Lumbar Surgical Procedures

By Brandon J. Kambach, MD

An Overview of Some Common Lumbar Surgical Procedures

Common Lumbar Surgical Procedures are necessary for some conditions.

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It is important to understand common lumbar surgical procedures. Two of the most common lumbar surgical procedures performed by spinal surgeons include:

  • Decompression surgery.
  • Fusion surgery.

Common Lumbar Surgical Procedure: Lumbar Decompression Surgery

Lumbar decompression surgeries are indicated to relieve neurogenic pain related to what is perceived to be a disc herniation or bone spur. Disc herniation and bone spur can lead to irritation of a spinal nerve root. This can cause significant lower extremity pain with associated neurological changes such as leg weakness, sensory changes, and diminished reflexes. This can be due to the irritation of the corresponding nerve root. Two of the most common lumbar decompression surgeries are Microdiscectomy and Laminectomy/Laminotomy procedures.  A Microdiscectomy procedure is performed through a small incision in the midline of the low back at the level of the disc injury and with the use of a scope. The nerve root is accessed, and part of a disc that compresses the nerve root is removed. Other indications of laminectomy or laminotomy procedures include lumbosacral or degenerative spondylolisthesis.

Common Lumbar Surgical Procedure: Lumbar Fusion Surgery

Lumbar spinal fusion surgeries are procedures which makes use of a bone graft inserted directly into space between to adjacent vertebra with the intent of the bone fusing the two segments, which is reinforced by two titanium screws inserted into the pedicles of two adjoining segments on each side of the spine and a rod connecting the two screws. Options for fusing the lumbar spine are currently available and named according to the incision’s location. The most common fusion surgery is the posterior lumbar interbody fusion (PLIF).

A PLIF procedure includes an incision at the back with full retraction of the posterior musculature. Another option is the anterior lumbar interbody fusion (ALIF). This involves an incision through the abdominal muscles to expose the front part of the vertebral bodies. Other approaches include the lateral approach where the incision is made on the lateral side of the torso, cutting through the psoas muscle to expose the vertebral bodies’ lateral aspect. Indications for lumbar spinal fusion include persistent non-radiating low back pain with degenerative disc disease (DDD) and back pain with neurologic findings in spondylolisthesis.

About the Author

Dr. Brandon Kambach is a fellowship-trained orthopedic spine surgeon specializing in cervical, thoracic, and lumbar spine disorders. He performs various spinal surgical procedures such as laminectomies, minimally invasive surgeries such as microendoscopic discectomy, and spinal fusion surgeries such as posterior and lateral approaches. Outside his medical practice, Dr. Kambach is an avid runner and has participated in ultramarathons and Ironman triathlons.  For more articles like An Overview of Some Common Lumbar Surgical Procedures, visit our trending library here.

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