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Lumbar spondylolisthesis or degeneration

Lumbar Fusion Surgery

 

Overview

Spinal furoin is a surgical procedure used to correct spinal problems, such as spinal stenosis, spondylolisthesis, degenerative disc diseases, spinal fracture, spinal infection or spinal tumor.

Spine surgery is typically recommended only when a period of nonsurgical treatment — such as medications and physical therapy — has not relieved the painful symptoms caused by your back problem. In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis.

If you have leg pain or numbness (neurological symptoms) in addition to back pain, your surgeon may also perform a decompression (laminectomy). This procedure involves removing bone and diseased tissues that are putting pressure on spinal nerves.

Fusion will take away some spinal flexibility, but most spinal fusions involve only small segments of the spine and do not limit motion very much. The majority of patients will not notice a decrease in range of motion. Your surgeon will talk with you about whether your specific procedure may impact flexibility or range of motion in your spine.

 

Features

Spinal fusion is traditionally done as "open approach," meaning the area being operated on is opened with a long incision to allow surgeons to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.

Minimally invasive spine surgery (MISS) was developed to treat spine problems with less injury to the muscles and other normal structures in the spine. Other advantages to MISS include smaller incisions, less bleeding, and shorter stays in the hospital.

 

 

We also established an Enhanced Recovery After Surgery (ERAS) pathway for spinal fusion surgery, which is the first ERAS spinal fusion care team in Taiwan. The ERAS pathway that combines evidence-based perioperative strategies to accelerate the functional recovery process, less postoperative pain and improve surgical outcomes.

 

Procedure

For traditional open spinal fusion, the surgeon accesses to the spine from the back. A longitudinal skin incision was made (according to the spine segments) and paraspinal muscle was dissected to show the spine anatomy. Laminectomy was performed for adequate spinal canal decompression. Pedicle screws were inserted under C-arm fluoroscopic guides. Bone graft harvested from local autologous bone chips, bone bank or artificial bone substitute was used to enhance the chance of successful spinal fusion.

For MISS, many minimally invasive techniques have also been developed. Using small instruments. Any bone or disk material that is removed exits through special retractors, and any devices necessary for fusion — such as screws or rods — are inserted through the retractor.

In order to see where to place the incision and insert the retractor, the surgeon is guided intra-operative O-arm navigation system or ROSA robotic system. This method displays real-time spine images of the patient's spine on a screen throughout the surgery. The surgeon also uses an operating microscope to magnify the view through the retractor.

Notification

Infection: Antibiotics are regularly given to the patient before, during, and often after surgery to lessen the risk of infections.

Bleeding: A certain amount of bleeding is expected, but this is not typically significant.

Nonunion Patients who smoke are more likely to develop a pseudarthrosis. This is a condition where there is not enough bone formation. If this occurs, a second surgery may be needed in order to obtain a solid fusion.

Nerve damage: It is possible that the nerves or blood vessels may be injured during these operations; rather these complications are very rare.

Hematoma: Another uncommon complication is the formation of blood clots in the operation area and cause radiculopathy or cauda equine syndrome.

 

Estimated Cost

For estimated medical costs, please contact International Medical Services Center.

 

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