Clinical Trials at The Spine Center

Dr. McCarthy and the Spine Center team are dedicated to the discovery of new ways to diagnose and treat spinal injuries and disorders. The Spine Center team is engaged in clinical studies testing the effectiveness and safety of new devices and procedures in addition to studies that seek to expand the scientific and medical knowledge of existing procedures. Patients at the Spine Center have the opportunity to contribute to our research process by participating in one of our clinical trials. Please see below for more information on our currently available studies. Forms in this section require Adobe Reader.

Frequently asked questions about Clinical Research

What is a clinical research study?

Also called a clinical trial, a clinical research study is a scientific study of a medical treatment.  Research studies can evaluate new medical treatments, such as new drugs or procedures, or they can be used to learn more about the effectiveness of existing treatments. Data is collected before, during and after treatment to evaluate patients’ experiences and results. Once this data is analyzed, it can be published and shared with the clinical community. Clinical research results are very important for guiding and advancing clinical care. For studies involving investigational treatments, the results are used to gain FDA approval and ultimately reimbursement from insurance companies. For studies involving existing treatments, the results help guide physicians’ recommendations to patients and, with enough studies, establish standard of care treatments.

What types of clinical research studies are being conducted at the Spine Center?

Some of the studies we are conducting at the Spine Center are sponsored, multi-center, post-market device studies. This means we are evaluating surgical devices that are FDA approved and used by surgeons throughout the US. One type of post-market study seeks to determine if the device being studied is comparable or better than a similar device and surgical procedure. Patients in this type of study will be randomized to receive one of two comparable surgical devices. In another type of post-market study, all patients receive the same surgery. These studies evaluate efficacy based on patient improvement only. Both types of studies are used to advance the clinical knowledge of existing spine surgeries.

We are also involved in some in-house research. In-house studies are not sponsored; they are conducted to evaluate patient outcomes after surgery or other treatment at the Spine Center. These studies provide us with real results and statistics from our patient population that can be used in clinical decision making.

All studies conducted at the Spine Center are approved by the Western Institutional Review Board. This is a central IRB that reviews and monitors research studies. They provide guidelines for research sites to follow and ensure the protection of all research participants.

What is required of a patient in a research study?

Before a patient can be enrolled in a research study, he/she must sign an Informed Consent. This is a study specific consent form that the research staff will review with you. The Consent form is a great resource with patient oriented details about the study and all study procedures.

After a patient has consented to participate in a study, he/she will be asked to attend pre-operative and post-operative office visits (similar to standard care), get x-rays and/or MRIs, and fill out questionnaires about pain and function.  All sponsored studies offer compensation for patients fully participating in study visits. Our current studies offer up to $600 if you complete all the study visits. The sponsor company will also pay for all study specific tests or treatments that are not covered by your insurance company.

Why should I participate?

In addition to financial compensation for study visits, patients involved in a research study at the Spine Center receive the same support, care and the same surgical options that they would outside of the study. The study staff is an added resource; we are available to address any questions or concerns and coordinate all study activities. We carefully monitor research participants before and after surgery. Would you like to contribute to advancing treatments for spine care? Learn more about the current research studies at the Spine Center below.

Spine Injections

Facet Joint Injection

The facet joint is where the vertebrae of your spine connect together.  If there is arthritis or inflammation surrounding this joint it can be a source of your low back pain. This pain is usually worsened with standing and extension of your lower back.

A facet injection is an injection of steroid into the facet joint of the spine. The steroid decreases inflammation in this joint and can relieve pain. Since steroid is used this procedure may provide relief anywhere from weeks to months and in some cases years. These injections can be repeated if needed for continued pain relief.

Risks are rare but include infection, bleeding, prolonged increase in pain, and nerve damage. This procedure is done under X-ray guidance and IV sedation for your comfort.

Epidural Steroid Injection

An epidural steroid injection (ESI) is an injection of long lasting steroid (“cortisone”) in the epidural space; this space is the area which surrounds the spinal cord and the spinal nerves. The steroid medication injected reduces the inflammation and/or swelling of nerves in the epidural space, which may in turn reduce pain, tingling, numbness, and other symptoms. An ESI may be performed to relieve symptoms that are caused by spinal stenosis, spondylosis, or disc herniation. The procedure is done under IV sedation and with the guidance of an X-ray machine. The actual injection takes only a few minutes to perform.

