LUMBAR FUSIONS

Spinal fusion, also called arthrodesis, is a surgical technique used to join two or more vertebrae (bones) within the spine. Lumbar fusion technique is the procedure of fusing the vertebrae in lumbar portion of the spine (lower back).

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Lumbar fusion surgery may be used to treat spondylolisthesis (slipping of the spine bones), degenerated discs, scoliosis or kyphosis (abnormal curvature of the spine), spinal infections or tumors, traumatic injury of the spine, recurrent disc herniation, and unstable spine.

The surgery can be done as an open or laparoscopic (keyhole) surgery.

Your surgeon may approach your spine from the back, abdomen or neck, depending on the area to be treated.

In spinal fusion, a piece of bone, taken from other parts of the body or donated from a bone bank is transplanted between the adjacent vertebrae. Screws, plates, or cages may be used with the bone graft to help hold the spine.

During the surgery, your surgeon performs a discectomy where a portion of the diseased or damaged disc material is removed. After the removal, the roof of the vertebra will be trimmed or removed to relieve the pressure on the nerve and this procedure is called as laminectomy. Following laminectomy, the bone graft (small chips of bone) will be placed alongside of the vertebrae between the vertebrae to be fused. Screws are placed into the vertebrae to be fused. Rods are attached to connect the screws, to stabilize and hold the bones together while the fusion heals.

As with every surgery, lumbar fusion surgery is associated with certain complications and they include:

  • Spine infection

  • Damage to the spinal nerves

  • Loss of sensation

  • Problems with bowel or bladder control

  • Dislocation of the implant

  • Pseudoarthrosis, a painful condition occurring because of non-healing of the bone effusion, and a false joint grows at the site

  • Blood clot formation in the legs

  • Pain at the bone graft site

 

 

LUMBAR ARTIFICIAL DISC REPLACEMENTS

Lumbar artificial disc replacement is a surgical method of replacing the diseased or damaged intervertebral discs of the spinal column with an artificial disc to restore motion to the spine. It can be considered as an alternative to spinal fusion for patients with low back pain.

Artificial disc replacement is indicated in patients with degenerative disc disease, a condition referred to as a gradual degeneration of the disc between the vertebrae caused by a natural process of ageing.

Your doctor may recommend certain tests such as, magnetic resonance imaging (MRI), discography, computed tomography (CT or CAT scan), and X-rays to identify the cause of pain. Patients with back pain caused from bulged or worn out intervertebral discs and patients with no significant facet joint disease are recommended for artificial disc replacement. The surgery is not recommended in patients with scoliosis, previous spinal surgery and morbidly obese.

During the surgery, an incision is made in the abdomen, and the muscles and the blood vessels are gently moved apart for better view and room for surgery. The disc space is opened and the damaged disc is removed and replaced with the artificial disc.

Disc Design:

Artificial disc designs are among two types, disc nucleus replacement and total disc replacement.

With the disc nucleus replacement, only the central portion of the disc (nucleus) is removed and replaced with mechanical device, while the outer ring of the disc (annulus) is not removed. However, disc nucleus replacement procedure is not commonly practiced and is in investigative stage. In total artificial disc replacement, the annulus and nucleus are replaced with the mechanical device to restore normal spinal function. Artificial discs are usually made up of metal, plastic or a combination of metal and plastic. Medical grade plastic (polyethylene) and medical grade cobalt chromium or titanium alloy are used for disc design.

An artificial disc implantation does not require healing and therefore rehabilitation can be started soon after the surgery. Hospital stay of about 2 to 4 days may be required. Basic exercises including regular walking and stretching may be performed during the first few weeks after surgery.

Artificial disc replacement surgery may cause certain complications and they include:

  • Infection

  • Injury to blood vessels

  • Dislodgement or breakage of the device

  • Wear of the device materials

  • Continued or increasing pain

  • Bleeding

  • Bladder problems

 

 

MINIMALLY INVASIVE LUMBAR FUSIONS

Spinal fusion is a surgical technique used to join two or more vertebrae in the spine and to minimize the pain caused by movement of these vertebrae. Fusion of vertebrae in the lumbar portion of the spine is called as lumbar fusion and the surgery can be done as an open or minimally invasive procedure.

