Our Procedures
Our Procedures
Minimally Invasive and Interventional Procedures
Minimally Invasive and Interventional Procedures
Overview
Minimally invasive spine interventions focus on reducing pain and improving function with techniques that minimize tissue damage and recovery time. These approaches include nerve blocks, injections, and advanced image-guided procedures, offering alternatives to traditional surgery for targeted relief.
Key Procedures
Nerve blocks are a key component of these interventions, designed to temporarily block pain signals from specific nerves using anesthetic or anti-inflammatory medications. Peripheral nerve blocks target nerves outside the spinal cord, while epidural injections deliver medication near spinal nerves to reduce inflammation. Additionally, spinal anesthesia or analgesia involves administering medication into cerebrospinal fluid for broader pain relief. Image-guided injections utilize techniques like ultrasound or fluoroscopy to ensure precise delivery of steroids or anesthetics to inflamed nerves or joints. This precision allows for selective nerve root blocks, which diagnose and treat nerve inflammation by targeting specific spinal nerves. Facet joint or sacroiliac injections address localized pain from arthritic or degenerated joints. Another important procedure is vertebral augmentation, which stabilizes compression fractures, such as those related to osteoporosis, with bone cement injections under imaging guidance.
Benefits
The benefits of these minimally invasive interventions are significant. They offer reduced recovery time, with procedures like nerve blocks taking only a few minutes to administer, and effects are often felt within a short period. Additionally, these techniques carry lower risks compared to open surgery, as they involve smaller incisions or needle-based methods that minimize muscle damage and blood loss. This targeted approach focuses on specific pain generators, often avoiding the need for systemic medications.
Considerations
When considering these interventions, it's important to weigh the evidence and potential controversies. Some procedures, such as epidural steroid injections, face debate over long-term efficacy and trial methodologies. Patient selection is crucial, with these interventions often being ideal for those who have not responded to conservative treatments or have contraindications to surgery. By carefully evaluating each patient's needs and medical history, healthcare providers can determine the most appropriate minimally invasive option for achieving optimal pain relief and functional improvement.
Overview
Minimally invasive spine interventions focus on reducing pain and improving function with techniques that minimize tissue damage and recovery time. These approaches include nerve blocks, injections, and advanced image-guided procedures, offering alternatives to traditional surgery for targeted relief.
Key Procedures
Nerve blocks are a key component of these interventions, designed to temporarily block pain signals from specific nerves using anesthetic or anti-inflammatory medications. Peripheral nerve blocks target nerves outside the spinal cord, while epidural injections deliver medication near spinal nerves to reduce inflammation. Additionally, spinal anesthesia or analgesia involves administering medication into cerebrospinal fluid for broader pain relief. Image-guided injections utilize techniques like ultrasound or fluoroscopy to ensure precise delivery of steroids or anesthetics to inflamed nerves or joints. This precision allows for selective nerve root blocks, which diagnose and treat nerve inflammation by targeting specific spinal nerves. Facet joint or sacroiliac injections address localized pain from arthritic or degenerated joints. Another important procedure is vertebral augmentation, which stabilizes compression fractures, such as those related to osteoporosis, with bone cement injections under imaging guidance.
Benefits
The benefits of these minimally invasive interventions are significant. They offer reduced recovery time, with procedures like nerve blocks taking only a few minutes to administer, and effects are often felt within a short period. Additionally, these techniques carry lower risks compared to open surgery, as they involve smaller incisions or needle-based methods that minimize muscle damage and blood loss. This targeted approach focuses on specific pain generators, often avoiding the need for systemic medications.
Considerations
When considering these interventions, it's important to weigh the evidence and potential controversies. Some procedures, such as epidural steroid injections, face debate over long-term efficacy and trial methodologies. Patient selection is crucial, with these interventions often being ideal for those who have not responded to conservative treatments or have contraindications to surgery. By carefully evaluating each patient's needs and medical history, healthcare providers can determine the most appropriate minimally invasive option for achieving optimal pain relief and functional improvement.
Decompressions and Fusions
Decompressions and Fusions
Overview
Decompression and fusion surgeries address nerve compression, spinal instability, and mobility challenges caused by conditions such as herniated discs, spinal stenosis, and degenerative disc disease. These procedures aim to relieve pressure on nerves, stabilize spinal structures, and restore function through targeted interventions.
