Surgical Options
Patients are initially evaluated by a physiatrist to make sure all non-surgical options including physical therapy and non-narcotic pain management are exhausted prior to considering a surgical solution. In this section, we discuss which patients should undergo surgery.
Lumbar Microdiskectomy
This surgery is done for patients with lumbar radiculopathy from a disc herniation or foraminal stenosis. Patients are put to sleep with general anesthesia and then turned prone (face down). The level localized through X-Ray and accessed through a small incision in the lower back measuring 1.5 inches in length. Using a microscope, a small amount of the lamina is removed and the disc space identified. The disc fragment is then removed, leaving the majority of the non-herniated disc intact.
The surgery takes approximately 45 minutes. Patients usually go home the same day.
View a video detailing this proceedure >
Lumbar Laminectomy
This surgery is done for patients who have lumbar stenosis presenting with Neurogenic Claudication. MRI shows compression of the nerve roots centrally at one or multiple levels. During surgery, the lamina are removed as well as a small part of the facet joint to decompress the nerves and thecal sac.
The surgery takes approximately 45 minutes. Patients usually go home the same day.
View a video detailing this proceedure >
Lumbar Foraminotomy
A Lumbar Foraminotomy is a surgical procedure designed to relieve nerve compression by enlarging the foramen, the passageway where spinal nerves exit the spinal column. It is most commonly performed at the L3-4, L4-5, and L5-S1 levels.
Most surgeons have seen success in using this procedure for patients with lumbar foraminal stenosis, which can cause radiating leg pain, numbness, or weakness due to nerve compression. This procedure is often recommended when conservative treatments such as physical therapy, medication, or injections have failed to provide relief. A Lumbar Foraminotomy removes bone or tissue pressing on the nerve, allowing for improved function and reduced pain without the need for spinal fusion.
The surgery takes approximately 60 to 90 minutes. Patients usually go home the same day.
View a video detailing this proceedure >
Lumbar Laminectomy with Interspinous Device
Similar to a Lumbar Laminectomy, but the spinous process is preserved, the lamina is removed through a Laminotomy rather than laminectomy. A device is placed in between the spinous process to prevent further movement and reduce the likelihood of recurrent stenosis.
The surgery takes approximately 45 minutes. Patients usually go home the same day.
View a video detailing this proceedure >
Lumbar Fusion & Decompression (TLIF)
Similar to a Lumbar Laminectomy, but the spinous process is preserved, the lamina is removed through a Laminotomy rather than laminectomy. A device is placed in between the spinous process to prevent further movement and reduce the likelihood of recurrent stenosis.
The surgery takes approximately 45 minutes. Patients usually go home the same day.
View a video detailing this proceedure >
Lateral Lumbar Fusion & Decompression (XLIF)
Also known as an XLIF (Extreme Lateral Interbody Fusion), is an approach to the spine through lateral flank. It is
most commonly used to operate upon the L2-3, L3-4 and sometimes L45 levels. Most surgeons have seen success in using this procedure for adjacent segment disease after a previous fusion. For instance, a patient undergoes a fusion at L4-5 and later develops stenosis at L3-4. Rather than extend the fusion, an XLIF can be performed in a short period of time, minimal surgical exposure, and with the patient going home the next day.
The surgery takes approximately 60 minutes. Patients usually go home the same day.
Lumbar Tumor Resection
Most surgeons have seen success in using this procedure for tumor removal with minimal disruption to surrounding muscles and structures. In some cases, this approach is also beneficial for patients with adjacent segment disease after a previous fusion. For instance, if a patient undergoes a fusion at L4-5 and later develops stenosis or instability at L3-4, a lateral approach allows for targeted treatment without extending the fusion. This technique provides a shorter surgical time, minimal exposure, and allows the patient to return home the next day.
The surgery takes approximately 60 minutes. Patients usually go home the same day.