Spinal Fusion

Spinal fusion is performed to join (fuse) the vertebrae together in patients with conditions such as spinal stenosis, degenerative disc disease or spondylolisthesis. This procedure may be performed anywhere on the spine, depending on which vertebrae are affected. Spinal fusion is most often performed in the lumbar and cervical spine.

Spine fusion surgery can be performed through an incision in the front or back of the body, depending on the location of the affected vertebrae and each patient’s individual condition. During the procedure, the disc between the affected vertebrae is removed, and a bone graft is inserted into the empty space. Movement of the spine in the treated area will not be possible after surgery, so it is usually only performed in one area. Patients will require physical therapy and other assistance after surgery in order to restore proper function.

Posterior Lumbar Interbody Fusion

Posterior Lumbar Interbody Fusion (PLIF) is a type of spinal fusion surgery that involves replacing a damaged intervertebral disc in the lower back with a metal or plastic bone spacer. This procedure effectively relieves pain and other symptoms caused by spondylolisthesis, degenerative disc disease and other conditions.

During the PLIF procedure, an incision is made in the back to remove the damaged disc with special instruments. The empty space is then filled with two small bone graft spacers that are placed on either side of the interbody space. The nerves are slightly moved during this procedure so that the disc can be easily removed.

After PLIF surgery, patients will need to stay in the hospital for three to five days, and will work with physical and occupational therapists during their stay in order to restore functionality to the spine. You will likely be able to return to work and other activities after two to three weeks, although exercise and physical activity should be avoided for much longer.

Micro Endoscopic Posterior Cervical Discectomy

Micro endoscopic discectomy is a minimally invasive surgical procedure that removes small portions of a herniated or diseased disc in order to relieve pain, weakness and tingling within the neck (cervical spine) and arms. These symptoms develop when the affected disc places pressure on nearby nerve roots. While surgery is not required for all patients, it is often effective in significantly relieving symptoms in patients with severe pain.

During the micro endoscopic discectomy procedure, a small incision is made in the back of the neck, into which a guide wire is inserted and lead to the affected disc. A camera is inserted so that the surgeon can carefully inspect the disc before clearing away the herniated portion to relieve pressure on the nerves. The nerves may be carefully moved during this procedure to carefully clear away the disc, but they will be removed to their proper position.

Cervical micro endoscopic discectomy is performed on an outpatient basis and takes about 45 minutes to an hour. Patients will be able to drive three to five days after surgery, and can return to work as soon as soreness in the neck subsides, which is usually after a week. Your doctor will provide specific post-operative instructions for you based on your individual procedure.

Lumbar Pedicle Screw Fixation

Pedicle screw fixation is performed in conjunction with spinal fusion surgery to secure the vertebrae of the treated area in a fixed position. These devices provide stability and support to the spine after surgery and keep bone grafts in position while the spine heals. While pedicle screws provide anchor points on the spinal segment, metal rods are used to connect them together.

Once the bone graft has grown and fuses to the surrounding bones, the screws and rods are not considered medically necessary.  However, they can remain in place for most patients with an eliminated need for invasive removal surgery. In some patients, the pedicle screws may begin to cause discomfort and should be removed in these cases.

While initial treatment with screws was associated with many risks, current treatments are considered safe for most patients with certain spinal conditions. Most patients experience significant or total improvement in pain symptoms after surgery, and are able to stop using pain medication on a regular basis. Your doctor will discuss any potential risks of this procedure with you before your surgery.

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