Click here to read an article from the American Academy of Orthopaedic Surgeons about spinal injections.

Cervical Procedures

Anterior Cervical Disectomy Fusion

This is a common procedure performed when disc or bone fragments are pushing on the spinal cord or spinal nerves in the neck area. This condition generally causes pain that radiates into the shoulders or arms and sometimes causes problems with walking and fine motor skills. The surgery is performed by making an incision on the front side of the neck then creating a natural plane that allows for exposure of the spinal column. At this point, disc, bone and ligament tissue is removed and the compressed nerves are released. This space is then filled with a structural device and bone graft to allow for fusion of the motion segment. The procedure is done under general anesthesia and most patients stay only one night in the hospital. Following surgery, the patient wears a neck brace for 2 to 6 weeks and can return to most activities within two weeks.

Scoliosis Procedures

Scoliosis Corrective Surgery

This is generally a very complex procedure in which a curved spine is straightened using a variety of correction methods.  This is most commonly performed in adolescent patients who have not reached skeletal maturity and have spinal curves that measure greater than 40 degrees. The surgery is performed under general anesthesia and usually involves a long incision down the center of the back to allow for exposure of the curved spine. Special screws and rods are carefully affixed to the spine to allow for gentle straightening and de-rotation.  Following surgery, patients stay in the hospital around 3 to 5 days for careful observation, pain control and physical therapy. Patients are braced for approximately 8 weeks following this procedure.

Click here to read an article posted by one of our Physician Assistants, Meegan Domangue, PA-C.

Lumbar Procedures

Microdiscetomy (laminotomy)

The microdiscectomy procedure is indicated in patients with sciatica or lumbar radiculopathy that is the result of a slipped disc (herniated nucleus polposus).  This is done under general anesthesia through a small 2 cm incision. Using microscopic magnification and minimally invasive surgical techniques, a small rim of bone is shaved to allow access to the nerve and disc.

Through the small incision the nerve is localized and gently retracted. This allows exposure of the disc herniation. This disc fragment is then easily removed with a special instrument. This removes the pressure and irritation from the nerve and as a result alleviates the sciatic pain. Patients typically go home several hours after the surgery.

Interspinous Decompression (Aspen Device)

Microdiscectomy

This is a low-risk surgical procedure used to indirectly decompress pinched nerves in the spine. The surgery is performed using a standard incision and exposure of the spinous processes (the raised bones you feel on your back). The space between two of these bones is expanded with special instrumentation and a spacer device is inserted and clamped into place. This allows the inflamed bony and soft tissues to relax and move away from the nerve structures in and around the spinal canal.

Patients with lumbar stenosis who have primarily leg symptoms (pain, tingling, weakness) are generally good candidates for this procedure. Patients who have complete resolution of symptoms upon sitting or forced bending (such as leaning on a shopping cart) generally have excellent results with this low-risk surgery. One major advantage of this procedure is that it is usually performed in less than one hour and usually requires limited hospitalization – even in patients with multiple medical problems.

Endoscopic Spine Surgery

Endoscopic Rhizotomy

The facet joints of the lumbar spine are responsible for controlling motion and providing stability to the lower back. These small articulations can develop arthritis and inflammation similar to the hip, knee and other larger joints in the body. The facets are thought to be responsible for low back pain in up to 40% of cases. The facet joints are innervated by a small medial branch of the spinal nerve. This nerve is responsible for transmitting the sensation of pain from the facet back to the brain. In patients with suspected facet related pain, the medial branch has historically been targeted with a rhizotomy. This procedure has been classically done by pain management doctors. A probe is inserted percutaneously with X-ray guidance to the area where the nerve is thought to be located based on anatomic relationships. The probe is then heated and wanded back and forth with the hope of ablating the nerve and relieving the pain. However, this blind technique can have its limitations and failures, and recurrence rates can be high. When this procedure is successful, patients can experience relief of their lower back pain up to 12-18 months.

