Non-invasive Surgery

These procedures are free of serious complications, with a short hospital stay and recovery, allowing a fast return of the patient to daily routine activities.In addition: they are minimally invasive therapeutic procedures; general anesthesia is not required; does not interfere with bone structures; does not imply removal of the disc; without cutaneous scar; have a high expected success rate; do not prevent surgery, if it is strictly necessary.They can be used in patients with complaints of pain referred to the spine (with or without irradiation to the arm or leg), with poor response to pharmacological treatment, as well as in patients undergoing previous invasive surgery without symptomatic improvement or with clinical recurrence/aggravation (Failed Back Surgery Syndrome).These treatments are not suitable for all patients with a vertebral / spinal pain, requiring a medical consultation, with a diagnostic discussion and therapeutic options.

Kyphoplasty consists of a minimally invasive procedure in which an inflatable balloon is introduced into the percutaneously fractured vertebral body and inflated prior to the injection of orthopedic cement polymethylmethacrylate (PMMA), causing expansion of the vertebra affected.

The inflated balloon allows the fracture fragments to be elevated, the restoration of the height of the vertebral body and the correction of the kyphosis, through the filling of the cavity created with cement.

Kyphoplasty is indicated in the following cases:

• Post-traumatic vertebral fractures;
• Osteoporotic fractures;
• Pathological fractures;
• Vertebral metastases;
• Vertebral hemangiomas.

Neurolysis corresponds to the rupture or lysis of a spinal nerve or part of their components (roots or branches) through a neurolytic agent. The neurolytic agent may be mechanical (for example, scalpel), chemical (for example, absolute alcohol) or physical (for example, heat produced by radiofrequency waves).

Radiofrequency neurolysis is a surgical technique used for the treatment of spinal pain that originates in the interapophyseal joint. Complete and intentional lysis of the nerve is rarely indicated because of the limitations that can result from this type of procedure. Thus, in spinal surgery, when it is called neurolysis, it generally refers to the selective lysis of a part of the elements that compose the nerve. Most of the time, seeks to rupture the branches that contains the fibers that lead the painful stimulus.

In lumbar neurolysis by radiofrequency, the rupture of nervous tissue takes place through the heat produced by the radiofrequency waves emitted from the tip of an electrode positioned in the anatomical path of the spinal nerve to be approached.

Neurolysis is generally used to treat chronic pain. It is used in the treatment of facet syndrome (disease caused by arthrosis in the spine, ie, degeneration of the facet joints) in elderly patients who do not respond to conservative measures. But it can also be used as a technique to control pain in patients with cancer, for example.

Ozone nucleolysis in the treatment of herniated discs is as effective, safe and uncomplicated procedure. It consists of the administration of a mixture of oxygen-ozone inside the disc and beside the compressed nerve.

Ozone injected into the disc promotes the reduction of their volume and consequently decreases the pressure exerted on the nerve that is responsible for back pain (with or without irradiation by the arms or legs) and may be accompanied by changes in sensitivity or decrease of muscle strength. The injection beside the affected nerve has anti-inflammatory and analgesic properties.

Nucleolysis is a minimally invasive procedure used in the treatment of spinal pathologies, such as herniated disc, discopathies and chronic muscular contractures.

It is an innovative technique in Portugal for the treatment of invertebrate disk hernias, especially in the cervical and lumbar regions.

It is a minimally invasive technique, "non-surgical", which consists of the application of a plasma energy source through an advanced fiber-optic system at a very precise location of the herniated disc under high-definition imaging control. The aim is to reduce the intradiscal tension, forcing the disc herniation to return to its initial position, with consequent relief of the tension on the nerves and, consequently, the pain. It does not involve the dissection of muscles or the surgical removal of the disc and is free of the usual complications of surgery.

It is an extremely safe technique, without risks or complications, with short-term hospital stay (maximum 2 days) and allows a quick return to the routines of daily and professional life.

The minimally invasive treatment of disc hernias at any vertebral level (cervical, dorsal and lumbar) can be performed by nucleoplasty by coablation using the Arthrocare system.

It has excellent results internationally. Through this system it is possible to reduce the nucleus of the herniated disc, the pressure inside the disc, the protrusion of the disc hernia, and consequently the compression and the local inflammation on the compromised nerve root. This treatment can be performed in patients with complaints of pain referred to the spine (with or without irradiation to the arm or leg), with poor response to medications, as well as in patients submitted to prior conventional surgery without symptomatic improvement or with recurrent or clinical deterioration.

Although less common than osteoporosis, neoplastic disease is well known as a cause of painful compression fracture. These fractures may be associated with primary or metastatic malignancies, myeloma, and with aggressiveness of some benign tumors, such as hemangiomas. The biopsy of suspected lesions is guided by computed tomography or ultrasound, with local anesthesia.