NJ Spine Institute
Testimonial
Name
Phone
Email
Comment
Verify
NJ Spine Institute
37 West Century Road, Suite 104
Paramus, New Jersey 07652
Ph: (201) 493-0123
Fax: (201) 493-0127
View Map

Procedures We Perform

Spine Anatomy

CERVICAL (NECK)

LUMBAR (LOWER BACK)

Anterior Cervical Corpectomy Anterior Lumbar Interbody Fusion (ALIF)
Anterior Cervical Disc Replacement (PCM) Endoscopic Lumbar Fusion
Anterior Cervical Discectomy and Fusion (ACDF) Interspinous Process Decompression (X-STOP)
Anterior Endoscopic Cervical Micro Discectomy Kyphoplasty
Laminectomy Cervical Laminectomy
Laminectomy Cervical with Fusion Laser Disk Surgery
Spinal Fusion Lumbar Disc Microsurgery
  Lumbar Interbody Fusion (IBF)
  Lumbar Pedicle Screw Fixation
  Micro Endoscopic Discectomy
  Minimally Invasive Posterior Lumbar Interbody fusion (PLIF)
  Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF)
  Vertebral Augmentation
  Vertebroplasy
  YESS Selective Endoscopic Discectomy


Conditions We Treat

SPINE CONDITIONS


SPINE CONDITIONS


Anatomy of the Spine Scoliosis
Cervical Radiculopathy Spinal Stenosis
Degenerative Disc Disease Spinal Stenosis (Cervical)
Herniated Disc (Cervical) Spondylolisthesis
Herniated Discs Spondylosis
Lumbar Radiculopathy (Sciatica) Where Back Pain Begins
Myelopathy Where Neck Pain Begins
Osteoporosis  


Overview of Minimally Invasive Spine Surgery

Minimally invasive spine surgery is the performance of surgery through small incision(s), usually with the aid of endoscopic visualization (very small devices or cameras designed for viewing internal portions of the body). Minimally invasive spine surgery has developed out of the desire to effectively treat disorders of the spinal discs with minimal muscle related injury, and with rapid recovery.

Endoscopic Fusion

Endoscopic fusion, a minimally-invasive form of spinal fusion, can be used to correct degenerative disc disease, spondylolisthesis, scoliosis, and other disorders of the spine. This method reduces patient trauma associated with traditional open surgery by minimizing prolonged muscle retraction, scarring, incision size and blood loss. The process preserves healthy muscle and soft tissue and reduces post-operative pain and recovery time. Patients can leave the outpatient center the next day, with less pain, and  the expectation of a quicker return to their daily routines within weeks.

Dr. Quartararo begins the procedure by inserting an endoscope through a small 1cm incision. An endoscope is a camera positioned at the end of a cable that magnifies and illuminates the area of surgery onto a TV screen enlarging the operating field.  Dr. Quartararo is able to perform the surgery after making a series of small incisions, each about 1 cm in length, instead of a traditionally much larger open incision.

Endoscopic surgery also utilizes tunnel-like access portals, through which small surgical instruments are inserted to perform the removal of herniated disc material and the insertion of allograft and support devices. This allows Dr. Quartararo to reach the operative site and perform the surgery with minimal disturbance of the surrounding tissue.   Dr. Quartararo’s goal is to utilize minimally-invasive techiques on all his procedures in order to accelerate patient recovery rate.



Micro Endoscopic Discectomy

Many kinds of minimally invasive procedures for spine pathology have been developed over the years. Micro endoscopic discectomy (MED) is one of the minimally invasive procedures for lumbar disc surgery. This method is characterized by using a tubular retractor system and unique visualization through the oblique lens of an endoscope. The tubular retractor system allows reduced tissue or muscle trauma, and the oblique endoscope can provide a clear and wide visualization of the operative field beyond the confines of the tubular retractor.

Click here
to view an animation of this procedure.



