Annuloplasty: A relatively new procedure where an electrode is introduced into a lumbar disc via a needle and the skin (annulus) of the disc is heated to purportedly realign the collagen fibers in the annulus and thereby reduce back pain. Early results with this treatment are encouraging but long-term benefit has yet to be documented.
Laminectomy: A lamina is the arch of bone attached to the backside of the vertebra which creates a canal for the nerves to pass through. Think of the Arc de Triomphe in Paris creating an opening through which all that traffic passes. A laminectomy is a removal of the upper one half of that arch to gain access to the spine canal to remove tumors or the causes of spinal stenosis (thick joints and ligaments). It is commonly used as a term for any operation on the low back designed to remove the herniated portion of a disc but is a misnomer as disc hernia removal requires such a minimal laminectomy it is called a laminotomy.
Foramenotomy: Surgery where the opening (foramen) through which a nerve passes to leave the spine and go to the arm or leg is enlarged usually by removing some of the joint in that region (since the joint bones form the roof of the foramen).
Open Discectomy (also called Laminotomy-Discectomy): The term used to describe the removal of the herniated (bulging) portion of the skin of the disc and/or a ruptured piece of disc pulp. The entire disc is rarely removed in any low back operation.
Micro-discectomy: A discectomy performed using an operating microscope or special magnifying glasses which allows the surgeon to make a smaller incision and see better.
Suction-discectomy: Procedure in which a needle is introduced into the disc under local anesthesia and a very strong suction is applied to the needle to remove a small amount of the center of the disc pulp in the hope that such a reduction in pulp volume will allow a disc hernia to recede or shrink down away from a nerve. It’s like letting some air out of an inner tube to reduce the size of a weak spot that is pooching out.
Laser-discectomy: Same procedure as the suction discectomy but instead of suctioning out some pulp, some of the pulp is vaporized with the laser thus reducing pulp volume.
Endoscopic discectomy: Same maneuver as the micro-discectomy but done by introducing a needle into the back of sufficient size to pass an endoscope and instruments to see the herniated disc and remove disc material by grasping with small forceps.
Cervical discectomy and fusion: Operation where the spine is approached from the throat side and one or more discs are removed and replaced with a graft which usually results in the vertebrae on either side of the graft fusing into one bony unit. Usually performed to relieve neck pain accompanied by significant arm symptoms of pain, numbness or weakness.
Lumbar Fusion: Operation where one vertebra is connected or “fused” to the next vertebra so that no motion between them can occur in the future. It is accomplished by placing pieces of bone (the graft) between the vertebrae so that new bone cells travel through the graft and unite or fuse the two vertebrae into one solid unit of bone. The operation usually involves placing some metal screws, plates, rods or cages to hold the vertebrae immobile (like an internal cast) while the new bone growth occurs. This operation is usually done for very chronic back pain (when the pain is due to a degenerated disc) or for spondylolithesis to prevent further slippage/misalignment of the spine.