In spinal fusion, a piece of bone harvested from other parts of the body or collected from a bone bank, is transplanted between the adjacent vertebrae. As the healing occurs, the bone fuses with the spine. This stimulates growth of solid mass of bone which helps in stabilizing the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until new bone grows between them.

A minimally invasive lumbar fusion technique is used to treat fractured vertebra, lumbar instability, spine deformities – scoliosis or kyphosis, cervical disc hernias, tumors, back pain and failed back syndrome. Spondylolisthesis, a painful condition of the spine caused by disc displacement or slipped disc, can be treated with minimally invasive lumbar fusion technique.

Several techniques are practiced for minimally invasive surgery and they include

  • Anterior lumbar interbody fusion, ALIF – accessing the spine from the front

  • Posterior lumbar interbody fusion, PLIF – approaching the spine from the back

  • Transforaminal lumbar interbody fusion, TLIF – approaching from the side

In anterior approach, four small incisions of length approximately 1/2 inch are made on the abdomen, the muscles and blood vessels are retracted and the vertebrae will be fused.

In posterior approach, several 1-2 inch incisions are made on the back, a series of increasingly larger dilators are used to spread the muscles apart and to provide access to the spine. The rods and screws are placed through the dilator tubes. In some cases, an operating microscope may be used to provide a better view.

In TLIF procedure, a small incision of 2 inches will be made on the patient’s side. The muscles are moved apart and larger dilators are progressively placed down to the lumbar spine. Using specially designed instruments, through the dilator tube, the intervertebral disc is incised and removed.  A bone graft or metal or plastic spacer is then placed between the vertebrae. This bone graft then usually heals, forming a solid bone. This technique is used in combination with a posterior approach for placement of rods and screws to strengthen the fusion. 

Minimally invasive technique of fusion carries many advantages and they include:

  • Minimal damage to the adjacent tissues

  • Reduced post-operative pain

  • Reduced hospital stay

  • Faster recovery

  • Diminished blood loss

 

 

POSTERIOR LUMBAR FUSIONS

Spinal fusion, also called arthrodesis, is a surgical technique used to join two or more vertebrae (bones) within the spine. Lumbar fusion technique is the procedure of fusing the vertebrae in lumbar portion of the spine (lower back).

Lumbar fusion surgery may be used to treat spondylolisthesis (slipping of the spine bones), degenerated discs, scoliosis or kyphosis (abnormal curvature of the spine), spinal infections or tumors, traumatic injury of the spine, recurrent disc herniation, and unstable spine.

The surgery can be done as an open or laparoscopic (keyhole) surgery.

Posterior spinal fusion is a procedure where the surgeon makes an incision on the patient’s back part of the body exposing the spine; the soft tissues and blood vessels are kept apart.

In spinal fusion, a piece of bone, taken from other parts of the body or donated from a bone bank is transplanted between the adjacent vertebrae. Screws, plates, or cages may be used with the bone graft to help hold the spine.

 

 

POSTERIOR LUMBAR INTERBODY FUSION SURGERY

Spinal fusion is a surgical technique used to join two or more vertebrae in the spine and to minimize the pain caused by movement of these vertebrae. Fusion of vertebrae in lumbar portion of the spine is called as lumbar fusion and the surgery can be done as an open or minimally invasive procedure.

Several techniques are practiced for minimally invasive surgery and they include

  • Anterior lumbar interbody fusion, ALIF – accessing the spine from the front

  • Posterior lumbar interbody fusion, PLIF – approaching the spine from the back

  • Transforaminal lumbar interbody fusion, TLIF – approaching from the side

In PLIF surgery, several 1-2 inch incisions are made on the back, a series of increasingly larger dilators are used to spread the muscles apart and to provide access to the spine.  The rods and screws are placed through the dilator tubes. In some cases, an operating microscope may be used to provide a better view.

During the surgery, a piece of bone harvested from other parts of the body or collected from a bone bank is transplanted between the adjacent vertebrae. As the healing occurs, the bone fuses with the spine. This stimulates growth of solid mass of bone which helps in stabilizing the spine. In some cases, metal implants such as rods, hooks, wires, plates or screws are used to hold the vertebra firm until new bone grows between them.

A minimally invasive lumbar fusion technique is used to treat fractured vertebra, lumbar instability, spine deformities—scoliosis or kyphosis, cervical disc hernias, tumors, back pain and failed back syndrome. Spondylolisthesis, a painful condition of the spine caused by disc displacement or slipped disc, can be treated with minimally invasive lumbar fusion technique.

