This minimally invasive procedure is performed through an incision down the center of the back over the area of the herniated disc. The muscles are moved to the side so that the surgeon can see the back of the vertebrae.

Some of the most common operations that we do for the spine are lumbar microdiscectomy and lumbar laminectomy.

So lumbar fusion surgery is sometimes necessary for back pain, but in that situation one has to carefully correlate the clinical findings with the imaging findings. For most of the common back operations that we do, lumbar discectomy or lumbar laminectomy, a fairly small incision is made in the back approximately inch, inch-and-a-half in length.

Using microsurgical techniques we expose the nerves that are compressed and remove the offending herniated disc or bone spurs that are causing nerve compression, and this is an example of a disc herniation that may cause pressure on the nerves.

And again that’s a fairly quick operation with a very good success rate often requiring no more than 45 minutes to an hour of surgical time, blood loss is minimal, perhaps no more than two teaspoons of blood is lost, and patients are usually up and about within a few hours of surgery and quite often they can leave the same day.  Sometimes it may require an overnight stay. In treating this condition, often seeing a local massage therapist for muscle tension, a local personal trainer for muscle strength and a physiotherapist for release and conditioning is a good option.  

And these surgeries are actually very effective in relieving symptoms of sciatica, so pain, numbness, weakness in the legs, and the response is almost always immediate.  Sometimes lumbar fusion surgery is necessary, which is a bigger operation, and the indications are very different.

Lumbar fusion is necessary if somebody has a deformity or instability in the spine. It’s a bigger operation, but even so with current techniques available we can usually do that surgery through fairly small incisions. Nevertheless, it does require a few more days in the hospital.

But the important thing to recognize is that lumbar fusion is very rarely necessary for sciatica or spinal stenosis. It can be helpful for situations of back pain, but the clinical symptoms need to be correlated with the imaging findings. Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.    

So one of the most important things to recognize and appreciate is that while spine surgery can be very helpful, it is reserved for a specific condition such as disc herniations, spinal stenosis, spinal deformity, and it’s rarely needed for situations such as back pain alone, which is usually treated conservatively. Treated by a local Physiotherapist 

When spine surgery is necessary, there are a number of different options in terms of how to perform the surgery, but the important thing to recognize is that if the indications are correct, and the correct surgery is chosen, the results with spinal surgical procedures are very satisfying. Local Physiotherapy. 

Presenter: Dr. Ramesh Sahjpaul, Neurosurgeon, Vancouver, BC

Now Health Network Local Practitioners: Neurosurgeon