Spinal Surgery

Istituto Ortopedico Galeazzi

key figures 

CLINICAL SERVICES:

  • Adolescent Spine Deformity
  • Adult Spine Deformity
  • Degenerative Spine Diseases
  • Cervical Spine Diseases
  • Spine Fractures
  • Spondylolisthesis
  • Minimally Invasive Procedure
  • Spondylodiscitis

PROCEDURES PERFORMED PER YEAR: 400

The Spinal Surgery Unit, Division 1, performs spine procedures since 1975. The Division is made up of six orthopedic surgeon experts in the field of spine pathologies, including three researchers.  The team is engaged as speakers in about ten national and international congresses each year. The research activity includes, also, publications “in extenso” and abstract on index specialized journals, on Congress National and International Acts. The Unit organizes academic courses for surgeons and residents, and also fellow-ship for foreign residents and specialists.

 

treatmentS

Spine Deformity

Major field of interest of the Spinal Surgery Unit, are Spine Deformity, both in the coronal and in sagittal plane, in the adolescent and adult age and also early onset scoliosis in children. The main treatments for deformity in the paediatric and adolescent patients range from conservative treatment with custom-made brace and postural exercises for mild scoliosis and kyphosis, to surgical treatment for severe imbalance.  Daily meetings of the entire team take place in order to define the surgical plan and to discuss more complex clinical cases.  Technologies available in the surgical theatre for spine deformity are 3-D fluoroscopy and continuous intraoperative neuromonitoring (SEP, MEP and EMG for screw placement).
 
Main Pathologies Treated:

  • Paediatric and Adolescent Spine Deformity
    • Scoliosis – onset, idiopathic, severe
    • Kyphosis
    • Osteotomies
    • Spine Imbalance

Top Procedures:

  • Posterior Spine Instrumented Fusion with global de-rotation and translation for adolescent idiopathic scoliosis correction
  • Growing rod implant and lengthening in early onset scoliosis
  • Posterior, anterior and extreme-lateral instrumented fusion in the treatment of severe adult spine imbalance associated to different osteotomies types

Degenerative Spine Diseases  

An important field of interest are also degenerative spine diseases including cervical, thoracic and lumbar district. The main pathologies treated in this field are spinal stenosis, disc herniation, recurrent disc herniation, myelopathy, degenerative segmental instabilities. Treatments are conservative or surgical. Conservative treatment finds indication in mild symptomatic patients and consists of physiotherapy and dedicated exercises for spine rehabilitation.

Main Pathologies Treated:

  • Spinal Stenosis
  • Disc Herniation
  • Myelopathy:
    • Cervical
    • Thoracic
  • Degenerative Segmental instabilities

Top Procedures:

  • Micro discectomy
  • Cervical thoracic and lumbar spine decompression:
    • Laminotomy
    • Laminectomy
    • Open or French door for cervical spine decompression
    • Anterior cervical spine discectomy and fusion
    • Posterior lumbar instrumented fusion
    • Posterior lumbar interbody fusion (PLIF)
    • Transforaminal Lumbar Interbody Fusion (TLIF)
    • Posterior lumbar oblique interbody fusion (POLIF)
    • Extreme lateral interbody fusion (XLIF)

Spondylolisthesis

Of special interest to the Unit are also the isthmic, dysplastic, traumatic spondylolisthesis. A variety of surgical procedures are performed. The Unit is one of the first in Italy to perform the isthmic reconstruction on young patients with the use of the most modern techniques. All main surgical procedures are available for dysplastic, traumatic or severe isthmic spondylolisthesis as indicated below.  

Main Pathologies Treated:

  • Spondylolisthesis in paediatric and adult patients:
    • Isthmic
    • Dysplastic
    • Traumatic

Top Procedures:

  • Posterior lumbar instrumented fusion
  • Posterior lumbar interbody fusion (PLIF)
  • Transforaminal lumbar interbody fusion (TLIF)
  • Posterior lumbar oblique interbody fusion (POLIF)
  • Transdiscal screw fixation

Fractures: Osteoporotic, Traumatic and Spine Infections (Spondylodiscitis)

The team is also highly specialised in fractures both, osteoporotic, and traumatic, and spine infections. The diagnostic and therapeutic procedures are performed in the Unit and personalised to each patient. Diagnostic procedures include percutaneous or minimally invasive biopsy, performed under CT guide in collaboration with the Interventional Radiology Department or in the surgical theatre.

Main Pathologies Treated:

  • Fractures
    • Osteoporotic fractures
    • Traumatic Fractures
    • Spine Infections (spondylodiscitis)

Top Procedures:

  • Vertebroplasty (cement augmentation) for osteoporotic fractures
  • Fixation with or without screw cement augmentation for traumatic acute and chronic fractures

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • 3d Fluoroscopy
  • Pem And Pes Neuromonitoring With Electomiografy (Intraoperative)