There are many different treatments for severe back pain, including medication and physical therapy. In some situations, however, surgery is the best option to relieve the pain. One common type of back surgery is fusion, a procedure that permanently connects two or more vertebrae in the spine.
Spinal fusion is usually performed through the back (posterior) or through the front (anterior). At Saint Francis Medical Center, neurosurgeons often work jointly with general surgeons to perform anterior spinal fusion.
“I am trained as a neurosurgeon, so I do not perform many surgeries in the abdominal area,” says David G. Yingling, MD, neurosurgeon at Saint Francis. For this reason, Yingling partners with Ronald M. Richmond, MD, FACS, general surgeon at Saint Francis Medical Center, when performing anterior spinal fusions. “Dr. Richmond is trained in abdominal and vascular surgery, so it is extremely valuable to have him in the operating room.”
Anterior spinal fusion is often a better option than posterior fusion because it has a quicker recovery period. “When you access the spine through the back,” says Yingling, “there are large groups of muscles going up and down each side of the spine that have to be pushed out of the way. After the surgery, those muscles can spasm, causing significant pain for weeks or even months.”
Another advantage to approaching the surgery from the front is the minimal risk of nerve damage. During a spinal fusion, surgeons need to remove one or more of the disks (cushions between the vertebrae) in the spine. When they approach the area from the back, they need to work around the nerves before they reach the disk, whereas from the front, they usually do not need to expose the nerves.
Yingling and Richmond have been performing anterior spinal fusions together for several years. “We work very well as a team,” says Richmond. “When we combine our expertise, we can provide increased efficiency and safety, and because of that, we see very good outcomes. For the majority of our patients, their pain is significantly improved.”
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