traditional surgery while still providing long-term relief from persistent back and neck pain. 

Vertebroplasty, kyphoplasty, lumbar microdiscectomy and minimally invasive lumbar fusion are four procedures performed by the surgeons at Premier Orthopaedics. We spoke with surgeons Dr. Richard Levenberg and Dr. Mark Tantorski, to learn more about these minimally invasive options for back pain relief to better understand what conditions they treat and who they can help. 

Vertebroplasty & Kyphoplasty 

What conditions do vertebroplasty and kyphoplasty treat?  

Dr. Richard Levenberg: Vertebroplasty and kyphoplasty both treat compression fractures like those commonly experienced by people with osteoporosis. We’re all living older now, and people don’t have to be in pain.  

What is the benefit of these surgeries? 

RL: These minimally invasive procedures are game-changers compared to the standard of care in previous decades. The old-fashioned treatment was a brace, pain medicine and months of healing, which has a lot of disadvantages. The patient isn’t active so they lose more muscle, function and balance. These are much better treatments.   

The minimally invasive approach does not destroy soft tissues like muscles, making for a much easier recovery than traditional surgery. Both provide fast pain relief and stabilization for compression fractures, allowing patients to return to normal activities quickly. 

How do these surgeries work? 

RL: In a kyphoplasty procedure, the surgeon uses x-rays to guide a needle into the vertebra. A balloon catheter is placed inside, and the inflated balloon moves the fractured piece into a better position. The void created by the balloon is filled with bone cement, which acts as an internal cast in the spine to hold the vertebra in place. The cement immediately hardens, and the fracture is stabilized. The pain is gone. A vertebroplasty is similar, except the cement is inserted directly into the collapsed vertebrae to stabilize the fracture.  

Both eliminate the pain caused by compression fracture. I performed a kyphoplasty on a 104-year-old woman. She walked home from the hospital. 

What is recovery like? 

RL: Patients can’t lift anything heavy for a period of time after the procedure, but otherwise they can return to normal daily activities. 

When is the best time to seek treatment? 

RL: People should seek help sooner rather than later. Once a fracture occurs, it continues to collapse. The more collapse you get, the less straight and tall you are, which creates its own separate medical issues that affect lung function, appetite and walking.  

Lumbar Microdiscectomy 

What conditions does lumbar microdiscectomy treat? 

Dr. Mark Tantorski: This procedure is a minimally invasive surgery to relieve sciatica and leg pain caused by herniated discs with very little downtime.  

Discs are essentially the shock absorbers of the spine, and over time, they can degenerate. In disc herniation, one of those shock absorbers cracks open, and the inside material pushes out to press on the nerves. It can compress the spinal nerve and lead to horrible back pain, leg pain and even weakness in certain muscles in your legs. (This pain and weakness is known as sciatica.)  

There are many factors that lead to herniated discs including genetics, weight and environmental factors like occupation. Another group to likely to suffer from this is recreational athletes. I call them weekend warriors. They work their 9-to-5 job during the week, but then on the weekends they want to be Tiger Woods or Serena Williams, and they push too hard, and boom, they injure a disc. 

How does this surgery work? 

MT: The spinal canal has a finite amount of space. When a disc herniation occurs, you lose some of that space, and it presses on the nerve sac. We go down to the area and find where the material is pushed out and remove that small portion of the disc, usually less than 1 percent of it, to create that space. 

Surgeons use microscopic visualization for the procedure through an incision that is less than an inch. The procedure takes between 30 minutes to an hour. The precision technology and small incision mean there is less cutting through muscle and other tissues, which leads to a faster recovery. Patients do receive general anesthesia, but it’s a day procedure without an overnight stay.  

What is recovery like? 

MT: Nerve healing can take weeks or months to recover, but the acute sciatica pain is immediately relieved. I tell people to expect to wake up and have a degree of improvement in nerve pain right away. An overwhelming majority of people who have nerve pain wake up and it’s better. 

Complete healing takes about three months, over which time there is significant improvement in pain and muscle function. Patients have to avoid certain activities, especially a high-level athlete or a weekend warrior, but there aren’t a lot of restrictions. After the appropriate healing, they can go back to their normal activities.  

Minimally Invasive Lumbar Fusion 

What conditions does minimally invasive lumbar fusion treat? 

MT: The most common is spinal stenosis, which is a narrowing around the nerves. Others include spondylolisthesis, when a vertebra shifts out of place, and arthritis and degenerative disc disease.  

How does this surgery work? 

There are a number of approaches in minimally invasive lumbar fusion, which will be individualized based on the patient’s needs and which one the surgeon recommends. In any approach, one or more vertebrae are fused to stabilize the spine to prevent the pain caused by the movement between them.  

The surgeon uses microscopic visualization on the area of concern through a very small incision, while the patient is under general anesthesia. The procedure takes care of the nerve compression and makes sure the spine is in the right position and stable. It’s not the only option, but it is often the definitive option for these conditions. 

The alternative treatment of open fusion surgery would include a longer recovery, more blood loss and a hospital stay. Minimally invasive lumbar fusion is a quicker procedure that does not damage muscles and soft tissue around the spine, leading to a faster recovery with less postoperative pain while still achieving the same or better outcomes as traditional surgery. 

What is recovery like? 

Recovery can vary based on the patient’s existing medical problems, but usually they can start physical therapy within a couple of weeks to work toward resuming normal activities. By three to four months, a recreational golfer, for example, could start getting back into that. The days of three months of bed rest are long gone. 

There are many options offered by the spinal experts at Premier Orthopaedics to relieve persistent back and neck pain without the long recoveries or hospital stays of traditional surgery. These cutting-edge, minimally invasive techniques help patients to resume their normal daily activities without pain. To schedule a consultation, visit premierortho.com. 

This is a paid partnership between Premier Orthopaedics and Philadelphia Magazine