Lumbar Disc Microsurgery

Lumbar microsurgery is a way of doing low-back surgery through a small incision. There are two types of lumbar microsurgery. Micro decompression is removal of bone from the spine. Micro discectomy is removal of disk. This removal takes pressure off nerves and reduces symptoms.

Click here
to view an animation of this procedure.



Anterior Endoscopic Cervical Micro Discectomy

Click here to view an animation of this procedure.



YESS Selective Endoscopic Discectomy

Selective Endoscopic Discectomy is a minimally invasive spine surgery technique that utilizes an endoscope to treat herniated, protruded, extruded, or degenerative discs that are a contributing factor to leg and back pain. The endoscope allows the surgeon to use a “1cm” incision to access the herniated disc. Muscle and tissue are dilated rather than being cut when accessing the disc. This leads to less tissue destruction, less postoperative pain, quicker recovery times, earlier rehabilitation, and avoidance of general anesthesia. The excellent visualization via the endoscope permits the surgeon to selectively remove a portion of the herniated nucleus pulposus that is contributing to the patients’ leg and back pain.

Click here to view an animation of this procedure.



Interspinous Process Decompression (X-STOP)

IPD is a minimally invasive surgical procedure in which an implant is placed between the spinous processes of the symptomatic disc levels. IPD's were developed for patients who have LSS (Lumbar Spinal Stenosis), suffer symptoms of neurogenic intermittent claudication, and who are able to relieve their symptoms when they bend forward or flex their spines.

These devices are designed to limit pathologic extension of the spinal segments and maintain them in a neutral or slightly flexed position, which may allow patients to resume their normal posture rather than flex the entire spine to gain symptom relief.

The procedure may be performed in either the operating room or special procedures room at the hospital. Using local anesthesia and with the help of X-ray guidance, the X-STOP implant is inserted through a small incision in the skin of your back.

Click here
to view an animation of this procedure.



Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF)

Also known as mini-open TLIF, a transforaminal lumbar interbody fusion is a minimally invasive surgical technique that is performed in patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease, and recurrent disc herniation. The TLIF approach may also have potential in patients with low back pain caused by post-laminectomy instability, spinal trauma, or for treating pseudoarthrosis..

The procedure is performed from the back (posterior) with the patient on his or her stomach. The major difference in the TLIF approach is that the operation is performed unilaterally, and the bone graft is inserted into the disc space through the side.

Using x-ray guidance, a 2- to 4-cm incision is made approximately 4 to 5 cm lateral to the midline. The muscles are gradually dilated and a tubular retractor is inserted to allow access to the affected area of the lumbar spine. The lamina is removed to allow visualization of the nerve roots, and the facet joints may be trimmed or removed to allow more room for the nerve roots.

The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement. Surgeons may position small screws on the other side of the spine through a percutaneous technique to provide additional stability. The tubular retractor is removed, allowing the dilated muscles to come back together, and the incision is closed. This procedure typically takes about 2 ½ hours to perform.

Click here to view an animation of this procedure.



Minimally Invasive Posterior Lumbar Interbody Fusion (PLIF)

Minimally Invasive Posterior lumbar interbody fusion (PLIF) is a minimally invasive surgical technique for placing bone graft between adjacent vertebrae (interbody). Using x-ray guidance, two 2.5-cm incisions are made on either side of the lower back. The muscles are gradually dilated and tubular retractors inserted to allow access to the affected area of the lumbar spine. The lamina is removed to allow visualization of the nerve roots.

The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement. The tubular retractors are removed, allowing the dilated muscles to come back together, and the incisions are closed. This procedure typically takes about 3 to 3 ½ hours to perform. Indications for this procedure may include pain and spinal instability resulting from spondylolisthesis, degenerative disc disease, or when a discectomy is performed to relieve nerve compression and the patient has associated mechanical low back pain.

Click here
to view an animation of this procedure.



Vertebral Augmentation

Augmentation means to add to, vertebral indicates a vertebra, and percutaneous means through the skin. PVA is minimally invasive procedure to augment a vertebra that has fractured because of osteoporosis or injury to the spine. There are two types of PVA: kyphoplasty and vertebroplasty.

