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Spinal Cord Injury

Spinal Cord Injury

WakeMed’s neurosurgeons have the skills and experience to expertly perform a variety of surgeries to treat spine conditions, depending on a patient’s needs. These are a few types of spinal fusion, decompression, and disc replacement and removal surgeries that we offer.

Disc Replacement

Artificial Cervical Disc Implantation — Artificial cervical disc implantation is available for patients with degenerative disc disease who only need one disc replaced. This surgery removes the damaged disc and restores disc height, reduces pain or weakness in the limbs, and provides better neck and spine mobility.

Patients must have had at least six months of therapy and conservative treatment, and have a history of good health. Patients with osteoporosis, a prior spinal fusion in the same region, arthritis or other possible contraindicated conditions are typically not candidates.

Artificial Disc Surgery — Also called spinal arthroplasty, artificial disc surgery is only recommended in adults with degenerative disc disease in one disc, that is located from L4 to S1. The diseased or damaged disc is replaced with an artificial disc made of plastic, metal or ceramic.

Artificial disc surgery completely removes the diseased or damaged disc, restores vertebral height, decreases pain, preserves movement and has a relatively quick recovery. Patients with degenerative disc disease in more than one disc or who have osteoporosis, arthritis or certain allergies are not candidates.

Disc and Facet Joint Removal

Anterior Cervical Discectomy

In an anterior cervical discectomy, the surgeon removes the discs or spurs that are pressing on the spinal cord. It’s usually performed to relieve the pain and pressure placed on nerve roots or on the spinal cord caused by herniated discs and bone spurs.

Medial Facetectomy — Medial facetectomy removes one or both facet joints on a vertebra. Facet joints help support the weight and control movement between individual vertebra of the spine.

When they become stiff and swollen, patients can have debilitating pain and decreased mobility. Typically, this occurs due to compression from overuse, high-impact exercise, disc compression, arthritis and injury.

When conservative therapies — such as medication, ice, rest and physical therapy — are no longer effective, patients can opt for removal of the facet joints.

Spinal Fusion — For many years, spinal fusion was the only option for patients dealing with chronic pain from a degenerated disc. The surgery, which is still a viable and useful procedure, is done using a bone graft to fuse two or more vertebral bones together.

Cervical Spinal Fusion — Cervical spinal fusion is done following an injury to the neck or during another surgical procedure to treat herniated disks or spinal stenosis. It involves fusing the bones in the neck to give stability and support.

The surgeon may use bone from another region of the patient’s body, donor bone or a man-made material to fuse the bones together.

Lumbar Spinal Fusion — Lumbar spinal fusion permanently connects two or more vertebrae without allowing movement between them. The procedure, which is done to treat fractures, age-related disc degeneration and spinal stenosis, helps restore stability in the spine.

In many cases, spinal fusion is performed along with other surgeries, such as removal of bone or herniated discs that are narrowing the spinal canal or pressing on nerves. While this surgery restricts movement, it reduces pain, numbness and weakness in the lower back and legs.

Sextant Fusion — Sextant fusion is a minimally invasive spinal fusion surgery offered at WakeMed. This innovative procedure allows for a complete vertebral fusion without disrupting the major muscles or tissues normally experienced during an open or more traditional spinal fusion.

Using the CD HORIZON® SEXTANT® Spinal System, surgeons perform spinal fusion — where bone is grafted between two vertebrae to allow them to grow together — using a series of tiny incisions in the skin and separating the muscles at natural divisions.

Patients benefit by having a smaller scar, shorter hospitalization and recovery, and reduced pain.

Decompression Surgery

Discectomy or Microdiscectomy — In a discectomy or microdiscectomy, most of a herniated disc is removed from the back. This helps relieve compression or pinching on the spinal nerve caused by a damaged disc.

Posterior Microdiscectomy — Posterior microdiscectomy, also called microdecompression, is a minimally invasive procedure that relieves pressure from the spinal nerves.

Usually, patients who undergo this surgery have been suffering from chronic neck and back pain and haven’t received relief using medication or therapy.

Foraminectomy — Foraminectomy releases pinched spinal nerves from foraminal stenosis. The neural foramen is the opening inside a vertebra where the nerve roots exit the spine.

