Lumbar (Low Back)

Lumbar Laminectomy

A lumbar laminectomy is a spine surgery that involves removing bone to relieve excess pressure on the spinal nerve(s) in the lumbar spine (low back). The term laminectomy is derived from the Latin words lamina (thin plate, sheet or layer), and -ectomy (removal). A laminectomy removes or drills away part of the lamina (roof) of the vertebrae to create space for the nerves leaving the spine.

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Lumbar Microdiscectomy

Lumbar microdiscectomy is an operation that involves using microsurgical techniques to access and treat one or more bulging discs in the lumbar spine. By providing magnification and illumination, the operating microscope allows for a limited dissection. Magnifying spectatcles are an alternative used by some surgeons. That portion of the herniated disc which is pinching one or more nerve roots is removed. The term discectomy is derived from the Latin words discus (flat, circular object or plate) and -ectomy (removal).

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Lumbar Spinal Fusion Surgery

Lumbar spinal fusion is a surgical technique in which one or more of the vertebrae of the spine are joined together (fused), to maintain their separation and alignment, and to stop them from moving against each other. This is done by placing bone grafts or bone graft substitutes between the affected vertebrae. The graft material acts as a binding medium and also helps to maintain normal disc height (see under “Disadvantages of Discectomy” in the foregoing). As the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine.

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Anterior Lumbar Interbody Fusion (ALIF)

Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front of the body to remove disc or bone material from in between two adjacent lumbar vertebrae. The disc material is then replaced by a block bone graft, or more usually by a titanium or PEEK plastic cage containing bone graft or bone morphogenetic protein.

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Transforaminal Lumbar Interbody Fusion

Transforaminal lumbar interbody fusion (TLIF) is a form of spine surgery in which the lumbar spine is approached through a number of small incisions in the back. The name of the procedure is derived from: transforaminal (through the foramen), lumbar (lower back), interbody (implants or bone graft placed between two vertebral bodies) and fusion (spinal stabilization).

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Posterior Lumbar Interbody Fusion (PLIF)

This is the Gold Standard for lumbar fusions performed from behind, as it involves the creation of a very stable, very reliable construct with two cages replacing each diseased disc, and pedicle screws and rods to prevent movement of the vertebrae while the bone graft within the cages knits the two vertebrae together over a 6-9 month period.

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Extreme Lateral Lumbar Interbody Fusion (X-LIF)

The extreme lateral approach is a more recent innovation in lumbar fusion surgery and is performed with the patient lying on one side. Through a small incision approximately 8cms in length the surgeon accesses the side of the lumbar spine between the first and fourth lumbar vertebrae. The method is not suitable for the lowest level of lumbar spine at L5/S1, and sometimes not for L4/5 either, because the iliac crest (hip bone) gets in the way.

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Artificial Lumbar Disc Implantation (Lumbar Disc Arthroplasty)

Artificial lumbar discs have been available in one form or another for more than 20 years now, but have evolved remarkably over that period. The early discs were simple ball-and-socket joints, but these have now been challenged by newer disc designs using polymer and composite materials, which aim to emulate more closely the functions of the healthy human disc.

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Deformity correction- Adult

The hydration of the centres of our spinal discs is maximum in early childhood. Thereafter throughout life all of our discs are drying out, and that is one of the reasons why we are all getting gradually shorter as we age.

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