While Dr. Eubanks is one of Northeast Ohio’s top spine surgeons, surgery is never his first option in treating a patient. Although he takes on a high volume of spine surgeries each year, nearly 90% of his cases are handled non-surgically.
Dr. Eubanks performs more than 350 spine surgeries each year. Seeing a highly experienced doctor is, of course, a benefit to patients. Studies have shown that high volume surgeons have better patient outcomes as the more surgeries a doctor and his team performs, the greater the results for the patient.
Dr. Eubanks specializes in minimally invasive spine surgery. He is highly trained in a wide range of treatment options and surgical procedures to treat back pain and spine conditions – from the most common to the most complex.
Common surgical procedures Dr. Eubanks provides:
Minimally Invasive Spine Surgery (MISS)
MISS typically refers to spinal surgery performed through small incisions with the use of specialized tubular retractors, a microscope or endoscope, and sometimes nerve monitoring techniques. MISS surgery is technically challenging but offers the benefits of less tissue disruption (and, therefore, less surgical pain), minimal blood loss, lower infection rates, faster recovery, and the potential for outpatient surgery. While MISS surgery has been associated with the term “laser,” it typically does NOT employ lasers, but the techniques mentioned above. These techniques can be used for both decompression and fusion operations.
Minimally Invasive Decompressions
MIS decompressions have revolutionized spinal surgery by allowing decompression of nerves through small incisions. MIS decompressions can be done on spinal nerves in the cervical, thoracic, or lumbar spine. These operations can be performed with very little disruption of the surrounding soft tissues and almost no blood loss. Because of this minimal soft tissue disruption, most of these procedures can be performed on an outpatient basis and allow for faster recovery. These procedures can also be ideal for older patients with poor bone quality and medical co-morbidities which might preclude a larger, more traditional spinal surgery.
Laminoplasty
Laminoplasty is an operation typically performed in the cervical spine to relieve pressure on the spinal cord in the neck. It was popularized in Asia as a treatment for spinal stenosis and resulting myelopathy (spinal cord dysfunction) resulting from cord compression. The operation hinges open the roof of the spinal canal to create more space for the spinal cord. Theoretic advantages to laminoplasty include: less soft tissue mobilization, less blood loss, and the avoidance of fusion. Laminoplasty indications are limited, however, and this procedure is not ideal for many patients with cervical stenosis and myelopathy.
Posterior Cervical Decompression and Fusion
This operation involves approaching the cervical spine from the back of the neck. It typically involves doing a laminectomy (removing the roof the spinal canal) to relieve pressure on the compressed spinal cord. After the laminectomy, it is then necessary to stabilize the spine to prevent from further neurologic injury. This means that spinal instrumentation and bone graft are used to fuse the spine in a stable position. This spinal fusion operation is ideal for the patient with multiple levels of spinal cord compression or neck anatomy which makes an anterior approach unreasonable.
Transforaminal Lumbar Interbody spinal Fusion (TLIF)
Transforaminal lumbar interbody fusion (TLIF) is a form of spinal fusion surgery in which the lumbar spine is approached through an incision in the back. The name of the procedure is derived from: transforaminal (through the foramen), lumbar (lower back), interbody (implants or bone graft placed between two vertebral bodies) and fusion (spinal stabilization).
The TLIF is a variation of the posterior lumbar interbody fusion (PLIF), in that it provides 360-degree fusion, avoids anterior access and associated complications, decreases manipulation of neural structures, reduces damage to ligamentous elements, minimizes excessive bone removal, enhances biomechanical stability, and provides early mobilization.
Traditional, open spine surgery involves cutting or stripping the muscles from the spine. But today, a TLIF may be performed using minimally invasive spine surgery, a treatment that involves small incisions and muscle dilation, allowing the surgeon to gently separate the muscles surrounding the spine rather than cutting them. A minimally invasive approach preserves the surrounding muscular and vascular function and minimizes scarring.
Anterior Cervical Discectomy & Spinal Fusion (ACDF)
Anterior cervical discectomy with spinal fusion is a surgical procedure that involves relieving the pressure placed on nerve roots and/or the spinal cord by a herniated disc or bone spurs in the neck – a condition referred to as nerve root compression.
Cervical refers to the seven vertebrae of the neck. Discs are the spongy, cartilaginous pads between each vertebra and “ectomy” means “to take out.” In a cervical discectomy, the surgeon accesses the cervical spine through a small incision in the neck and removes all or part of the disc – and/or in some cases bone material – that’s pressing on the nerves and causing pain.
Spinal fusion involves placing bone graft between two or more affected vertebrae to promote bone growth between the vertebral bodies. The graft material acts as a binding medium and also helps maintain normal disc height. As the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.
Extreme Lateral Interbody Fusion (XLIF)
This is a minimally invasive decompression and spinal fusion technique performed through the flank. Special tissue dilators and retractors are used with nerve monitoring to dilate through the psoas (hip flexor) muscle. This allows access to the disc space. Typically, this procedure is performed on the lumbar spine. The disc is taken out, the disc space is distracted to open up the space for the nerves, and a cage with bone graft is then placed in the disc space to keep the nerves decompressed. Often, this lateral fusion technique is supplemented with posterior pedicle screw instrumentation.
This fusion technique is attractive because it has minimal soft tissue disruption and typically very little blood loss. It allows for the restoration of more normal spinal alignment in patients with instability or deformity.
Visit our Patient Education Section for more details on surgical procedures.