Minimally invasive technique of fusion carries many advantages and they include:

  • Minimal damage to the adjacent tissues

  • Reduced post-operative pain

  • Reduced hospital stay

  • Faster recovery

  • Diminished blood loss

 

 

POSTEROLATERAL LUMBAR FUSION

Posterolateral lumbar fusion is a surgical technique that involves correction of spinal problems from the back of the spine by placing bone graft between segments in the back and leaving the disc space intact.

Minimally invasive surgical techniques may be used to perform the procedure.

  • Indications:

Patients with spinal instability in their lower back due to degenerative disc disease, spondylolisthesis or spinal stenosis that has not responded to other non-surgical treatment measures such as rest, physical therapy or medications may be recommended for Posterolateral Lumbar Fusion.

  • Procedure:

In this procedure, the patient lies on his or her stomach. The surgeon makes a small incision in the back over the vertebra (e) to be treated. The surgeon dilates the surrounding muscles of the spine to access the section of the spine to be stabilized. The lamina, roof of the vertebra, is removed to visualize the nerve roots and the facet joints that are directly over the nerve roots are trimmed to provide the nerve roots more space.

The bone graft is implemented between the transverse processes in the back of the spine. Screws and rods can also be used to stabilize the spine for better healing and fusion. At the end of the procedure, the incision is closed and usually it leaves behind a minimal scar.

This procedure includes a smaller incision and muscle dilation that allows the surgeon to gently separate the surrounding muscles of the spine rather than cutting them.

  • Recovery:

After the minimally invasive procedure, most patients are discharged the day after surgery, but a few patients may require prolonged hospitalization. Many patients observe immediate improvement of some or all their symptoms but sometimes the improvement of the symptoms may be gradual.

Contribution of a positive approach, realistic expectations and compliance with your doctor’s post-surgical instructions helps bring a satisfactory outcome to the surgical procedure. Most patients can resume their regular activities within several weeks.

  • Risks and Complications:

The complications include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which usually requires an additional surgery.

Discuss with your spine surgeon if you have any questions regarding the procedure.

 

 

TRANSFORAMINAL LUMBAR INTERBODY FUSION (TLIF)

Transforaminal lumbar interbody fusion (TLIF) is a type of spinal fusion procedure in which bone graft is placed between the affected vertebrae in the lower back (lumbar) region through an incision on the patient’s back.

  • Indications:

Based on the spinal condition, age, activity levels, and the medical history of the patient, the surgeon may recommend TLIF as a treatment option.

It is indicated in the following spinal instability conditions:

  • Degenerative disc disease (damaged disc)

  • Spondylolisthesis (slippage of one vertebra on another)

  • Spinal stenosis

The common symptoms associated with lumbar spinal instability are pain, numbness, and muscle weakness in the lower back, hips and legs.

  • Procedure:

The basic steps involved are as follows:

  • A small incision is made in the skin on your back over the affected vertebrae

  • Muscles encircling the affected spine are retracted to gain accessibility to the spine

  • Lamina covering the vertebra is removed to view the nerve roots

  • Facet joints (structures that connect the vertebrae to one another) may be undercut or trimmed to provide more space for the nerve roots

  • Nerve roots are moved away to remove the disc material from the anterior region of the spine

  • Bone graft is inserted between the vertebrae

  • Screws and rods are fixed to stabilize the spine

  • Soft tissues are re-approximated and the incision is closed

  • Recovery:

Patients who have undergone TLIF surgery are usually discharged on the same day, but in some cases, hospital stay may be extended. Most of the patients observe immediate improvement of some or all their symptoms but sometimes the improvement of the symptoms may be gradual.

Your surgeon may recommend few specific post-operative instructions for a fast and better recovery. Generally, patients may return to their routine activities within weeks after surgery.

  • Risks and Complications:

The possible complications associated with TLIF include:

  • Infection

  • Nerve damage

  • Blood clots

  • Blood loss

  • Bowel or bladder problems

The primary risk of TLIF is failure of fusion of vertebral bone and bone graft which may require an additional surgery.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to TLIF procedure.