Decompressions
Decompression surgeries focus on alleviating nerve pressure by removing or modifying tissues compressing the spinal cord or nerves. Laminectomy involves removing part of the vertebral bone to create space in the spinal canal, often used for spinal stenosis or bone spurs. Discectomy targets herniated discs by excising the damaged portion pressing on nerves, frequently performed alongside laminectomy for access. Laminotomy and laminoplasty refine this approach: laminotomy creates a small opening in the bone to reduce pressure, while laminoplasty reshapes the bone to preserve spinal alignment, particularly in cervical cases.
Minimally invasive techniques, such as microdiscectomy or keyhole surgery, use smaller incisions and specialized tools to minimize tissue damage and recovery time. These methods are ideal for patients requiring precise intervention with reduced postoperative risks.
Fusions
Spinal fusion stabilizes the spine by permanently connecting two or more vertebrae, often combined with decompression to address instability. This procedure is critical for degenerative disc disease, fractures, or spinal deformities where excessive motion exacerbates pain. Bone grafts or synthetic materials are used to promote bone growth between vertebrae, while instrumentation like rods or screws may reinforce stability.
Fusion sacrifices some spinal mobility to prevent further nerve compression or structural collapse. However, artificial disc replacement offers an alternative for select patients, preserving motion by replacing damaged discs with prosthetic implants.
Considerations
Decompression and fusion surgeries are typically reserved for cases unresponsive to non-surgical treatments like physical therapy, medications, or injections. Risks include infection, blood clots, and adjacent segment degeneration. Recovery varies: laminectomy or discectomy may allow return to light activity relatively quickly, while fusion requires longer healing due to bone integration.
Collaborative care involving physiotherapists and pain specialists optimizes rehabilitation. Patient selection is crucial, balancing factors like age, symptom severity, and overall health to ensure realistic expectations and safe outcomes.
Overview
Decompression and fusion surgeries address nerve compression, spinal instability, and mobility challenges caused by conditions such as herniated discs, spinal stenosis, and degenerative disc disease. These procedures aim to relieve pressure on nerves, stabilize spinal structures, and restore function through targeted interventions.
Decompressions
Decompression surgeries focus on alleviating nerve pressure by removing or modifying tissues compressing the spinal cord or nerves. Laminectomy involves removing part of the vertebral bone to create space in the spinal canal, often used for spinal stenosis or bone spurs. Discectomy targets herniated discs by excising the damaged portion pressing on nerves, frequently performed alongside laminectomy for access. Laminotomy and laminoplasty refine this approach: laminotomy creates a small opening in the bone to reduce pressure, while laminoplasty reshapes the bone to preserve spinal alignment, particularly in cervical cases.
Minimally invasive techniques, such as microdiscectomy or keyhole surgery, use smaller incisions and specialized tools to minimize tissue damage and recovery time. These methods are ideal for patients requiring precise intervention with reduced postoperative risks.
Fusions
Spinal fusion stabilizes the spine by permanently connecting two or more vertebrae, often combined with decompression to address instability. This procedure is critical for degenerative disc disease, fractures, or spinal deformities where excessive motion exacerbates pain. Bone grafts or synthetic materials are used to promote bone growth between vertebrae, while instrumentation like rods or screws may reinforce stability.
Fusion sacrifices some spinal mobility to prevent further nerve compression or structural collapse. However, artificial disc replacement offers an alternative for select patients, preserving motion by replacing damaged discs with prosthetic implants.
Considerations
Decompression and fusion surgeries are typically reserved for cases unresponsive to non-surgical treatments like physical therapy, medications, or injections. Risks include infection, blood clots, and adjacent segment degeneration. Recovery varies: laminectomy or discectomy may allow return to light activity relatively quickly, while fusion requires longer healing due to bone integration.
Collaborative care involving physiotherapists and pain specialists optimizes rehabilitation. Patient selection is crucial, balancing factors like age, symptom severity, and overall health to ensure realistic expectations and safe outcomes.
Major Reconstructions and Deformity Corrections
Major Reconstructions and Deformity Corrections
Overview
Surgical correction of large spinal deformities represents some of the most technically demanding and rewarding work in spinal care. These complex procedures carry higher potential complication rates and are never pursued without thorough consideration. Dr. Oitment collaborates closely with patients to ensure decisions are grounded in clear objectives, realistic expectations, and a meticulously crafted, evidence-based plan.