Most patients who have this type of surgery have some form of degenerative disc disease, herniated discs, and spondylosis or facet joint disease, and have suffered with foraminal stenosis affecting their quality of life.

The surgery removes any bone, tissue or excess materials that reduce space in the foraminal canal. Also called decompression surgery, the procedure is normally combined with a laminectomy, which is the removal of the lamina bone. By performing both of these procedures, the patient can get immediate relief from pain that often radiates down the legs, weakness or loss of motor function.

Laminectomy — Laminectomy is a type of decompression surgery that relieves pressure on a spinal nerve.

The surgery involves removing the lamina — the bony, cartilage that covers the back of the spinal cord. This allows the spinal cord, nerves, and blood vessels more space to relax. It is normally done to treat injuries and provide relief from the pain and pressure put on the spine due to bony overgrowth, herniated discs or a tumor.

Most patients respond to conservative treatment of medication and physical therapy, but in worsening cases, surgery may be required.

Posterior Cervical Laminectomy — This surgical procedure helps relieve pressure on the spinal cord and swelling in the nerves. Patients diagnosed with spinal stenosis often have weakness and even paralysis in their arms and extremities.

A laminectomy removes the lamina, or the back of the spinal canal, so that it no longer pinches the nerves.

Laminotomy — Laminotomy is the partial removal of the lamina to help relieve the pain and pressure in the leg from sciatica associated with a herniated disc.

Based on the severity of the injury or condition, the surgeon may be able to use minimally invasive surgery. This involves a smaller incision of about one inch or less. Retractors and specialized equipment are used and a fiberoptic light and camera are inserted at the surgical site to guide the procedure.

Reconstructive Spinal Surgery

Anterior Cervical Corpectomy — Anterior cervical corpectomy is performed when a patient has severe compression of the spinal cord caused by disease or injury. In most cases, patients have difficulty moving or turning their head.

To get relief from the pain and to restore mobility, neurosurgeons at WakeMed perform cervical corpectomy, a reconstructive cervical spinal surgery that removes one or more discs and vertebrae pressing on the spinal cord. They are replaced with a titanium cage and bone that is grafted to provide stability.

Incomplete Spinal Injury

Patients with incomplete spinal cord injuries have some function below the injury. In these cases, it may be only on one side of the body or one arm or leg may have more feeling or movement than the other. Incomplete spinal cord injuries are based on the pattern of injury:

Anterior cord syndrome — an injury to the motor and sensory pathways in the anterior section of the spinal cord. Patients have some feeling in their limbs, but no movement.

Central cord syndrome — normally associated with trauma to the nerve fibers that run from the brain to the spinal cord. This type of injury can result in paralysis to the arms and hands, but not in the legs or feet.

Brown-Sequard syndrome — is when the injury is confined to one side of the spinal cord, and impacts movement and feeling on the opposite side of the body since nerve pathways move to the other side after entering the spinal cord.

Surgery for spinal cord injury — WakeMed has 24/7/365 coverage through our Raleigh Campus Level I Trauma Center. Patients who are admitted through our emergency department have immediate access to a team of specialty trained trauma physicians, neurologists and neurosurgeons who can quickly assess and treat spinal cord injuries.

Most patients with a spinal cord injury are admitted through WakeMed’s emergency department as a trauma case. After stabilization and immobilization to ensure no further damage, patients undergo imaging tests to determine the extent of the injury. These patients are admitted to our intensive care unit and can be placed in traction and given steroid therapy to help reduce swelling and encourage healing. In some cases, patients need immediate surgery to repair a herniated disc, blood clot or other injury that is causing compression. While the goal of surgery is to restore function, some injuries cannot be reversed due to the severe damage; however, surgery can help stabilize and reduce the likelihood of chronic pain. Learn about some common surgeries performed on the neck and back .

Following surgery, patients recover in our inpatient rehab unit where they will undergo multiple therapies, including physical therapy, occupational therapy and other specialty therapies that will help the patient achieve the best possible recovery.

Make an Appointment

We welcome new patients. If you’d like to meet with one of WakeMed’s neurological experts, please make an appointment by calling us at 919-350-7000.

WakeMed also features a comprehensive spinal cord injury rehab program.