 

 

MINIMALLY INVASIVE LUMBAR DISCECTOMY

Lumbar discectomy is a spinal surgery that involves removal of damaged intervertebral disc to relieve pressure on the spinal nerves (decompression) in the lumbar (lower back) region. Minimally invasive technique is implemented to perform the surgery.

The lumbar region forms the lower portion of the spine and comprises of five vertebrae (L1-L5).

  • Indications:

It is indicated in cases of severe nerve root compression due to a ruptured disc. Symptoms of nerve impingement include back pain or radiating pain into the hips, buttocks or legs, numbness or tingling sensation and muscle weakness in the back and lower extremities.

  • Procedure:

The procedure will be performed with the patients lying on their stomach. A small incision is made over the lower back and the surgeon gently separates the muscles to access the affected disc. A tubular retractor can be inserted to produce a portal through which the surgeon can perform the surgery. Through the tubular retractor, a portion of lamina, the bony vertebral component that covers the posterior wall of the spinal canal, is removed to expose the compressed area of the spinal cord or nerve roots. Removal of the lamina releases the source of compression from the herniated disc or bone spurs. The complete procedure is known as decompression. After the completion of the procedure, the incision is closed leaving behind a minimal scar.

  • Recovery:

Recovery period depends on the body’s healing capacity. The post-surgical hospitalization includes the rehabilitation program. If required, your surgeon may prescribe pain medications or a brace and follow-up physical therapy upon discharge.

The period of your rest or inactivity depends on a few factors such as the type of surgical procedure and the approach used to access your spine, the size of the incision and presence of any complications. Return to work or normal activity depends on the type of work or activity you plan to perform. Usually 3 to 6 weeks is the ideal time of healing.

Strictly adhere to the post-operative instructions suggested by your spine surgeon to promote healing and reduce the possibility of post-operative complications.

  • Advantages:

Some of the benefits include:

  • Very small incisions are placed

  • Surgery can be performed in less time

  • Minimal damage to the surrounding structures

  • Shorter recovery time with less post-surgical complications

  • Lower rate of infection

  • Greater range of motion with less post-operative pain

Discuss with your surgeon if you have any concerns regarding the surgery

 

 

LUMBAR MICRODISCECTOMY

Microdiscectomy is a surgical procedure employed to relieve the pressure over the spinal cord and/or nerve roots, caused by a ruptured (herniated) intervertebral disc. A herniated disc, common in the lower back (lumbar spine) occurs when the inner gelatinous substance of the disc escapes through a tear in the outer, fibrous ring (annulus fibrosis). This may compress the spinal cord or the surrounding nerves, resulting in pain, sensory changes, or weakness in the lower extremities.

It is usually indicated in patients with herniated lumbar disc, who have not found adequate pain relief with conservative treatment. This procedure involves the use of microsurgical techniques to gain access to the lumbar spine. Only a small portion of the herniated disc that compresses the spinal nerve is removed.

  • Procedure:

A microdiscectomy is performed under general anesthesia. Your surgeon will make a small incision in the midline over your lower back. Through this incision, a series of progressively larger tubes are placed and positioned over the herniated disc. The affected nerve root is then identified. Your surgeon removes a small portion of the bony structure or disc material that is pressing on the spinal nerve using microsurgical techniques. The incisions are closed with absorbable sutures and covered with a dressing.

  • Postoperative Care:

Following the surgery, patients will be discharged on the same day or the next day. Post-operatively, patients are advised to gradually increase their activity levels. If required, physical therapy is started after four to six weeks of the surgery to improve strength and range of motion.
Benefits of microdiscectomy include:

  • Less muscle and soft tissue disruption

  • Shorter recovery time

  • Minimal postoperative pain and discomfort

  • Fewer risks of complications

 

 

LUMBAR LAMINECTOMY

Lumbar laminectomy, also known as decompression laminectomy, is a spinal surgery done to relieve excess pressure on the spinal nerve(s) in the lumbar (lower back) region. The term laminectomy originated from the Latin word ‘lamina’ refers to a thin plate and the word ‘ectomy’ means removal. The purpose of laminectomy is removal of the lamina or roof of the vertebra to provide enough space for the nerves to exit the spinal canal (decompression).

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  • Indications:

Spinal stenosis is one of the major indications for lumbar laminectomy. It is a condition of narrowing of spinal canal due to arthritic changes of facet joints and intervertebral discs. This causes enlargement of the joint that exerts pressure on the spinal nerves.

