A structural device, made of bone, metal, carbon filter or other materials, is placed to take the supportive place of the removed disk and packed with bone, so that ultimately fusion between the bone (body of the vertebrae) above and below occurs. Transforaminal Lumbar Interbody Fusion (TLIF): Removal of the degenerative disk by going through the skin on the back, removal of the posterior bone of the spinal canal, retraction of the nerves to get to the disk space.Similar to TLIF, this is often done on both sides of the spine. Posterior Lumbar Interbody Fusion (PLIF): Removal of the degenerative disk by going through the skin on the back, removal of the posterior bone of the spinal canal, retraction of the nerves to get to the disk space.Anterior Lumbar Interbody Fusion (ALIF): Removal of the degenerative disk by going through the lower abdomen.Medial Facetectomy: Removal of part of the facet (bony joint) which may be overgrown, to create more space in the spinal canal.Foraminotomy: Surgical opening or enlargement of the bony exit for the nerve root as it leaves the spinal canal can be done alone, or along with laminotomy/laminectomy. Laminotomy: Creates an opening in the bone (in the lamina) to relieve pressure on the nerve roots.Other types of surgeries or techniques/methods to treat lumbar spinal stenosis include: A spinal fusion with or without spinal instrumentation may be used to enhance fusion and support unstable areas of the spine. A neurosurgeon may perform a laminectomy with or without fusing vertebrae or removing part of a disk. The most common surgery in the lumbar spine is called decompressive laminectomy, in which the laminae (roof) of the vertebrae are removed to create more space for the nerves. Spinal fusion may assist in strengthening and stabilizing the spine, and may thereby help to alleviate severe and chronic back pain. Spinal fusion is an operation that creates a solid union between two or more vertebrae. In a small percentage of patients, spinal instability may require that spinal fusion be performed - this decision generally is determined prior to surgery. There are several different surgical procedures that can be utilized, the choice of which is influenced by the severity of the case. The patient is in reasonably good health.Medications and physical therapy are not effective.Loss of normal bowel and/or bladder functions.Progressive neurological deficits develop (leg weakness, foot drop, numbness in the limb).Back and leg pain limits normal activity or impairs quality of life.As with any surgery, a patient’s risks include age, overall health and other issues, which are all taken into consideration beforehand.Ī patient may be considered a candidate for surgery if: There are different types of spinal surgeries available, and depending on the specific case, a neurosurgeon will help to determine what procedure might be appropriate for the patient. A doctor may recommend surgery if non-surgical management (as described above) does not improve symptoms.
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