Conditions We Treat
Our practice addresses a wide range of spinal deformities, including congenital scoliosis, adolescent idiopathic scoliosis, and adult degenerative deformities. We also manage Scheuermann’s kyphosis, inflammatory conditions such as ankylosing spondylitis, syndromic deformities like neurofibromatosis, and complex revision surgeries for previously treated cases. Each condition requires tailored strategies to address unique anatomical and functional challenges.
Our Approach
Every surgical plan is individualized to reflect the patient’s unique needs and goals. We prioritize minimizing risks through careful preoperative staging and advanced techniques, such as osteotomies and vertebral column resection for severe deformities. Outcomes are maximized by aligning surgical strategies with each patient’s functional and quality-of-life priorities, whether that involves restoring posture, reducing pain, or improving mobility. Whenever feasible, we preserve natural spinal motion and bone integrity to support long-term health.
Collaborative Care
For select adolescent cases, we partner with the Hospital for Sick Children (SickKids) to integrate specialized pediatric expertise into treatment plans. This collaboration ensures younger patients receive age-appropriate, multidisciplinary care. We also work closely with physiotherapists, pain management specialists, and other providers to optimize recovery and support patients through every phase of their journey.
Overview
Surgical correction of large spinal deformities represents some of the most technically demanding and rewarding work in spinal care. These complex procedures carry higher potential complication rates and are never pursued without thorough consideration. Dr. Oitment collaborates closely with patients to ensure decisions are grounded in clear objectives, realistic expectations, and a meticulously crafted, evidence-based plan.
Conditions We Treat
Our practice addresses a wide range of spinal deformities, including congenital scoliosis, adolescent idiopathic scoliosis, and adult degenerative deformities. We also manage Scheuermann’s kyphosis, inflammatory conditions such as ankylosing spondylitis, syndromic deformities like neurofibromatosis, and complex revision surgeries for previously treated cases. Each condition requires tailored strategies to address unique anatomical and functional challenges.
Our Approach
Every surgical plan is individualized to reflect the patient’s unique needs and goals. We prioritize minimizing risks through careful preoperative staging and advanced techniques, such as osteotomies and vertebral column resection for severe deformities. Outcomes are maximized by aligning surgical strategies with each patient’s functional and quality-of-life priorities, whether that involves restoring posture, reducing pain, or improving mobility. Whenever feasible, we preserve natural spinal motion and bone integrity to support long-term health.
Collaborative Care
For select adolescent cases, we partner with the Hospital for Sick Children (SickKids) to integrate specialized pediatric expertise into treatment plans. This collaboration ensures younger patients receive age-appropriate, multidisciplinary care. We also work closely with physiotherapists, pain management specialists, and other providers to optimize recovery and support patients through every phase of their journey.
Our Procedures
Minimally Invasive and Interventional Procedures
Minimally Invasive and Interventional Procedures
Overview
Minimally invasive spine interventions focus on reducing pain and improving function with techniques that minimize tissue damage and recovery time. These approaches include nerve blocks, injections, and advanced image-guided procedures, offering alternatives to traditional surgery for targeted relief.
Key Procedures
Nerve blocks are a key component of these interventions, designed to temporarily block pain signals from specific nerves using anesthetic or anti-inflammatory medications. Peripheral nerve blocks target nerves outside the spinal cord, while epidural injections deliver medication near spinal nerves to reduce inflammation. Additionally, spinal anesthesia or analgesia involves administering medication into cerebrospinal fluid for broader pain relief. Image-guided injections utilize techniques like ultrasound or fluoroscopy to ensure precise delivery of steroids or anesthetics to inflamed nerves or joints. This precision allows for selective nerve root blocks, which diagnose and treat nerve inflammation by targeting specific spinal nerves. Facet joint or sacroiliac injections address localized pain from arthritic or degenerated joints. Another important procedure is vertebral augmentation, which stabilizes compression fractures, such as those related to osteoporosis, with bone cement injections under imaging guidance.
Image-Guided Injections
All procedures are performed using best practices with real-time X-ray (fluoroscopic) guidance to ensure precision and safety. We offer a range of therapeutic options, including corticosteroid injections, Platelet-Rich Plasma (PRP), and other advanced treatments tailored to your condition.
