Lower Back (Lumbar) Surgery

Low back pain and related symptoms are common but seldom is lumbar spine surgery necessary.  Disorders that cause low back problems include lumbar spinal stenosis, disc herniation, adult degenerative spondylolisthesis, and degenerative disc disease. These conditions can cause severe pain and may lead you to think surgery is your only option.

When might your neurosurgeon consider surgery?

• Spinal instability develops
• Pain and symptoms cannot be non-surgically managed
• Pain becomes unrelenting
• Neurological dysfunction occurs
• Bowel or bladder dysfunction develops

Surgical choice

Your neurosurgeon may recommend a minimally invasive spine surgical (MISS) procedure instead of traditional spine surgery. The goals of either MISS or traditional spine surgery include: reduce nerve compression (called decompression) and stabilize the lumbar spine. During the discussion, you learn if your procedure can be performed as a minimally invasive spine surgery or open approach, and why.

Surgery may include spinal fusion with instrumentation. Spinal fusion utilizes bone graft to stimulate bone growth. Spinal instrumentation involves use of implants including rods, screws, and interbody devices to immediately stabilize the spine. Fusion occurs as the spine heals.

Types of lumbar spine surgery

Be assured that your neurosurgeon will discuss the best option to treat your lumbar condition. The type of surgical procedure depends on many factors, including your diagnosis and the goals of surgery.  Listed below are several types of low back spine surgical procedures:

• Anterior lumbar interbody fusion (ALIF)
• Axial lumbar interbody fusion (AxiaLIF)
• Direct lateral lumbar interbody fusion (DLIF)
• Image Guided Spine Surgery
• Intradiscal Electrothermoplasty (IDET)
• Laminoplasty
• Laminotomy
• Posterior lumbar interbody fusion (PLIF)
• Transforaminal lumbar interbody fusion (TLIF)

Before your procedure

Before surgery, you visit your primary care doctor and/or other medical specialists (i.e., heart doctor, endocrinologist) to obtain a general health clearance. This means your doctor has carefully evaluated your health in terms of undergoing surgery. Your assessment may include blood tests, x-rays or other imaging studies, as well as special tests for existing medical problems (i.e., diabetes, osteoporosis).

Review potential benefits and risks

Of course, the potential benefits of the surgery are important to know, but so are the possible risks and complications. Your risks and complications may be different from those of another patient because you are unique. Your neurosurgeon takes that into serious consideration and thoughtfully explains potential risks to you, which may include infection, bleeding, reaction to anesthesia, and nerve damage.

After surgery

You are moved from the operating room into the recovery area. Here, the nurses and medical staff closely monitor your vital signs with attention to managing post-operative pain. You should expect some discomfort.

Post-operative care

Your surgery is over, but now your recovery starts! If you do not understand your post-surgical instructions or a problem develops, please call us-we are here to help you.

 Conventional post-spine surgery instructions

• Schedule your post-operative appointment call (281) 446-3876
• If your doctor prescribes a lumbar brace, wear it as prescribed
• Keep your incision(s) dry and clean
• If showering is permitted, keep your incision(s) covered and dry
• Rest; you will fatigue easily while your body heals
• Do not take a tub bath, go swimming, or sit in a hot tub or pool
• Begin physical therapy and/or exercise as instructed
• Take medications as prescribed
• Do not lift or carry anything heavier than a shoe
• Walking is encouraged
• Do not drive until cleared by your neurosurgeon
• Avoid riding in a car; short distances are permitted
• Do not smoke or use tobacco
• Eat well, your body needs nutritious food to heal

Call your neurosurgeon’s office (281) 446-3876

• Fever 101 degrees Fahrenheit or higher
• Redness and/or swelling around the incision site expands
• Change in the amount, odor or appearance of the incision drainage
• Incision pain increases
• Bowel or bladder dysfunction develops
• Genital area numbness develops

Talk with your neurosurgeon

We hope this information about lumbar (low back) spine surgery has answered your immediate questions. Remember, your neurosurgeon is your most valuable source to answer your questions about symptoms, treatment and your healthcare.