New Procedure Helps Prevent Recurrent Disc Herniation
Lyerly Neurosurgeon Paulo Monteiro, MD, Pioneers New Technique at Baptist Medical Center

Jacksonville, Florida, February 25, 2009 -- Spine surgery can be very beneficial for many people suffering from radiating pain caused by a herniated disc. The standard of care is to remove the portion of the disc that is applying pressure to the nerves. This procedure is referred to as a spinal discectomy and typically requires the surgeon to make an incision in the outer layer of the disc which is called the anulus fibrosus. Previously, there has been no easy method to close the anulus following the removal of the tissue. Therefore, surgeons commonly leave the anulus to heal on its own.

Many patients find relief with this procedure, but for many others, the disc could re-herniate through this opening in the anulus resulting in continuing pain and potentially requiring additional surgery. Statistics show that approximately 30% of patients have pain following a lumbar discectomy and an estimated 15% of patients require a re-operation.

Today, there is a new approach called anular disc repair. This leading-edge treatment is being performed at Baptist Medical Center by neurosurgeon Paulo Monteiro, MD, with Lyerly Neurosurgery, who did the first anular disc repair in Northeast Florida; his partners, neurosurgeons Javier Garcia-Bengochea, MD, Andrew Cannestra, MD, and Bradley Wallace, MD, are the only other surgeons in the region who are doing this innovative new procedure.

After removing the ruptured portion of the disc, the surgeon inserts a surgical mesh implant, opens it like an umbrella, and then pulls it back to cover the space. The device is held in place against cartilage with a few stitches, and new tissue eventually grows around the device plugging the hole. By repairing the defect using the Xclose™ Tissue Repair System developed by Anulex Technologies, Inc., the inner disc material can't push out again and compress the nerve root. This pressure on the nerve is what causes the back pain.

"This makes great sense," says Dr. Monteiro. "This is the first time we have a device that treats the compromised tissue of the anulus fibrosus following a discectomy procedure. I have performed more than 30 procedures using the implant and have been very pleased with its success."

The procedure is performed as outpatient surgery. Patients are usually walking the same day and commonly begin physical therapy and exercise within 10 days to two weeks.

Not every patient is eligible to receive the implant; 10-15% have a spinal canal that may be too small for the device or the tear in their disc is too large to hold the implant.

For more information about this procedure, call Lyerly Neurosurgery at 904.388.6518.