Endoscopic RhizotomyThe Spine Center at the Bone and Joint Clinic of Baton Rouge has been performing a new and innovative procedure for facet related back pain. Patients are diagnosed with this condition through a physical examination, radiographic studies and a confirmatory medial branch block injection. Appropriate patients are considered for the endoscopically assisted medial branch rhizotomy.

During this procedure, an endoscope is inserted percutaneously and the medial branch nerve is located with direct visualization. The endoscope has a unique working channel through which special instruments such as a laser or radiofrequency probe can be inserted. Using these instruments, the medial branch nerve can then be ablated under direct visualization. It is theorized that this procedure will allow more accurate targeting of this nerve and thus more predictable and lasting results than the more common blind medial branch rhizotomy. This procedure has been performed with great success at the Bone and Joint Clinic since 2009. The Spine Center is currently enrolling patients in a clinical study to collect comparative data on the effectiveness of this new technique.

Endoscopic Discectomy

Endoscopic Discectomy

In this procedure, a small camera is inserted into a degenerated or herniated disc for the purpose of removing small fragments that are causing pain.  It is only indicated for specific types of disc lesions that are usually associated with a tear. During the procedure, a heat probe or laser is used to aid in sealing the torn disc and ablating loose tissue.  This is an outpatient procedure performed with the patient under sedation.  Patients are usually placed in a brace for several weeks following the procedure and allowed to return to most activities within two weeks.

Sacroiliac Joint Fusion with the iFuse Implant System

iFuse Implant System
“Immediately upon getting my senses back from surgery, I knew I was better.”

The iFuse Implant System is a minimally invasive option for patients suffering from sacroiliac joint disorders, including SI joint disruptions and degenerative sacroiliitis.

The iFuse Implant System procedure takes about an hour and involves three small titanium implants inserted surgically across the sacroiliac joint. The entire procedure is done through a small incision, with no soft tissue stripping and minimal tendon irritation. Patients may leave the hospital the next day after surgery and can usually resume daily living activities within six weeks, depending on how well they are healing and based on physician’s orders.

The iFuse Implant System procedure offers several benefits compared to traditional sacroiliac joint surgery:

  • Minimal incision size
  • Immediate post-operative stabilization
  • Minimal soft tissue stripping
  • Potential of a quicker recovery

iFuse Implant System Indications and Risk Statement

The iFuse Implant System is intended for sacroiliac joint fusion for conditions including sacroiliac joint disruptions and degenerative sacroiliitis. As with all surgical procedures and permanent implants, there are risks and considerations associated with surgery and use of the iFuse Implant. You should discuss these risks and considerations with your physician before deciding if this treatment option is right for you.

iFuse Implant System Frequently Asked Questions

1. What are some causes for pain in the lower back, buttocks or pelvic region?

Low back pain is a common symptom that affects many people during their lifetime. For some, low back pain can be an acute, shortterm problem. Others experience chronic, long-term symptoms. There are many structures in the lower back and pelvic area that can cause pain. Most commonly, people think of a “slipped disc” as a cause of low back pain. The word “sciatica” may be used when describing low back pain. Occasionally, hip problems can be confused with low back conditions. In fact, there are many causes of back pain, including arthritis of the back, osteoporosis, and a poorly aligned spine. The SI joint can be a significant contributor to pain in the lower back, pelvic region, buttocks, or legs.

2. Where is my SI joint?

The SI joint is located in the pelvis, linking the iliac bone (pelvis) to the sacrum (lowest part of the spine above the tailbone).

3. How does my SI joint work?

The function of the SI joint is to transfer weight and forces due to movement from your upper body through the pelvis to your legs and vice versa. The SI joint is an essential component for shock absorption to prevent impact forces during walking from reaching the spine. The primary role of the sacroiliac joint is to provide stability for the pelvis and to bear the load of the upper body.

4. Why does the SI joint start having problems?

If the motion in your pelvis is asymmetric, then problems can occur in your SI joint. You could have asymmetric motion if your legs are significantly different in length. This can be congenital or caused due to an injury or illness such as polio or scoliosis. Other conditions that can predispose you to SI joint problems include having one leg that is weaker, such as seen with hip osteoarthritis. These biomechanical conditions, or even wearing inappropriate footwear, can alter your gait and cause repetitive stress to your sacroiliac joint and related structures. Other potential causes of SI joint problems include joint disruptions, degenerative sacroiliitis, history of trauma, pregnancy/ childbirth, and other unknown reasons. Injury from accidents is another predisposing factor for SI joint pain.

