Lumbar spine: Diagnosis and surgical information with videos listed below
Lumbar Spine Anatomy video
Sacroiliac Joint Anatomy
Common Conditions (Videos):
- Degenerative Disc Disease
Degenerative disc disease refers to when the disc itself is the source of back pain or neck pain as a result of a damaged and degenerative disc. Degenerative disc disease may be treated with medications, ice/heat, active physical therapy/exercise, or behavioral and lifestyle changes, or require spinal fusion or artificial disc replacement surgery for uncontrollable, severe pain that has not responded in time to previous non-surgical care and when an anatomical cause of the pain has been identified. Degenerative Disc Disease:
Degenerative Disc Disease DDD
- Herniated Disc
A herniated disc can produce lower back pain and/or leg pain (sciatica) or less often neck pain and/or arm pain as a result of the disc’s soft, inner core extruding through its tough, outer core, and coming in contact with and irritating a nearby spinal nerve. A herniated disc may be effectively treated with pain medications, injections, chiropractic care, physical therapy and exercise, or require surgery for symptoms that have been unresponsive to non-surgical care.Herniated disc:
Lumbar Herniated Disc videoTreatment options for disc herniation:
Treatment Lumbar Herniated Disc video
- Osteoporosis and Vertebral Fractures
Osteoporosis is a thinning of the bones that occurs with aging (more often in women than men, especially after menopause), leaving the bones porous, fragile and susceptible to vertebral fractures that are frequently dismissed as general back pain. Osteoporosis is treatable with non-surgical treatments like exercise, medications and education on diet and nutrition aimed to slow bone loss and prevent fractures. Osteoporotic vertebral fractures may be treated with rest, rigid back braces that support the spine, ice and heat, pain medications or surgeries such as kyphoplasty or vertebroplasty when the fracture is causing severe pain and deformity and has failed to respond to non-surgical care.
Spinal Compression Fracture videoKyphosis:
Osteoarthritis is a very common form of arthritis that occurs when the cartilage between aligning facet joints in the back portion of the spine mechanically breaks down over time, leading to common symptoms like inflammation, stiffness and pain in these joints, and possibly resulting in bone spurs that irritate or trap the spinal nerves. Non-surgical care such as medications, exercise, physical therapy and chiropractic is typically the first line of osteoarthritis treatment. In rare cases, osteoarthritis may require a spinal fusion surgery when the joint is severely unstable or a lumbar laminectomy surgery when the spinal nerves are affected.
Sciatica describes symptoms of leg pain and possible tingling, numbness or weakness that travels from the lower back down the sciatic nerve in the back of the leg, often as a result of a pinched nerve from a herniated disc or other conditions like degenerative disc disease, spinal stenosis or spondylolisthesis. Sciatica symptoms may be treated with heat/ice, over-the-counter or prescription medications, epidural steroid injections, acupuncture, massage therapy, manual manipulation, physical therapy or exercise, or require surgery for severe pain that has not responded to non-surgical care.
Lumbar radiculopathy/ Sciatica:
Lumbar Radiculopathy videoSpinal Stenosis:
Lumbar Spinal Stenosis video
Spondylolisthesis refers to when one vertebral body slips forward over another, often as a result of a defect in a small segment of bone (the pars interarticularis) that joins the facet joints in the back of the spine, possibly leading to back pain and leg pain that restricts normal activity levels. Another common cause of spondylolisthesis is degeneration within the facet joints (degenerative spondylolisthesis). Typically recommended treatments for spondylolisthesis include non-surgical care like bracing that immobilizes the spine for short periods of time, pain medications and/or anti-inflammatory medications, hamstring stretches and other controlled, gradual exercises. Surgery combining a decompressive laminectomy with a spinal fusion is rarely needed for spondylolisthesis symptoms that are not healing or have neurological components. Spondylosis:
Non-fusion surgeries (Videos):
- Lumbar Microdiscectomy / Decompression Surgery
Decompression is a surgical procedure that aims to free up space for a spinal nerve that is pinched as a result of a herniated disc, spinal stenosis or spondylolisthesis. A decompression surgery involves removing a portion of bone that is putting pressure on the nerve, with the goal of providing more room for the nerve to heal and function. Microsurgical discectomy:
Lumbar Microdiscectomy Surgery video
- Laminectomy Surgery
A laminectomy is a surgical procedure that aims to alleviate leg pain and lower back pain as a result of neural impingement caused by lumbar spinal stenosis. A laminectomy involves removing a small portion of bone over the nerve root and/or disc material from under the nerve root to provide more space and a better healing environment for the nerve. Lumbar Laminectomy:
Lumbar Laminectomy Surgery video
- coflex® Interlaminar Stabilization®
The coflex® device is a small titanium implant that can help relieve pain caused by spinal stenosis. It’s FDA approved and has 5 years of clinical evidence to support it being an alternative to spinal fusion.
