Page 2 - Laminoplasty

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Artificial Disc Replacements (ADR) may be helpful in
treating a bulging or herniated disc. A herniation is when
the gel-like material within the disc can bulge or rupture
through a weak area in the surrounding wall (annulus).
Irritation and swelling occurs when this material squeez-
es out and painfully presses on a nerve. ADR can also be
used to treat certain cases of degenerative disc disease.
The discs dry out and shrink, losing their flexibility and
cushioning properties. These changes lead to foraminal or
central stenosis or a disc herniation
Both procedures are done from the font of the body. For
the ADR done in the neck the incision is made in one of
the creases of your neck. The ADRs done in lumbar spine
are done near or just below the belly button anteriorly.
For the lumbar procedures Dr. Pazmiño uses a Vascular
surgeon to perform the approach and closure afterwards.
This is because in order to insert the disc replacement the
vessels near the front of the spine need to be safeguarded
and retracted as the disc is placed in its final position.
Cervical Incision Lumbar Incision
After the disc is removed, the space between the bony
vertebrae is empty. To preserve mobility Dr. Pazmiño
inserts the arthroplasty or ADR. The ADR serves as an
artificial disc between the two vertebral bodies maintain-
ing mobility and range of motion. To make sure the disc
stays in place afterwards they are immobilized with a thin
metal fin or small 12 mm screws. Immediately following
surgery the body begins its natural healing process and
new bone cells form onto the surface of the disc. Ask
Dr. Pazmiño to show you these pores on the model. After
3 - 6 months the bone literally grows onto and grabs the
endplates of the disc replacement. Once this happens
you can begin activities without any restrictions: surfing,
motorcycling, mountain biking, and running.
In the Xray and the image below you can see what this
procedure looks like in the neck after a Cervical ADR. The
disc has been removed and in its place a PRODISC ADR
has been placed in between the bones. The disc is held in
place by thin metallic fin or keel. This provides immediate
fixation after surgery. Final fixation is provided by your
bone growing onto the pores of the device.
What are the results?
Artificial Disc Replacements are successful in relieving
Neck and Arm pain in cervical patients, and Back and
Leg pains in lumbar patients. These products have been
approved by the FDA for single level use in both the
cervical and lumbar spine. Dr. Pazmiño has specifically
done research regarding the outcomes after ADRs and
presented his results on a national at many conferences.
What are my instructions after surgery?
After surgery, pain is managed with narcotic medica-
tion for a limited period (2 to 4 weeks). Hoarseness,
sore throat, or difficulty swallowing may occur in some
patients and should not be cause for alarm. These symp-
toms usually resolve in 1 to 4 weeks. For the first two
months do not use non-steroidal anti-inflammatory drugs
(NSAIDs) (e.g., aspirin; ibuprofen, Advil, Motrin, naprox-
en sodium, Aleve). Do not smoke. Smoking delays heal-
ing by increasing the risk of complications (e.g., infection)
and inhibits the bones’ ability to fuse. Do not lift anything
heavier than 5 pounds (e.g., gallon of milk). Dr. Pazmiño
requests all patients gradually return to your normal activ-
ities. Walking is encouraged; start with a short distance
and gradually increase to 1 to 2 miles daily. A physical
therapy program may be recommended by Dr. Pazmiño.
You may shower immediately after surgery. No tub baths,
hot tubs, or swimming pools for three weeks. Soon you
will be able to return to complete unrestricted activities.
Follow Dr. Pazmiño’s specific instructions. Call for your
follow up appointment in Dr. Pazmiño’ office which will
be 2-3 weeks after surgery. For further information feel
free to look us up online at
www. spinecal .com
Normal Disc Herniation
Back / Posterior
Front of Spine / Anterior