5. How does the SI joint cause pain?

The SI joint is a synovial joint. This type of joint has free nerve endings that can cause chronic pain if the joint degenerates or does not move properly. The SI joint has been long known to cause pain in the lower back and buttocks. Like any other joint in the body, the SI joint can become arthritic or its support ligaments can become loose or injured. When this happens, people can feel pain in their back, especially with lifting, running or even walking. In these cases, the pain is sometimes similar to the pain caused by a “disc” or spinal arthritis.

6. How common are SI joint problems?

It is commonly reported in clinical literature that up to 25% of all low back pain is caused by the SI joint. Risk factors associated with lower back pain may include, smoking, poor physical condition, positive family history, and occupational lifting.5,6,7

7. How is low back pain due to the SI joint manifested?

Many people have pain that worsens over time. However, over half the time SI joint pain can be related to a specific event, often an injury. It is difficult to directly relate any specific functioning difficulty (including walking, sitting, standing, sleeping on the affected side, job activity, bowel movements, cough, sneeze, etc.) to the sacroiliac joint as a source of pain.

8. Who is at risk for SI joint problems?

Women may be at increased risk for SI joint problems because of their broader pelvises, the greater curve of their necks, and shorter limb lengths. In addition, pregnancy often leads to stretching of the pelvis, specifically in the sacroiliac ligaments.

9. How would I know that my SI joint is not functioning properly?

If you have trouble sleeping comfortably, or frequently experience your leg giving way, pain in certain lying or bending positions, or tenderness in your buttocks, you may have an SI joint disorder.

10. Will my doctor check for SI problems?

Doctors do not always look for the SI joint as a source of lower back pain, although many articles have been written about it. Sometimes your lower back pain may have been previously diagnosed as originating from the lumbar spine. However, if your symptoms don’t fit what the doctor can see on an MRI, this may indicate that your pain is coming from a place other than the lumbar spinal region. Your doctor may determine if your SI joint is the source of your pain by ruling out other sources of pain as well as running specific tests.

11. What should I tell my doctor about my back or buttock pain?

The most important information you can give your doctor is the exact location of your pain. Try to notice when the pain occurs and how intensely you feel it in various locations, including your low back, buttocks, and legs. Also, be sure to tell your doctor about any previous injury that may have either directly affected your pelvis, or caused you to walk asymmetrically.

12. How will my doctor determine whether I have SI joint problems?

Your doctor will consider all the information you provide, including any history of injury, location of your pain, and problems standing or sleeping. Your doctor will also give you a physical examination. You may be asked to stand or move in different positions and point to where you feel pain. Your doctor may manipulate your joints or feel for tenderness over your SI joint.

In addition, X-rays, a CT scan, or MRI may be helpful in diagnosis of SI joint disorders. It is also important to remember that more than one condition (like a disc or hip problem) can coexist with SI joint problems and your doctor will need to check for other factors that may be causing your pain.

The most widely used method to determine the cause of SI joint pain is to inject the SI joint with a painkiller. Your doctor will deliver the injection with either fluoroscopic guidance or CT guidance to ensure that the needle is accurately placed in the SI joint. If, following the injection, your pain is decreased by more than 75%, then it can be concluded that the SI joint is either the source or a major contributor to your low back pain. If the level of pain does not change after the injection, it is unlikely that the SI joint is the cause of your low back pain.

13. How easy is it to diagnose SI joint problems?

It is not always easy to diagnose SI joint disorders, but provocative tests and injections are helpful for confirming the SI joint as the pain source. Sometimes your physical findings may indicate a SI joint condition, but chronic changes may also be seen in your lumbar spine. Your doctor may discuss the difficulty of making a correct diagnosis in the presence of multiple problems.

14. What are some options for treatment of SI problems? 

There are several options for treating SI joint problems. Some people respond to physical therapy, chiropractic manipulations, and exercises. Others require more interventional treatments including various oral medications, or therapeutic injections. These treatments are performed repetitively, and frequently symptom improvement using these therapies is temporary. Once non-surgical treatment options have been tried and do not provide relief, your surgeon may consider other options, including surgery.