coflex® Interlaminar Stabilization®:
coflex® Interlaminar Stabilization® video- Property of Paradigm Spine, LLC. Copyright 2017
- Fracture Repair: Vertebroplasty and kyphoplasty Surgery
Vertebroplasty and Kyphoplasty are minimally invasive procedures for treatment of vertebral fractures that are causing severe pain that has not improved after a number of weeks of non-surgical care like pain medications and braces. Both vertebroplasty and kyphoplasty involve a small incision and the injection of bone cement in the fractured vertebra to provide stability; prior to the injection of the bone cement, kyphoplasty involves the use of an inflated balloon to restore fractured vertebrae that have collapsed and become wedged.
Kyphoplasty Osteoporosis Fracture Treatment videoVertebroplasty:
- Spinal Cord Stimulator
A Spinal Cord Stimulator is to relieve pain from nerve damage in the trunk, arms or legs. It is also referred to as neurostimulation. Failed back surgery syndrome, cervical and lumbar radiculitis, and neuropathy are a few conditions that may be helped by this therapy. Unlike most treatments requiring surgery, spinal cord stimulation can be tried for a short time before a person commits to having the implant or having any lasting negative effects. The trial period is part of a two-step screening process to select those most likely to benefit. Should a patient not want the trial anymore, the lead is pulled out in the office, and a small bandage is applied—a simple, painless process.
Careful screening is needed because spinal cord stimulation does not work for everyone.
Spinal Cord Stimulator:
Spinal Cord Stimulator Video
Rhizotomy is a surgical procedure to sever nerve roots in the spinal cord. The procedure effectively relieves chronic back pain and muscle spasms. For spinal joint pain, a facet rhizotomy may provide lasting low back pain relief by disabling the sensory nerve at the facet joint. An electrified hot probe is inserted at the sensory nerve just outside the joint to disable the nerve and prevent pain signals from reaching the brain. If a patient responds well to facet injections, a rhizotomy will likely be an effective pain treatment.
Fusion surgeries (Videos):
- Spinal and SI Joint Fusion
Spinal and SI joint fusion is a surgical procedure that aims to decrease back, neck, or SI joint pain as a result of conditions like degenerative disc disease, spondylolisthesis or SI joint dysfunction. During a fusion surgery, bone is grafted to stop motion at painful vertebral segment(s) or joint and thus reduce severe pain and functional limitations.
Anterior Lumbar Interbody Fusion:
ALIF Anterior Lumbar Interbody Fusion videoPosterior Lumbar Fusion:
Spine Fusion Surgery videoCorpectomy:
Lumbar Corpectomy Surgery video
- Artificial Disc Replacement
Artificial disc replacement surgery is a spinal fusion alternative that aims to replace a painful disc that is causing back pain or neck pain. Artificial disc replacement surgery involves removing the painful, natural disc and inserting an artificial disc that can preserve some of the motion of that spinal element. Closely related, nucleoplasty surgery replaces only the center of the disc (nucleus) while leaving the disc’s outer portion (annulus) intact.
Artificial Disc Replacement surgery:
Total Disc Replacement Back Surgery video
- Sacroiliac Joint Fusion
Sacroiliac joint fusion surgery may be recommended to treat sacroiliac joint pain when nonsurgical treatments are ineffective. In this procedure bone graft and/or instrumentation are used to encourage bone growth over the sacroiliac joint creating one immobile unit (a fusion). Removing motion in the joint can effectively reduce pain and instability caused by sacroiliac joint dysfunction or inflammation (sacroiliitis).
SI Joint Fusion Surgery:
SI-Bone iFuse Implant System