Procedures We Perform

Managing all aspects of the spine, NJNBI offers an array of surgical options including:

Anterior Cervical Discectomy and Fusion Surgery

ACDF is a minimally invasive surgical procedure for relieving pressure on the nerve roots that causes pain, numbness or tingling in the neck and arm.

Anterior Lumbar Interbody Fusion (ALIF)

ALIF is a surgical procedure performed to fuse vertebrae in the spine together to provide stability.

Cervical (Neck) Procedures

The cervical spine is comprised of seven vertebrae that begin at the base of the skull and connect to the top of the thoracic spine in the shoulder region.

Cervical Laminectomy

A cervical laminectomy is a procedure that relieves painful pressure on the spinal cord in patients with spinal stenosis.

Laminoplasty

A laminoplasty is a surgical procedure for creating more space in the spinal canal.

Lateral Lumbar Interbody Fusion

Lateral lumbar interbody fusion is a procedure that accesses the spine from incisions created on the side of the body.

Lumbar (Lower Back) Procedures

The lumbar spine is the lower portion of the back that curves inward toward the abdomen.

Lumbar Decompression Surgery

Lumbar decompression surgery treats spinal stenosis, a condition in which the spinal nerve roots are compressed by degenerated portions of the lumbar spine.

Lumbar Fusion

Lumbar Fusion is a procedure where the vertebrae in the lower back are surgically joined together, minimizing any movement of the vertebrae themselves.

Lumbar Laminectomy

A laminectomy, also known as a decompression surgery, is a surgical procedure that relieves pressure on the spinal nerves or cord.

Lumbar Microdiscectomy

A lumbar microdiscectomy is where an incision is made on the disc herniation to remove the portion creating pressure on the nerve roots.

Microdisectomy

A microdiscectomy is a minimally invasive procedure conducted to relieve nerve impingement (pinched nerves) and allow the nerves to heal.

Minimally Invasive Surgery (MIS)

Minimally invasive spine surgery is a procedure using specialized techniques and instruments allowing Dr. LaRocca to operate with few effects on the body.

Posterior & Anterior Spinal Fusion

Spinal fusion is a surgery performed to permanently connect two or more vertebrae in the spine together for stability, eliminating motion.

Posterior Cervical Laminotomy

A posterior laminotomy is a procedure typically performed on the cervical (neck) region of the spine for relieving pressure on the spinal cord and nerves.

Posterior Lumbar Interbody Fusion

Posterior lumbar interbody fusion is a procedure performed to fuse the vertebrae in the lumbar region of the spine together for stability.

Scoliosis Fusion Surgery

Scoliosis fusion surgery is a procedure for correcting the curvature of the spine resulting from disc degeneration of the spine.

Thoracic (Middle Back) Procedures

The thoracic spine consists of the upper and middle sections of the back, extending approximately five inches past the end of the shoulder blades and connecting to lumbar spine.

Transforaminal Lumbar Interbody Fusion

Transforaminal Lumbar Interbody Fusion is a surgical procedure conducted to fuse the vertebrae in the lumbar region into solid bone for stability.

What is Lateral Lumbar Interbody Fusion (LLIF)

Also known as extreme lateral (XLIF) or direct lateral interbody fusion (DLIF), LLIF is a procedure that accesses the spine from incisions created on the side of the body. It is performed to provide relief from symptoms due to conditions such as:

Degenerative disc disease, the natural deterioration of the spinal discs over time
Degenerative scoliosis, a curvature of the spine caused by the degeneration of the facet joints
Herniated disc, damage to the spinal discs that causes nerve “pinching” or impingement
Spinal tumors, abnormal tissue growth in or on the spine
Spondylolisthesis, a condition in which one of the vertebrae of the spine slips out of place

The focus of a surgical treatment is to drastically improve quality of life. Back doctor Dr. LaRocca may propose back surgery in the event of noticeable tiredness, extreme pains or when all other treatment options have been implemented.

What to Expect Before and After the Procedure

During the Procedure

During the procedure, Dr. LaRocca may approach the spine through an incision in the flank, the space on the side of the body between the ribs and the hip. In doing so, he avoids separating back muscles, cutting bone, moving major blood vessels, or moving spinal nerves as opposed to approaches such as:

Anterior lumbar interbody fusion (ALIF)
Posterior lumbar interbody fusion (PLIF)
Transforaminal lumbar interbody fusion (TLIF)

A surgical instrument known as a tubular retractor is then inserted through the skin and onto the spinal column to hold the muscles open.

Once there is a clear view of the spine, the affected spinal disc material is removed and a spacer known as a cage containing bone graft material is placed in the empty space to encourage the two vertebrae to heal and fuse together. The bone graft material is rarely taken from the hip but may also be donated from a cadaver or consist of various biologically active materials that promote bone growth. Screws made of titanium may then be inserted to hold the cage in place.

There are a few advantages to this approach over other approaches, including:

Avoiding the spinal nerves
Better alignment of the vertebrae
Easier access to the spine
Faster recovery
Less damage to the muscle tissue

Dr. LaRocca can help patients determine what approach is best based on the individualized needs of patients.

After the Procedure

Patients may be allowed to leave the day of surgery or the day after due to the minimally invasive nature of the procedure. Patients may return to normal activity within four to six weeks.