Click here to view an animation of this procedure.



Kyphoplasty

Kyphoplasty is a medical procedure that attempts to stop the pain caused by the bone fracture and attempts to restore the height and angle of kyphosis of a fractured vertebra (of certain types), followed by its stabilization using injected bone filler material. Kyphoplasty and vertebroplasty represent the two procedures that percutaneously attempt to augment the strength of fractured or weakened vertebrae.

Click here to view an animation of this procedure.



Vertebroplasty

Vertebroplasty is a medical spinal procedure where bone cement is injected through a small hole in the skin (percutaneously) into a fractured vertebra with the goal of relieving the pain of osteoporotic compression fractures. It has been found to be very effective in treating compression fracture of the spine.

The procedure can be performed under either local or general anesthesia, on multiple levels, out-patient or in-patient, and is viewed as minimally invasive. It was most commonly performed for spinal compression fractures caused by osteoporosis, a condition that weakens the bone, and is also sometimes performed for certain other conditions that may have led to a spinal fracture.

Click here to view an animation of this procedure.



Laminectomy

Laminectomy is a spine operation to remove the portion of the vertebral bone called the lamina. There are many variations of laminectomy. In the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut, and the parts of the vertebra adjacent to the lamina are left intact. The traditional form of laminectomy (conventional laminectomy) excises much more than just the lamina; the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure, and weeks to months with conventional open surgery

Click here to view an animation of this procedure.



Laminectomy Cervical

Click here to view an animation of this procedure.



Laminectomy (Cervical) with Fusion

Click here to view an animation of this procedure.



Lumbar Interbody Fusion (IBF)

Click here to view an animation of this procedure.



Anterior Cervical Discectomy and Fusion (ACDF)

(ACDF) is a procedure used to treat cervical spine conditions that cause arm pain (radiculopathy), neck pain (degenerative disc disease) and myelopathy. The procedure entails a surgical exposure from the front of the neck and an anterior exposure to the spine. The cervical disc is removed, the disc space is distracted and a bone graft material is used to hold the disc space distracted. Securing the fusion with a plate and screws may or may not be required.

Click here to view an animation of this procedure.



Anterior Cervical Corpectomy

Anterior cervical corpectomy and fusion (ACCF) is performed for patients with symptomatic, progressive cervical spinal stenosis and myelopathy. It is performed to remove the large, arthritic osteophytes (bone spurs) that are compressing the spinal cord and spinal nerves. However, in order to do so generally involves removing nearly the entire vertebral body and disc, which must be replaced with a piece of bone graft and mended (fused) together to maintain stability.

Click here to view an animation of this procedure.



Anterior Lumbar Interbody Fusion (ALIF)

This procedure is done from the front of the body through an anterior approach, We most often utilize this procedure for degenerative conditions that cause back or leg pain as a result of degenerative disc disease, spondylolisthesis or scoliosis. The Disc space is entered from the front (through a small incision in the abdomen) and cleaned out. The disc space height is then restored with spacers (cages) that are filled with bone graft or Bone Morphogenic Protein (BMP). The goal of this surgery is to restore the spinal alignment, decompress the exiting nerve roots and obtain a fusion of the vertebrae.

Click here
to view an animation of this procedure.



Spinal Fusion

Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to combine two or more vertebrae. Supplementary bone tissue (either autograft or allograft) is used in conjunction with the body's natural osteoblastic processes. This procedure is used primarily to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the vertebrae themselves.
Spinal fusion is done most commonly in the lumbar region of the spine, but it is also used to treat cervical and thoracic problems. The indications for lumbar spinal fusion are controversial.[1] People rarely have problems with the thoracic spine because there is little normal motion in the thoracic spine. Patients requiring spinal fusion have either neurological deficits or severe pain which has not responded to conservative treatment.

Click here to view an animation of this procedure.



Lumbar Pedicle Screw Fixation

Click here to view an animation of this procedure.



Anterior Cervical Disc Replacement (PCM)

Click here to view an animation of this procedure.