The lumbar spine is the lower part of your back and is made up of five large bones called vertebrae, labeled L1 through L5. This area supports most of your body’s weight and helps you move, like bending, twisting, or standing upright. Between each bone is a soft disc that works like a cushion or shock absorber, helping protect your spine during everyday activities like walking, lifting, or sitting.
Nerves in the lumbar spine travel down to your legs and control movement and feeling. Since your lower back handles a lot of movement and weight, it’s a common place for issues like slipped discs, narrowing of the spinal canal (spinal stenosis), or pinched nerves (lumbar radiculopathy).
An Anterior Lumbar Interbody Fusion (ALIF) is a surgical procedure used to treat conditions affecting the lumbar spine, such as degenerative disc disease, spinal instability, or deformities. ALIF involves approaching the spine through the front of the body, specifically the lower abdomen. During the ALIF procedure, an incision is made in the lower abdomen, providing access to the lumbar spine. With the assistance of a trained vascular surgeon, important vessels are secured and moved out of the surgical field.
The damaged or degenerated disc is removed from between two vertebrae, and a bone graft or a synthetic implant is inserted into the disc space. This bone graft encourages the growth of new bone, ultimately fusing the adjacent vertebrae together. The anterior approach allows for direct access to the intervertebral discs without disturbing the spinal muscles at the back, which can be particularly beneficial for certain spinal conditions. Additionally, spinal instrumentation such as screws or plates may be used to provide stability during the fusion process. ALIF aims to alleviate pain, restore spinal stability, and promote the fusion of vertebrae.
A Lateral Lumbar Interbody Fusion (LLIF) is a minimally invasive procedure that allows for placement of an intervertebral body device similar to what is seen in an anterior lumbar interbody fusion but through a small incision in the side.
The approach utilizes real time neuromonitoring and image guidance with fluoroscopy, navigation, or robotics. Through the restoration of intervertebral height an indirect decompression of the neural elements can be achieved. The indirect decompression can be supplemented with a laminectomy and foraminotomy to achieve an excellent decompression.
Posterior based instrumentation can be used to help stabilize the spine and promote healing of the bone. LLIF is often used to address problems that have developed adjacent to a prior fusion and can help avoid posterior scar tissue from prior surgeries. LLIF allows for the potential for symptomatic relief, improvement in quality of life with a potential for a shorter hospital stay.
The affected disc is removed, and the artificial disc is implanted in its place. This prosthetic disc is designed to replicate the natural movement and function of a healthy disc, allowing for continued flexibility and motion in the lumbar spine. Lumbar arthroplasty is considered an alternative to lumbar fusion, which involves joining two or more vertebrae together.
The goal of lumbar arthroplasty is to preserve motion at the treated level, potentially reducing the risk of adjacent segment degeneration that can occur after fusion surgery. This procedure is typically recommended for individuals with symptomatic lumbar disc degeneration who have not found relief from conservative treatments.
A lumbar fusion is a surgical procedure aimed at stabilizing and reducing motion between vertebrae in the lumbar (lower) spine. Typically used to treat conditions such as degenerative disc disease, spondylolisthesis, or spinal instability, lumbar fusion involves joining two or more vertebrae together. During the procedure, the surgeon makes an incision in the lower back, accessing the lumbar spine.
The damaged or degenerated joint is removed, and a bone graft is inserted in its place. This bone graft encourages the growth of new bone, fusing the adjacent vertebrae. Hardware such as screws, rods, or cages may be used to provide stability during the fusion process. Lumbar fusion aims to alleviate pain, restore spinal stability, and prevent further degeneration.
The decision to undergo lumbar fusion is typically made after conservative treatments like physical therapy or medication have proven ineffective, and the procedure is tailored to the individual’s specific condition. Recovery from lumbar fusion varies among patients, and postoperative care often involves a period of physical therapy to optimize healing and restore function.
Minimally invasive microdiscectomy is a surgical procedure used to treat herniated discs in the spine. This approach is designed to alleviate symptoms like pain, numbness, or weakness caused by pressure on the spinal nerves. During the procedure, small incisions are made, and specialized instruments, including a microscope, are used for precision.
The surgeon accesses the affected area through the small incisions, minimizing disruption to surrounding tissues. The use of a microscope provides enhanced visibility, allowing the surgeon to pinpoint the exact location of the herniated disc. The surgeon then carefully removes the portion of the disc that is compressing the spinal nerves.
This minimally invasive technique aims to reduce postoperative pain, speed up recovery, and allow for a quicker return to normal activities compared to traditional open surgery. The smaller incisions contribute to less tissue damage and scarring.
Sacroiliac joint fusion is a surgical procedure aimed at addressing chronic pain and instability in the sacroiliac joint, which connects the spine to the hip in the pelvis. This surgery is considered for individuals experiencing persistent lower back, buttock, or leg pain attributed to sacroiliac joint dysfunction or degeneration.
During sacroiliac joint fusion, the surgeon works to create stability by connecting the iliac bone of the pelvis to the sacrum, the triangular bone at the base of the spine. This is achieved by placing bone grafts or implants across the sacroiliac joint to promote the fusion of joint surfaces.
Various techniques can be employed for sacroiliac joint fusion, including open fusion, which involves a larger incision for direct access, and minimally invasive fusion, which utilizes smaller incisions and specialized instruments for potentially faster recovery. The decision to undergo sacroiliac joint fusion is typically made when conservative treatments, such as physical therapy or medications, have proven ineffective. The surgery aims to stabilize the joint, reduce pain, and enhance overall spine and pelvis function.
