 Thoracic spine problems are uncommon. The need for surgery is rare. However, when the need for surgery does arise, the magnitude of surgery can be quite extensive. Thoracoscopic spine surgery has been developed and pioneered by orthopaedic surgeons such as John Regan, M.D., at the Texas Back Institute. Thoracoscopic surgery can spare the patient a large, rib-sacrificing incision. This also means a quicker, less painful recovery. Dr. Lurate is the first and only surgeon in this area to perform such surgery.
On the other hand, cervical spine problems are common. Cervical spine surgery has traditionally evolved in a somewhat segregated fashion in the past. Orthopaedic surgeons and neurosurgeons often developed different techniques and philosophies with both specialties making significant contributions toward the advancement of the field. However, the modern era has seen a more unified approach. Spine training programs and organizations such as the North American Spine Society, once dominated by orthopaedic surgeons, now make no distinction as to specialty. In the cervical spine, many pioneering techniques of orthopaedic surgeons in the 1950's and beyond have been adopted and refined by most spine surgeons of both specialties.
The vast majority of cervical spine cases involve one or perhaps two levels. Most patients enter the hospital the day of surgery and go home by the afternoon of the next day. The cases below represent more extreme cases treated by Dr. Lurate.
Cases
 This is the case of a 68-year-old electrician with severe right sided neck, shoulder, and arm pain associated with weakness and numbness. The extensive degenerative disease of his cervical spine had resulted in ominous narrowing of his spinal canal at multiple levels, placing his spinal cord at considerable risk. Successful decompression and fusion was performed at all levels of involvement utilizing bone bank and a titanium plate. He enjoyed immediate relief of his pain, quick return to function and eventual return to work. This preoperative MRI view (looking from the side) shows the severity of the narrowing of the spinal canal that is impinging on the spinal cord.
The cross sections compare one of his more normal levels (Left) with a level of dangerous narrowing around the spinal cord (Right), and the existing nerve roots going into his arms.
This preoperative and post-operative x-ray shows the decompression and fusion. Note the restored disc space height and cervical lordosis (normal curve of the neck).
This is the case of a very pleasant woman who was experiencing severe upper extremity pain and numbness. She was found to have advanced degenerative changes of her cervical spine that had begun to affect the nerves going into her arm as well as the spinal cord itself at the neck region. The preoperative x-ray and MRI scan demonstrate the severity of the problem. She had a thorough and complete decompression and fusion with the aid of an internal titanium plate. The postoperative x-rays show very nice restoration of the disc space height along with the decompression. She was quite pleased with her pain relief and functional improvement. She was also quite grateful to her physician for the referral to Dr.
Lurate.
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