Sacroiliac joint fusion, is a surgical procedure intended to stabilize the joint and eliminate motion. SI joint fusion can relieve pain in many cases.8

15. How will my doctor determine whether I am a candidate for the iFuse Implant System Implant System?

Once the source of your low back pain has been diagnosed as SI joint in origin, your surgeon will discuss the iFuse Implant System Implant System procedure as a potential treatment option. You may be an iFuse Implant System surgical candidate if your low back symptoms are predominantly below your L5 vertebra, your doctor does not find any neurological problems, and is able to determine through maneuvering your joint that your pain originates in the SI joint. To confirm your diagnosis, your doctor may administer a CT guided injection of pain reducing medication to your SI joint and verify that you experience significant pain relief from it. Some doctors may repeat the injection to be sure.

16. What are iFuse Implant System implants made of?

The iFuse Implant System implants are small titanium rods about the size of your little finger. Titanium is a very strong but lightweight material, commonly used for medical device implants.

17. How do the iFuse Implant System Implants work?

The iFuse Implant System implants have triangular crosssections to keep them from rotating once they have been implanted. They are also coated with a titanium plasma spray that creates a rough surface to better secure the iFuse Implant System implants to bone. The stiffness of the implants holds the joint in place.

18. What is the procedure for iFuse Implant System?

The iFuse Implant Systemis used in a surgical procedure that is performed in an operating room with either general or spinal anesthesia. You will be lying face down while your surgeon uses the specially designed system to guide the instruments that prepare the bone and insert the implants. The surgical technique, iFuse Implant System implant, and supporting instrumentation are designed to offer maximum protection to your tissues during the surgical procedure. The entire procedure is performed through a small incision (approximately 2-3cm long), along the side of your buttock. During the procedure, X-ray guidance provides your surgeon with live imaging to facilitate proper placement of the implants. Typically three implants are placed, depending on your size.

19. What happens after my iFuse Implant System procedure?

Your doctor will provide recommendations. These may include post-operatively using crutches, a cane or a walker for 3 to 6 weeks, depending upon what your doctor recommends. You should not travel by air for a minimum of 2 weeks after an iFuse Implant System surgery. This limitation on air travel is strictly a precaution, and has to do with decreasing what is already a low risk of clots forming in the veins of your legs.

At discharge, your doctor may arrange followup visits to assess the incision and take followup X-rays. It is recommended that you see your surgeon for a post-operative visit between 1 and 2 weeks following surgery. However each surgeon may have specific recommendations as patient situations may vary.

Based upon your doctor’s recommendation, you will need to come back at or around 12 weeks for more X-rays and, barring any complications and your doctor’s ok, you may resume full weight-bearing activities.

20. What can I do to avoid problems healing after iFuse Implant System surgery?

Your doctor will provide you with post-operative instructions. In general, you should avoid strenuous activities in the first six weeks and follow your surgeon’s post-operative weight bearing and activity instructions. Avoid smoking, which is thought to impair bone fusion. Discuss your current medications with your surgeon; some medications may impair bone growth (for example: steroids). If you have osteoporosis, ask your doctor what osteoporosis medications might be best for your bone health.9,10

21. How soon can I resume my normal daily activities?

Your doctor will advise you on resuming your daily living activities as your healing and symptoms allow. Depending on your occupation, you may be able to return to work at this time. You will need to have additional X-rays taken at 6 months and later at 1 year to assess your progress.

22. If I have an iFuse Implant System procedure, does it affect my ability to have other surgeries if I need them?

In some cases, a person may require other surgeries after having an iFuse Implant System procedure. The iFuse Implant System implants are not anticipated to affect the ability to have other surgeries.

23. If I have already had one or more spinal surgeries, does this affect my ability to have an MIS SI joint surgery?

The iFuse Implant System may be used in patients with previous orthopedic surgeries and spinal implants. SI joint problems may coexist with lumbar spine or hip conditions. SI joint problems may appear after lumbar spine surgery or hip replacements. The iFuse Implant System can be safely used after either lumber or hip surgeries or both. Your doctor will determine whether your health, including any impact from previous surgeries, influences your being a candidate for MIS sacroiliac joint fusion.

