Surgical Procedures

Used to treat a nerve root in the neck (cervical) spine pinched by a herniated disc fragment or bone spur (osteophyte) from spinal stenosis, TransCorporal Micro Discectomy (TCMD) is a minimally invasive procedure that allows a person to retain natural movement in the neck using his or her own disc, instead of requiring removal of the entire disc space followed by fusion or total disc replacement. With TCMD, no fusion is required, no motion is lost, and a person is not dependent lifelong upon an artificial metallic implant. TCMD allows over 2/3rd’s of people undergoing the procedure to return to work in less than five days, as opposed to being off work for several weeks to a few months, as when a cervical fusion or disc replacement is required.

The difference between TCMD and other frontal approaches to the cervical spine starts with how the surgeon accesses where the nerve root is pinched. Instead of removing the entire disc, a special guide is used to make a ¼ inch (6 mm) channel in an oblique angle through the bone above the point of compression. The herniated disc fragment or bone spur is then removed through the access channel. The access channel is then filled in using a special hollow plug filled with a person’s own bone marrow saved from creating the access channel. The access channel then heals, ultimately leaving only the person’s own bone tissue behind.

Not everyone with a herniated disc or spinal stenosis in the neck can benefit from TCMD. TCMD is not an appropriate treatment at this time when severe narrowing is present in both exit canals (foramina) at a symptomatic level, or when either the disc itself or the facet joints are severely degenerated at the level of interest. Either anterior cervical discectomy and fusion (ACDF) or total disc replacement (TDR) may be considered in such cases. Thankfully, in appropriately selected patients TCMD, ACDF and TDR all are procedures with high rates of success in alleviating radiating shoulder, arm and hand symptoms, and sometimes more than one technique is used in a single procedure to both treat a person’s symptoms and maintain as much natural movement as possible

TransCorp Spine
TransCorp Spine was founded by spine surgeons and engineers to address the surgical needs of both surgeons and patients in striving for better procedural outcomes and an early return to life activities (SM). TransCorp Spine is a privately-held, early-stage, medical device company dedicated to developing unique, commercially-viable, minimally-invasive and tissue-saving products and procedures for the treatment of spinal pathologies. transcorpspine.com

Artificial disc replacement surgery is performed when non-surgical treatments fail to relieve pain due to a degenerated or injured intervertebral disc. In a total disc replacement, the problematic disc is removed entirely and replaced with two plates that are attached to the vertebrae above and below the disc space. The plates may be designed to slide with respect to one another, or a spacer made with a soft core may be placed in between the plates, mimicking the original disc. Eventually, bone will grow into a special surface on each plate, holding it in place permanently. Until then, screws or pins are used, and these remain in place permanently, as does the disc itself. This surgery has some technical limitations in many patients but does offer a theoretical advantage over fusion in that movement at that level is preserved. It has not yet been proven that a fusion accelerates degeneration at the spinal level above or below the fusion, but if it does, TDR may lower this risk.

Carpal tunnel release surgery may be indicated when non-surgical treatments for carpal tunnel syndrome fail. It may also be performed when hand muscles lose strength or become smaller due to impingement of the median nerve, which runs through a small tunnel in the wrist. Swelling or other conditions can cause the nerve to become pinched, leading to pain and an inability to properly use part of the hand. Carpal tunnel release involves a hand incision to open a ligament pinching the median nerve. Doing this relieves the pain, numbness and tingling for many patients.

Kyphoplasty is a minimally-invasive procedure used to treat a vertebra damaged by osteoporosis, trauma, or other condition. It is performed when a portion of one or more vertebrae have collapsed, leading to pain, disfigurement, spinal instability, or height loss. During the procedure, the vertebra is entered with a small balloon inserted through a special catheter. The balloon is expanded to create a cavity for a cement-like compound that is injected through the catheter after the balloon is removed. The compound hardens within 30 minutes. Patients typically experience pain relief after kyphoplasty and many have a modest restoration of height lost due to the fracture.

Microscopic surgery has brought many advantages to patients with a variety of conditions. Microscopic brain surgery is used to treat aneurysms, remove tumors, and treat other brain conditions, while microscopic spinal surgery is utilized to relieve pressure on nerve roots, treat herniated discs, and relieve other spinal conditions. These types of surgery use advanced microscopic imaging, allowing the surgeon to reach the problem site with smaller incisions and less tissue damage. Patients typically have a quicker recovery time and less postoperative pain compared to open surgery. Eligibility for microscopic surgery is dependent the specifics of the patient’s condition.

Spinal fusion is a type of spinal surgery in which two vertebrae are connected together so that they will form into a solid bone. Metal plates, wires, hooks, rods, or screws may be utilized to connect the two vertebrae together and, eventually, new bone material will form, allowing the vertebrae to fuse into a single bone. In some cases, new technologies are used to facilitate spinal fusion. Spinal fusion and reconstruction may be used to treat herniated discs that must be removed, spondylolisthesis, and other spinal conditions.

The ulnar nerve runs from the neck down to the ring and little fingers. It controls some of the motion in the hand and forearm. This nerve can become entrapped in an area called the cubital tunnel, found behind the inner elbow. The nerve can become compressed by fibrous bands of tissue near the bony bump inside the elbow, leading to pain, weakness in the hand, and numbness or tingling of the ring and little fingers. Surgical correction is sometimes needed to free the nerve and the surgeon may decide that ulnar nerve transposition will work best. During this procedure, the ulnar nerve is moved from its current location to a new place in front of the elbow, either on top of, within, or under the muscle. Physical therapy or occupational therapy may be helpful to help restore normal function.