Motion preserving (non-fusion) Surgery
What is Motion-Preserving Spine Surgery?
Motion preserving spine surgery incorporate non-fusion techniques to address spine-related problems such as back pain, neck pain, nerve or stenosis-related pain (sciatica, radiculopathy).
While fusion is sometimes unavoidable, fusion can lead to accelerated break-down at non-fused levels and increase the need for future spine surgery. Spine surgeons call this phenomenon, "adjacent segment disease". The idea here, is that if you have a car with four tires, and you remove one, the remaining 3 will have to work harder, leading to earlier wear.
In our studies, the rate of adjacent segment disease, or, in other words, the need for future surgery following spine fusion, is up to 33% (1 in 3 people) within 5-10 years of the original surgery.
Therefore, whenever possible, for surgeons who are trained to do so, motion-preserving spine surgery should be offered to minimize the risk of future surgeries.
Further, motion-preserving surgeries typically are performed through ultra-minimally invasive approaches. This leads to much less pain following surgery and much faster recoveries. Many patients go home the same day of surgery with minimal pain medications and are back to normal activities within 4-6 weeks!
Motion preserving spine surgeries include:
1) Micro-invasive spine surgery including spinal endoscopy
2) Disc replacement surgery
It's important to remember, however, that not everyone is a candidate for motion-preserving spine surgery.
In this context, Dr. Chung and his team are happy to sit down with you and discuss whether you would be a candidate for this type of innovative surgery.
Conditions we treat
Treatments we provide
Cervical Disc Replacement
Cervical disc replacement or cervical disc arthroplasty can be performed in many instances instead of cervical fusion in the right candidate. The benefit of cervical disc replacement is that it preserves motion. More importantly, it may help to slow down the rate at which arthritis develops at the levels above and below where the disc replacement is performed. This is the main advantage of cervical disc replacement over fusion. Furthermore, recovery is typically quicker than with a fusion.
Cervical laminoplasty
Cervical laminoplasty is unique procedure that is performed to treat spinal cord pinching (i.e. cervical myelopathy) when it involves multiple levels. It is a motion-sparing surgery that may allow for quicker recovery than the alternative surgical options. It involves expanding the space where the spinal cord lives through a posterior (through the back) approach.
Cervical Decompression
In the cervical spine, in most cases, decompression (or un-pinching) of nerves occurs at the same time as a fusion or disc replacement surgery. That being said, in some cases, decompression alone can be performed in the cervical spine. Most often, this is done using a foraminotomy where the pinched nerve is un-pinched using a minimally invasive approach.
Lumbar Disc Replacement
Lumbar disc replacement or lumbar disc arthroplasty can be performed in many instances instead of lumbar fusion in the right candidate. The benefit of a lumbar disc replacement is that it preserves motion. More importantly, it may help to slow down the rate at which arthritis develops at the levels above and below where the disc replacement is performed. This is the main advantage of lumbar disc replacement over fusion. Furthermore, recovery is typically quicker than with a fusion.
Micro-Invasive Lumbar Decompression and Lumbar Microdiscectomy
Micro-invasive decompressions and microdiscectomies can be performed using a small specialized tube retractor and a microscope that allows for high precision with surgery. Specialized tools are used through the tube to unpinch nerves or remove a disc herniation. After surgery, you are typically left with an incision that is less than 1-2 centimeters in length.
Endoscopic Spine Surgery
Endoscopic spine surgery is similar to laparoscopic surgery in general surgery and arthroscopic surgery in orthopedics. It is the LEAST invasive spine surgical technique available today. It is typically done through small incisions less than 1 cm in length!
It has been shown to further minimize complications during surgery and to accelerate surgical recovery following spine surgery compared to more widely used surgical techniques.
However, it is technically challenging, and therefore only a small percentage of surgeons in the United States currently offer this type of surgery to their patients.
A word from Dr. Chung
It is important to remember that not everybody is a candidate for endoscopic spine surgery and there is no one-size fits all procedure for everybody. In some instances, more traditional techniques are still best. With double fellowship training and further advanced training in endoscopic spine techniques, I have extensive experience in both traditional and the latest minimally invasive techniques as well as outpatient surgery. Let me help you decide which type of surgery is best for you.