24. Could there be complications from the iFuse Implant System procedure?

As with all surgical procedures and permanent implants, there are risks and considerations associated with surgery and use of the iFuse Implant System Implant. You should discuss these risks and considerations with your physician before deciding if this treatment option is right for you.

 

5. Maigne, JY, et al. Sacroiliac joint pain after lumbar fusion: A study with anesthetic blocks, Eur. Spine J (2005) 14: 654-658.

6. Sembrano, JN et al. How often is Low Back Pain Not Coming from the back? Spine. 2009; 34 (1): E27-E32.

7. Cohen, SP, Sacroiliac Joint Pain: A Comprehensive Review of Anatomy, Dx, and Rx. Anesth Analg; 2005; 101:1440-53.

8. Buchowski, et al. Functional and radiographic outcome of sacroiliac arthrodesis for the disorders of the sacroiliac joint. The Spine Journal: Official Journal of the North American Spine Society 5, no. 5 (October 2005): 520-528; discussion 529

9. Fusion versus nonoperative management for chronic low back pain: do comorbid diseases or general health factors affect outcome? http://www.ncbi.nlm.nih.gov/pubmed/21897346

10. Dose-dependent inhibition of diclofenac sodium on posterior lumbar interbody fusion rates. http://www.ncbi.nlm.nih.gov/pubmed/18790686

Minimally Invasive Fusions

Minimally invasive fusion techniques are used to accomplish the same goals as open fusion surgery but with much smaller incisions, less tissue disruption, faster recovery, shorter hospital stays, less blood loss and less postoperative pain. There are several minimally invasive fusion techniques used at The Spine Center. Several are described below.

iFuse Implant System

The iFuse Implant System is a minimally invasive option for patients suffering from sacroiliac joint disorders, including SI joint disruptions and degenerative sacroiliitis.

The iFuse procedure takes about an hour and involves three small titanium implants inserted surgically across the sacroiliac joint. The entire procedure is done through a small incision, with no soft tissue stripping and minimal tendon irritation. Patients may leave the hospital the next day after surgery and can usually resume daily living activities within six weeks, depending on how well they are healing and based on physician’s orders.

The iFuse procedure offers several benefits compared to traditional sacroiliac joint surgery:

  • Minimal incision size
  • Immediate post-operative stabilization
  • Minimal soft tissue stripping
  • Potential of a quicker recovery

Learn More About The iFuse Implant System

Lateral Lumbar Fusion

This surgical technique is done with the patient positioned on their side. Through a small incision (2cm) special dilators are used to dilate down to the side of the vertebrae. Special nerve monitoring is used to navigate these away from the small nerves that are bundled in this area over the spine. Once in a safe position, a retractor is inserted  and the dilators are removed. Through this retractor, microscopic magnification is used to visualize the disc which is then removed. In place of the disc a special artificial spacer is placed with bone graft incoporated in its center. This allows distraction of the disc space that was previously collapsed and as a result indirectly opens the areas where the nerves were once compressed. In addition, this spacer provides structural support, corrects any scoliosis and allows fusion to occur in this area.  Using this minimally invasive technique avoids any incision or disruption of the sensitive muscles of the lower back.

Once the spacer has been inserted, the wound is closed and dressed and the patient is brought to the recovery area. Patients typically stay in the hospital one to two days. The video link below is a brief movie demonstrating the procedure.

Axial LIF

The Axial LIF procedure is a newly developed minimally invasive fusion technique that allows fusion of the lowest or the lower two levels of the low back through a tiny incision. This incision is placed at the base of the buttock far below the waist line. This is cosmetically advantageous and also allows us to avoid any incision on the sensitive muscles of the lower back.

axial-lifThrough a small 1 cm incision made at the base of the buttock, the space in front of the tailbone is entered. This region allows safer access to the front of the sacrum. A small hole is created in the sacrum that allows access to the disc space. Using special instruments and image guidance, work is done through this small hole to remove the disc and fuse the interbody area. Bone that was obtained from the small hole is used as the graft to allow the fusion. In addition, a special screw rod device is inserted to secure this area and distract the previously collapsed disc space. This indirectly opens the space where the nerves are exiting the spinal canal and as a result alleviates the pressure and pain created by this.

