How Dr. Pompliano approaches surgery
Surgery is recommended only after conservative options have been genuinely explored, or when there are clear signs of progressive nerve or spinal cord compromise. When an operation is the right answer, the priorities are precision, preserving healthy tissue and motion where possible, and getting you back to work and activity as quickly as safely possible. Minimally invasive and motion-sparing techniques are used whenever the diagnosis allows — and technology, including robotic assistance and navigation, is used when it adds real precision, not for its own sake.
The right operation, at the right level, for the right reason — nothing more.
Cervical (neck) procedures
Anterior Cervical Discectomy & Fusion (ACDF)
What it is: Removal of a damaged cervical disc through a small incision in the front of the neck, with the segment stabilized by a spacer and plate.
When it helps: Herniated discs or degenerative changes in the neck compressing a nerve or the spinal cord — arm pain, weakness, or myelopathy.
Cervical Artificial Disc Replacement
What it is: The damaged disc is replaced with a mobile implant that preserves natural neck motion instead of fusing the segment.
When it helps: Selected patients with nerve compression who are candidates for motion preservation — a particular focus of Dr. Pompliano's practice.
Posterior Decompression (Laminectomy / Foraminotomy)
What it is: Removal of bone or ligament that is narrowing the spinal canal or nerve exits, relieving pressure on neural structures.
When it helps: Spinal stenosis and nerve compression causing pain, numbness, weakness, or walking difficulty.
Microdiscectomy
What it is: Removal of the herniated fragment of a lumbar disc through a small incision, taking pressure off the affected nerve.
When it helps: Sciatica from a disc herniation that hasn't improved with conservative care, or with progressive weakness.
Lumbar fusion & reconstruction
TLIF (Transforaminal Lumbar Interbody Fusion)
What it is: Fusion of a lumbar segment through a posterior approach, placing a spacer in the disc space with screw fixation — frequently done minimally invasively.
When it helps: Spondylolisthesis, instability, or degenerative disc disease with nerve compression that requires stabilization.
ALIF (Anterior Lumbar Interbody Fusion)
What it is: Fusion performed through the abdomen, allowing placement of a large spacer that restores disc height and alignment.
When it helps: Selected patients with degenerative disc disease, spondylolisthesis, or alignment problems — sometimes combined with posterior fixation.
XLIF / Lateral Interbody Fusion
What it is: Fusion through a small incision on the side, sparing the back muscles and the major vessels at the front.
When it helps: Degenerative disease, instability, or deformity at levels suited to a lateral approach.
Spinal Reconstruction & Revision Surgery
What it is: Correction of spinal deformity (including scoliosis), failed prior surgery, or multi-level degenerative problems — fellowship-level complex reconstruction.
When it helps: Deformity, imbalance, or persistent problems after previous spine surgery.
Techniques used across procedures
Minimally Invasive Spine Surgery (MISS)
What it is: Smaller incisions, tubular or specialized retractors, and muscle-sparing corridors used across many of the procedures above.
When it helps: Suitable candidates across decompression and fusion procedures.
Robotic Assistance & Navigation
What it is: Computer-assisted planning, navigation, and robotic guidance for precise implant placement — used when it adds measurable precision to your operation.
When it helps: Fusion and reconstruction procedures where screw accuracy and alignment planning matter most.
Kyphoplasty / Vertebral Augmentation
What it is: Stabilization of painful vertebral compression fractures through a needle-sized approach, often with cement augmentation.
When it helps: Osteoporotic or traumatic compression fractures with persistent, function-limiting pain.
Wondering which — if any — of these applies to you? That's exactly what an evaluation is for. And if you've already been told you need one of these procedures, a second opinion is always welcome.