Peyton Manning's big comeback, capped off last weekend as a starter during the Pro Bowl, is a reminder that injuries don't have to slow you down. In 2011, Manning underwent neck surgery for a bulging disc. In 2012, he played the entire season for the Broncos. 

At a recent seminar, Dr. Thomas Puschak walked a group of patients through this type of spinal surgery, which is performed through the front of the neck to address pinched nerves or a compressed spinal cord.

This anterior approach allows surgeons to relieve pressure on the nerves or on the spinal cord by removing the disks, bones, or bone spurs that are causing the problem.

“These things that are compressing the nerve, or compressing the spinal cord, they actually sit in the front of our spine, they’re not sitting in the back,” Dr. Puschak explained. “It’s a very effective way and a very safe way to decompress the spine, either spinal cord or nerve root depending on the situation. You’re removing the actual structure that’s compressing it.”

The surgery also typically includes a bone graft to fill the space that was created when the problem areas were removed.

“You’re also expanding that disk space back out to its normal height and then placing bone graft or a cage in there so that it can’t collapse back down,” Dr. Puschak said.

Finally, a spinal fusion is performed to join together the bone graft and surrounding vertebrae to stabilize the area and limit friction that might cause pain and the reoccurrence of bone spurs.

“The purpose of the fusion is to improve that alignment and make it stable so that it can’t slide,” Dr. Puschak explained. “That one segment is now a unit.”

Fusions can be performed to address a variety of spinal issues including degenerative disk disease, spondylolisthesis, spinal stenosis, scoliosis, fracture, infection or tumors.