Lumbar spine surgery is only done when conservative methods have failed to bring about improvement in pain and disability. Surgery is done to relieve/reduce pain and to restore stability to the spine. This can be achieved either through decompression of a pinched nerve root by removing compressing tissue or by mechanical stabilization of the lower back.
To begin with, lumbar spine refers to the 5 spinal bones (L1 to L5) that make up the lower back region of the spine. These are the largest vertebrae and help in supporting the head and trunk. The L5 vertebra distributes the upper body’s weight through the sacrum and into the pelvic region (hips) and onto the legs. Any associated pathological changes in these lumbar bones can result in pain, numbness or burning sensations.
Lumbar Decompression Surgery
The common causes for decompression surgery are lumbar herniated disc or lumbar spinal stenosis. The following are some surgical techniques recommended for lumbar decompression:
Laminotomy – A small opening is made in the lamina to access disc content which has invaded the narrow space of the spinal canal. This relieves nerve compression.
Laminectomy – This is mostly used to treat spinal stenosis and involves partial or complete removal of the lamina. Laminectomy is done to access the disc that is causing narrowing of space within the spinal canal.
Foraminotomy – This technique is used to widen the opening of the nerve passageway (foramen), thus nerve compression caused by invading disc material or bone spurs pressing onto the exiting nerves, are relieved.
Discectomy – This technique involves removal of a part or all of a herniated/prolapsed disc to prevent pinching of a nerve. Here, the spine can be accessed from the anterior (abdominal cavity) or the posterior (back side).
Facetectomy – This technique is performed to reduce compression of a nerve or access the disc space by partial or complete removal of the facet joint.
Lumbar Fusion surgery
The second reason for lumbar spine surgery is performing lumbar fusions to stop pain created by movement of a vertebral segment. Degenerative disc diseases of the lumbar spine or spondylolisthesis are common disabilities requiring lumbar fusion surgery.
Fusion surgery involves the use of an auto-bone graft to block motion of a part of the spine joint. Bone graft procedures or bone stimulators may sometimes be used in fusion surgeries too. Some surgical approaches for spinal fusion include ALIF, PLIF, TLIF, XLIF, anterior/posterior fusion, etc.
Aside from decompression and spinal fusion surgeries, other procedures include Artificial Disc Replacement, Multi-level Lumbar Fusion, Motion preservation surgeries and Vertebral Augmentation.
The Sita Bhateja Specialty Hospital in Bangalore has a highly-specialised team of spine specialists and neurosurgeons who inspire great confidence in their patients due to the high success rates of surgeries performed here. Do check here for more information: http://www.sbshospital.com/