Symptoms of nerve impingement are back pain or radiating pain into the hips, buttocks or legs, numbness or tingling sensation and muscle weakness in the back and lower extremities.

  • Procedure:

Lumbar laminectomy is usually performed under general anesthesia. In this technique, the patient lies face down on the operating table. A small incision is made along the midline of the back. To have a clear view of the spine, the surgeon slowly retracts the soft tissues and muscles. A part of or the entire lamina is removed to eliminate the pressure on the nerve roots. In addition, other sources of compression such as bone spur or damaged disc is removed to relieve the symptoms. At the end of the procedure, the surgeon realigns the soft tissues and the incision is closed.

  • Recovery:

Following a laminectomy, you may observe an immediate improvement of some or all symptoms or sometimes a gradual improvement of the symptoms. The duration of hospitalization depends on the treatment rendered. At the end of the first day of the surgery you can move and walk around the hospital. Returning to your daily life or to work depends on how well you are healing and the type of work or activity level. Strictly follow the post-operative instructions suggested by your spine surgeon to promote healing and reduce the risk of post-operative complications.

  • Complications:

The complications of the lumbar laminectomy include infection, nerve damage, blood clots, blood loss, bowel and bladder problems and any problem associated with anesthesia. Talk to your surgeon if you have queries regarding lumbar laminectomy.

 

 

ANTERIOR LUMBAR CORPECTOMY AND FUSION

Anterior Lumbar Corpectomy and Fusion is a surgical technique performed to remove the vertebral bone or disc material between the vertebrae to alleviate pressure on the spinal cord and spinal nerves (decompression) in the lumbar (lower back) region.

The term corpectomy originates from the Latin word ‘corpus’ which means ‘body’ and the word ‘ectomy’ means ‘removal’. Spinal fusion is essential for spinal stability after the removal of vertebral bone and disc material to relieve the compression over the neural structure.

  • Indications:

Anterior lumbar corpectomy and fusion is recommended when non-surgical treatment options fail to reduce the symptoms.

Nerve compression in the lower back usually leads to back pain, numbness or weakness extending into the hips, buttocks and legs.

Common causes of spinal nerve compression are:

  • Degenerative spinal conditions such as herniated discs

  • Spinal fractures

  • Tumors

  • Infection

Before recommending surgery, the surgeon considers various factors such as age, condition to be treated, health, lifestyle, and the activity level of the patient.

  • Surgical Procedure:

For the procedure, the surgeon makes an incision in the side of the abdomen and retracts the soft tissues such as muscles to gain visibility to the spine. A portion of vertebral body and intervertebral disc is removed to access the involved neural structure. The source of compression is removed and the compressed nerves released. During the fusion of two adjacent vertebrae, bone graft or bone graft substitute is inserted between the vertebrae at the decompression site to promote healing and to preserve the normal disc height. Implant material such as rods, plates and screws are fixed to the treated vertebra (e) to deliver additional support and stability during the fusion and healing process. After the procedure, the surgeon realigns the soft tissues and closes the incision.

  • Recovery:

Following a Lumbar Corpectomy and Fusion, you may observe an immediate improvement of some or all symptoms or sometimes a gradual improvement of the symptoms. The duration of hospitalization depends on the treatment rendered. At the end of the first day of the surgery you can move and walk around the hospital. Returning to your daily life or to work depends on how well you are healing and the type of work or activity level. Follow your spinal surgeon’s instructions regarding the proper recovery program and instructions to augment the healing process for a successful recovery.

  • Risks or Complications:

The complications of the surgery include infection, nerve damage, blood clots or blood loss or bowel and bladder problems and any problem associated with anesthesia. The underlying risk of spinal fusion surgery is failure of fusion of vertebral bone and bone graft which usually requires an additional surgery. Talk to your spine surgeon if you have any concerns or queries regarding Anterior Lumbar Corpectomy and Fusion.

 

 

LUMBAR DISCECTOMY

Intervertebral discs are fibrocartilaginous cushions between adjacent vertebrae in the spine. The normal intervertebral disc is composed of a semi-liquid substance (nucleus pulposus) at the center surrounded by a fibrous ring (annulus fibrosis). A herniated disc, also known as a bulging disc, is a condition in which the inner gelatinous substance of the disc is forced out through a tear in the outer, fibrous ring (annulus fibrosus). This may compress the spinal cord or the nerves around the spinal cord. Lumbar discectomy is a surgical procedure performed to remove a herniated or ruptured disc from the lumbar (lower) region and relieve pressure on the nerve, alleviating pain.