Once this is complete the small incision closed and the patient is brought to recovery. Typically patients are discharged the next day. Click here to see a short video about Axial LIF procedure.

Percutaneous Fusion

Percutaneous fusion is a procedure that is accomplished through several small pokes in the skin. A 360° fusion can be obtained using special techniques and without the required incision and pain typical of an open fusion surgery.

percutaneous-fusionThrough the small pokes in the skin the disc is entered and removed using special instruments and nerve monitoring. Once the disc is cleared out, a special graft containment device is inserted into the space through a small canula. This device is then packed slowly with bone through this canula. As it is packed the device and disc space expands until it completely fills the disc space. This allows an interbody fusion. Screws and additional bone graft are placed through additional small pokes in the skin. This allows stabilization and fusion over time.

Patients typically are discharged the following day. As a result of the minimally invasive nature of this procedure; significant blood loss, postoperative pain, and hospital stays are all avoided.

Minimally Invasive TLIF

Transforaminal Lumbar Interbody Fusion (TLIF) is a surgery that has been used to decompress and fuse the lower back for many years. This surgery is still used commonly today and typically performed through an open approach. A minimally invasive TLIF accomplishes the same goals through a tiny incision. Special dilators and tubular retractors are used in combination with microscopic magnification to perform this surgery through the small incision.

mi-tlifThrough these small tubular retractors, the lumbar spine can be decompressed. During this process, bone spurs and disc material that is pressing on nerves and causing symptoms can be removed with special instruments. An implant is then placed where the disc once was to allow structural support and fusion. Screws are then placed through small poke incisions in the skin. This stabilizes the spine and supports the construct until the fusion can heal completely.

Typically patients are discharged 1 to 3 days after the surgery. As compared with open surgery, significant blood loss, postoperative pain, and hospital stay can be avoided through these minimally invasive techniques.

Click here to read an article about Minimally Invasive vs. Traditional Open Spine Surgery.

Laser Spine Surgery

Minimally Invasive Spine Surgery

Laser devices have been available for use in spine surgery for many years. However, it is not until recently through the process of improved instruments and techniques that laser use has become more realistic. Laser is a device that generates a very narrow, intense, and highly concentrated beam of light. When combined with current minimally invasive techniques, laser technology gives us yet another tool to effectively treat spine related conditions.

Dr. McCarthy performing minimally invasive laser spine surgery
Dr. McCarthy performing minimally invasive laser spine surgery

Laser devices can be used with endoscopic or minimally invasive tools to ablate disc herniations in order to alleviate nerve related leg pain, seal the outer layer of the disc to prevent recurrent problems with the spine, and to ablate the facet joints of the spine to alleviate back pain. In addition, laser devices are now being used in minimally invasive fusion procedures to facilitate spinal decompression.

The Spine Center at the Bone and Joint Clinic of Baton Rouge has always taken pride in being on the cutting edge of minimally invasive spine surgery techniques. We have employed minimally invasive techniques such as percutaneous fusions, endoscopic discectomies, rhizotomies, and other surgeries for many years. Additionally, we have continued to train in and develop the latest procedures in minimally invasive spine surgeries.

The Lumenis laser device at the Spine Hospital of Louisiana
The Lumenis laser device at the Spine Hospital of Louisiana

Spinal laser devices are still relatively rare and are found only in a small number of cities throughout the United States. The Spine Hospital of Louisiana recently became the only facility within 1500 miles of Baton Rouge to own and operate a laser device for the use in spinal surgery.  We are now able to utilize this technology to facilitate minimally invasive spine procedures. This allows further advancements of these techniques and offers Baton Rouge and Louisiana technology that was previously not available in this region.

Spine Procedures

The Minimally Invasive Approach

The Spine Center at the Bone and Joint Clinic of Baton Rouge is a leading center for the treatment of spinal disorders, led by Dr. Kevin McCarthy, a board certified and fellowship trained specialist in adult and pediatric spine surgery.

We have listed common spine procedures where you can click for more detailed information on individual procedures, with illustrations and images for some.