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Lumbar spinal surgery - series

Normal anatomy:
Normal anatomy

The spine is made of bones (vertebrae) separated by soft cushions (intervertebral discs).



Indications:
Indications

Lumbar (lower back) spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord.

Symptoms of lumbar spine problems include:

  • pain that extends (radiates) from the back to the buttocks or back of thigh
  • pain that interferes with daily activities
  • weakness of legs or feet
  • numbness of legs, feet, or toes
  • loss of bowel of bladder control


Incision:
Incision

The surgery is done while the patient is deep asleep and pain-free (general anesthesia). An incision is made over the lower back, in the midline.



Procedure:
Procedure

The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy) and the tissue that is causing pressure on the nerve or spinal cord is removed. The hole through which the nerve passes can be enlarged to prevent further pressure on the nerve. Sometimes, a piece of bone (bone graft), interbody cages, or pedicle screws may be used to strengthen the area of surgery.



Aftercare:
Aftercare

Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.




Review Date: 4/16/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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