Available Procedures:
Epidural Steroid Injections – for relief of nerve-related back and leg pain
Selective Nerve Root Blocks – to target specific inflamed or irritated nerve roots
Facet Joint Injections – to diagnose and treat arthritic or inflamed spinal joints
Medial Branch Blocks & Radiofrequency Ablations – to manage facet-related back pain
Sacroiliac (SI) Joint Injections – for lower back or pelvic pain
Lateral Sacral Nerve Root Injections and Ablations – for specialized pelvic or lower extremity pain management
Benefits
The benefits of these minimally invasive interventions are significant. They offer reduced recovery time, with procedures like nerve blocks taking only a few minutes to administer, and effects are often felt within a short period. Additionally, these techniques carry lower risks compared to open surgery, as they involve smaller incisions or needle-based methods that minimize muscle damage and blood loss. This targeted approach focuses on specific pain generators, often avoiding the need for systemic medications.
Considerations
When considering these interventions, it's important to weigh the evidence and potential controversies. Some procedures, such as epidural steroid injections, face debate over long-term efficacy and trial methodologies. Patient selection is crucial, with these interventions often being ideal for those who have not responded to conservative treatments or have contraindications to surgery. By carefully evaluating each patient's needs and medical history, healthcare providers can determine the most appropriate minimally invasive option for achieving optimal pain relief and functional improvement.
Decompressions and Fusions
Decompressions and Fusions
Overview
Decompression and fusion surgeries address nerve compression, spinal instability, and mobility challenges caused by conditions such as herniated discs, spinal stenosis, and degenerative disc disease. These procedures aim to relieve pressure on nerves, stabilize spinal structures, and restore function through targeted interventions.
Decompressions
Decompression surgeries focus on alleviating nerve pressure by removing or modifying tissues compressing the spinal cord or nerves. Laminectomy involves removing part of the vertebral bone to create space in the spinal canal, often used for spinal stenosis or bone spurs. Discectomy targets herniated discs by excising the damaged portion pressing on nerves, frequently performed alongside laminectomy for access. Laminotomy and laminoplasty refine this approach: laminotomy creates a small opening in the bone to reduce pressure, while laminoplasty reshapes the bone to preserve spinal alignment, particularly in cervical cases.
Minimally invasive techniques, such as microdiscectomy or keyhole surgery, use smaller incisions and specialized tools to minimize tissue damage and recovery time. These methods are ideal for patients requiring precise intervention with reduced postoperative risks.
Fusions
Spinal fusion stabilizes the spine by permanently connecting two or more vertebrae, often combined with decompression to address instability. This procedure is critical for degenerative disc disease, fractures, or spinal deformities where excessive motion exacerbates pain. Bone grafts or synthetic materials are used to promote bone growth between vertebrae, while instrumentation like rods or screws may reinforce stability.
Fusion sacrifices some spinal mobility to prevent further nerve compression or structural collapse. However, artificial disc replacement offers an alternative for select patients, preserving motion by replacing damaged discs with prosthetic implants.
Considerations
Decompression and fusion surgeries are typically reserved for cases unresponsive to non-surgical treatments like physical therapy, medications, or injections. Risks include infection, blood clots, and adjacent segment degeneration. Recovery varies: laminectomy or discectomy may allow return to light activity relatively quickly, while fusion requires longer healing due to bone integration.
Collaborative care involving physiotherapists and pain specialists optimizes rehabilitation. Patient selection is crucial, balancing factors like age, symptom severity, and overall health to ensure realistic expectations and safe outcomes.
Overview
Decompression and fusion surgeries address nerve compression, spinal instability, and mobility challenges caused by conditions such as herniated discs, spinal stenosis, and degenerative disc disease. These procedures aim to relieve pressure on nerves, stabilize spinal structures, and restore function through targeted interventions.
Decompressions
Decompression surgeries focus on alleviating nerve pressure by removing or modifying tissues compressing the spinal cord or nerves. Laminectomy involves removing part of the vertebral bone to create space in the spinal canal, often used for spinal stenosis or bone spurs. Discectomy targets herniated discs by excising the damaged portion pressing on nerves, frequently performed alongside laminectomy for access. Laminotomy and laminoplasty refine this approach: laminotomy creates a small opening in the bone to reduce pressure, while laminoplasty reshapes the bone to preserve spinal alignment, particularly in cervical cases.
Minimally invasive techniques, such as microdiscectomy or keyhole surgery, use smaller incisions and specialized tools to minimize tissue damage and recovery time. These methods are ideal for patients requiring precise intervention with reduced postoperative risks.
