The most common procedure is a discectomy, which involves removing the soft gel-like material in the disc. This procedure returns the disc to a more normal shape, relieving the pressure on the nerve. Neurosurgeons sometimes also remove a small piece of bone near the disc and irritated nerve to gain access to the disc or to give the area more space to expand and swell in the future. If the nerve is being pinched as it goes through the opening in the bone on the way to or from the spinal cord, the neurosurgeon can also perform a foraminotomy, which is a procedure designed to expand the opening the nerve travels through. With the spinal cord and nerves millimeters away, precision and delicacy are keys to a successful and safe procedure.
Neurosurgeons often use an operating microscope to help magnify the nerves and discs.
The neurosurgeon performs the procedure while viewing the affected area through a large microscope and this technique allows for better precision and a smaller incision. The technique translates beautifully in spine surgery and is a huge safety advantage for neurosurgeons and their patients. If several nerves and discs are the cause of the pain or there is degeneration and instability in the spinal column, the neurosurgeon may opt to fuse the bones together with bone grafts and stabilize the vertebra with instrumentation, including metal plates, screws, rods and cages. However, because of the metal instruments we use, there will be a limited loss of movement in the spine. The effect depends on where in the spine the fusion is done.