This procedure is performed under sterile conditions in an operating room with the patient under general or spinal anesthesia. You will lie face down. Your surgeon will make a small incision over the affected disc in the lumbar region. A small portion of bone may be removed along with the adjoining ligament to expose the herniated disc. Your surgeon visualizes the discs and the nerves through a surgical microscope. This enlarges the view of the surgical site, minimizing damage to the surrounding tissues. The spinal nerve root is then gently lifted with a special hook, to gain access to the injured disc, and the ruptured or herniated disc is removed. Any loose disc fragments are also removed. After the completion of the procedure, the surgical wound is irrigated with antibiotic solution and closed.

Following surgery, you are advised to limit activities for four weeks that involve bending and lifting, and sitting for long periods. Your recovery will involve physical therapy, where you will be taught certain exercises to improve flexibility and strength of your muscles around your spine. Depending on the level of activity, you will be able to resume work in two to six weeks.

As will all surgical procedures, lumbar discectomy may be associated with certain complications which include infection, nerve injury, spinal cord injury, ongoing pain and problems with anesthesia.

 

 

X-LIF EXTREME LATERAL INTERBODY FUSION

Extreme lateral interbody fusion (XLIF) is a minimally-invasive surgery that involves the fusing of two degenerative spinal vertebrae. The procedure is conducted to relieve painful motion in the back caused by spinal disorders.

Spinal problems occur primarily between vertebrae, where they are packed with a cushioning material called intervertebral disc. Over the years, the discs undergo wear and tear, allowing the vertebrae to painfully rub against each other every time we move and degenerate.

Fusing of degenerated vertebrae maintains the optimal disc space between them, aligns and stabilizes the spine, and protects the spinal cord and nerves from further damage.

  • Indications:

XLIF is considered when the patient does not respond well to pain killers, physical therapy and steroid injections. It is indicated for leg and back pain that are caused by any of the lumbar or lower spine disorders listed below.

  • Degenerative disc disease (damaged discs between two vertebrae)

  • Degenerative scoliosis (sideways curve of spine)

  • Degenerative spondylolisthesis (one vertebra moves away from the normal spine alignment)

  • Recurring disc herniation (ruptured disc)

  • Posterior pseudoarthrosis (previous failed fusion surgery)

  • Post-laminectomy syndrome (spinal instability following non-fusion surgery)

  • Adjacent level syndrome (condition that occurs next to previous fusion surgery)

  • Contraindications:

XLIF may not be an option for the following conditions:

  • Degenerative spondylolisthesis of greater than grade 2

  • Presence of scarring behind the abdominal cavity, on either side of the spine because of previous surgery or abscess

  • Procedure:

XLIF adopts a lateral approach when compared to traditional methods of spinal fusion techniques, and in doing so, spares the disruption of major back muscles, ligaments and bones. Since the procedure is done in close proximity with several important nerves in the spinal column, your surgeon will continuously monitor them with electromyography (EMG) to avoid any damage to the nerves.

The surgery takes about one hour and is performed under general anesthesia. You will be positioned onto one side. Using X-ray, your surgeon will locate and mark off the affected region. Through a small incision made in your back, your surgeon will hold back the peritoneum (outer covering of abdominal organs) and will make a second incision on your side for instruments called tubular dilators to pass through. The affected disc is then removed, and replaced with an implant filled with bone graft, which will aid in the fusion of the adjacent vertebrae. The instruments are removed and incision stitched and bandaged. Additional support with the help of plates, rods or screws may be inserted.

  • Recovery

XLIF ensures a quick recovery and lets you return to normal activities. As this approach, does not damage muscles, ideally you will be able to walk the evening of the surgery and will be discharged the next day. Following your discharge, you will be prescribed medication for pain.

  • Risks and Complications

The surgery may be associated with infection, damage to nerves, spinal cord or blood vessels, muscle weakness and enduring pain at the site of bone graft. There are chances of the implant failing to fuse the vertebrae and a progression in the existing disease. Other conditions such as deep vein thrombosis or clotting, urinary tract infection, stroke and pneumonia may develop following the procedure.