Spine Surgery 

There are several types of spine surgery.  Each type involve an incision along the back which will later be closed with sutures or staples.

Laminectomy-Discectomy
This procedure involves removing the lamina and disc from the affected vertebra.  This is to create an opening to take the pressure off the nerve. This opening is protected by the thick back muscles.

Spinal Fusion.
The diseased disc and lamina are first removed. Pieces of bone are removed from your hip (donor) and are placed along the spine and between the vertebrae.  This is called bone grafting. When the bone heals, this is called a bone fusion and the vertebrae no longer move separately.  This fusion takes three months to heal.

Preparing for Surgery
It may be necessary for an additional medical evaluation by your own family physician depending on any preexisting health conditions.  If you are a smoker, it is advisable for you to stop two weeks prior to surgery.  This will help your back to recover faster.  Certain medications may also be stopped two weeks before surgery as advised by the surgeon.  Patients in good health may be asked to donate one unit of their blood to be used following fusion surgery if necessary.

 

What Is Arthroscopy

An arthroscope is a small camera that allows your orthopedic surgeon to inspect and repair joint problems without a large incision.  The arthroscope is a narrow metal tube about as thick as a pencil.  It has a powerful lens and a fiber optic light to magnify and illuminate the inside of the joint.  With the “scope,” your surgeon can examine the inside of the joint, pinpoint the problem, and make repairs all during the same operation.  An arthroscope is used frequently for shoulder, knee, wrist, and ankle problems.  The scope is also used to assist in open procedures that would otherwise require much larger incisions (ACL reconstruction, meniscal repair, and joint fractures).

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Pediatric Orthopedics

Scoliosis
Scoliosis is a "side-to-side" curve of the spine.  Normally, the spine is straight if you look at a person's back from behind.  In scoliosis, the side-to-side curve may cause a child to lean to one side and often produces other noticeable physical deformities.  Scoliosis will often worsen as the child grows, especially during puberty.  Scoliosis can be diagnosed through a physical exam of the spine.

Depending on the severity of the curve, different treatments are available.  The severity is measured in degrees through use of x-ray and by physical exam.  For instance, in spinal curves less than 40 degrees, in a growing child, a scoliosis brace is recommended.

Braces have been shown to slow progression in some but not all cases.  There are two types of braces:

• TLSO - A brace that is worn 23 out of 24 hours per day
• Nighttime Bending Brace - A brace that is worn at nighttime only

For larger curves, surgery may be recommended to prevent the curve from getting worse.

Clubfoot
A Clubfoot is one of the most common congenital deformities of the foot.  The exact cause of a Clubfoot is unknown.  There are several different ideas as to the cause: 

• A halt of the development of the foot in the first trimester of pregnancy
• Intrauterine compression
• Neurological problems such as Spina Bifida

Early conservative treatment appears to produce the best results.  Treatment options can include manual stretching of the foot and serial casting.  Despite a conservative approach to treatment, usually surgical intervention is indicated.  Surgery is recommended after serial casting has been performed but has not been successful.

Turned In Pigeon Toes
You may notice that your child’s feet turn in (pigeon toes).  Many children have this problem and most outgrow it by the time they are ready to start kindergarten.  If your child has turning in of his feet, this "toeing in" can come from several places on his body.  The turning in can come from his feet, legs, or hips.  The majority of causes of "in-toeing" are normal developmental stages in your child's growth.  It is extremely common for children to "in-toe" and most improve with growth.  Occasionally, mild residual "in-toeing" will remain after school age but this has never been shown to interfere with the child's performance.  Only in exceptional cases is treatment recommended.