Fusions
Spinal fusion stabilizes the spine by permanently connecting two or more vertebrae, often combined with decompression to address instability. This procedure is critical for degenerative disc disease, fractures, or spinal deformities where excessive motion exacerbates pain. Bone grafts or synthetic materials are used to promote bone growth between vertebrae, while instrumentation like rods or screws may reinforce stability.
Fusion sacrifices some spinal mobility to prevent further nerve compression or structural collapse. However, artificial disc replacement offers an alternative for select patients, preserving motion by replacing damaged discs with prosthetic implants.
Considerations
Decompression and fusion surgeries are typically reserved for cases unresponsive to non-surgical treatments like physical therapy, medications, or injections. Risks include infection, blood clots, and adjacent segment degeneration. Recovery varies: laminectomy or discectomy may allow return to light activity relatively quickly, while fusion requires longer healing due to bone integration.
Collaborative care involving physiotherapists and pain specialists optimizes rehabilitation. Patient selection is crucial, balancing factors like age, symptom severity, and overall health to ensure realistic expectations and safe outcomes.
Major Reconstructions and Deformity Corrections
Major Reconstructions and Deformity Corrections
Overview
Surgical correction of large spinal deformities represents some of the most technically demanding and rewarding work in spinal care. These complex procedures carry higher potential complication rates and are never pursued without thorough consideration. Dr. Oitment collaborates closely with patients to ensure decisions are grounded in clear objectives, realistic expectations, and a meticulously crafted, evidence-based plan.
Conditions We Treat
Our practice addresses a wide range of spinal deformities, including congenital scoliosis, adolescent idiopathic scoliosis, and adult degenerative deformities. We also manage Scheuermann’s kyphosis, inflammatory conditions such as ankylosing spondylitis, syndromic deformities like neurofibromatosis, and complex revision surgeries for previously treated cases. Each condition requires tailored strategies to address unique anatomical and functional challenges.
Our Approach
Every surgical plan is individualized to reflect the patient’s unique needs and goals. We prioritize minimizing risks through careful preoperative staging and advanced techniques, such as osteotomies and vertebral column resection for severe deformities. Outcomes are maximized by aligning surgical strategies with each patient’s functional and quality-of-life priorities, whether that involves restoring posture, reducing pain, or improving mobility. Whenever feasible, we preserve natural spinal motion and bone integrity to support long-term health.
Collaborative Care
For select adolescent cases, we partner with the Hospital for Sick Children (SickKids) to integrate specialized pediatric expertise into treatment plans. This collaboration ensures younger patients receive age-appropriate, multidisciplinary care. We also work closely with physiotherapists, pain management specialists, and other providers to optimize recovery and support patients through every phase of their journey.
Overview
Surgical correction of large spinal deformities represents some of the most technically demanding and rewarding work in spinal care. These complex procedures carry higher potential complication rates and are never pursued without thorough consideration. Dr. Oitment collaborates closely with patients to ensure decisions are grounded in clear objectives, realistic expectations, and a meticulously crafted, evidence-based plan.
Conditions We Treat
Our practice addresses a wide range of spinal deformities, including congenital scoliosis, adolescent idiopathic scoliosis, and adult degenerative deformities. We also manage Scheuermann’s kyphosis, inflammatory conditions such as ankylosing spondylitis, syndromic deformities like neurofibromatosis, and complex revision surgeries for previously treated cases. Each condition requires tailored strategies to address unique anatomical and functional challenges.
Our Approach
Every surgical plan is individualized to reflect the patient’s unique needs and goals. We prioritize minimizing risks through careful preoperative staging and advanced techniques, such as osteotomies and vertebral column resection for severe deformities. Outcomes are maximized by aligning surgical strategies with each patient’s functional and quality-of-life priorities, whether that involves restoring posture, reducing pain, or improving mobility. Whenever feasible, we preserve natural spinal motion and bone integrity to support long-term health.
Collaborative Care
For select adolescent cases, we partner with the Hospital for Sick Children (SickKids) to integrate specialized pediatric expertise into treatment plans. This collaboration ensures younger patients receive age-appropriate, multidisciplinary care. We also work closely with physiotherapists, pain management specialists, and other providers to optimize recovery and support patients through every phase of their journey.
© Toronto Spine
© Toronto Spine
© Toronto Spine
