Minimally Invasive Spinal Fusion Surgery

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Minimally Invasive Spinal Fusion Surgery
Spinal fusion (spondylodesis or spondylosyndesis)
is the surgical method of joining two or more
verebrae. It is done most commonly in the lumbar
region of the spine, but it is also used to treat
cervical and thoracic problems. In this
procedure, the damaged and painful vertebrae are
fused into a solid stable bone. Fusion of the
spine is used primarily to eliminate the pain
caused by abnormal motion of the vertebrae by
immobilizing the faulty vertebrae themselves,
which is usually caused by degenerative
conditions. However, spinal fusion is also the
preferred way to treat most spinal deformities,
specifically scoliosis and kyphosis. But, the
results may vary according to the individual.
Some may not feel any improvement in their back
pain even after the surgery.

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Types of Spinal Fusion Surgery

• Posterolateral Fusion  In the back of the
  spine, the bone graft is placed in amid the
  transverse processes. With the help of wires and
  screws, the vertebrae is carefully fixed
  throughout the particles of every vertebrae. A
  rod is made up of metal which is attached on the
  side of vertebrae.
• Interbody Fusion  In this, the graft of the
  bone is placed in between the vertebrae and the
  area is generally engaged by the intervertebral
  disc. The disc is entirely removed in preparing
  for the spinal fusion. In order to maintain the
  disc height and spine alignment, a device can be
  placed in between the vertebrae. This device
  (intervertebral device) can either be prepared
  from titanium or plastic.
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Advantages of Spinal Fusion Surgery
By fusing the level, there is less concern
that the patient will need surgery again at that
level. If the discs and/or facets are pain
generators, as is often the case, a fusion will
ensure that motion at the level is stopped,
potentially eliminating the low back pain. A
second advantage of spinal fusion surgery is that
it reduces post-decompressive deformity. Some
patients develop post-laminectomy kyphosis, which
is an abnormal alignment of the spine. This too
can often lead to additional surgery. Similarly,
a fusion can correct any deformity the patient
had before surgery and ensure that the normal
alignment of the spine is restored. This may
reduce wear and tear (and need for future
surgery) on the neighboring levels.

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Minimally Invasive Posterior Lumbar Interbody
Fusion

The other method is the Minimally Invasive PLIF
procedure which is performed using x-ray
guidance. 2.5-cm incisions are made on either
side of the lower back The muscles are gradually
dilated and tubular retractors inserted to allow
access to the affected area of the lumbar spine.
The lamina is removed to allow visualization of
the nerve roots. The offending disc material is
removed from the spine and replaced with a bone
graft and structural support from a cage made of
bone, titanium, carbon-fiber, or a polymer,
followed by placement of rod and screws. The
tubular retractors are removed, allowing the
dilated muscles to come back together, and the
incisions are closed. This procedure typically
takes about 3 to 3 ½ hours to perform. There was
less blood loss,tissue trauma, operative time,
and quick recovery in this procedure as compared
to the traditional one.Generally the patients can
go home within 3-5 days after traditional PLIF
and within 1-2 days after a minimally invasive
PLIF

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