Anterior Lumbar Interbody Fusion (ALIF) involves removing a damaged disc to relieve the spinal cord or nerve root pressure and alleviate the corresponding pain, weakness, numbness, and tingling. After the discectomy is performed, a bone filled PEEK (plastic) or titanium interbody device is placed at the site of the removed disc. A buttress plate and corresponding screw can be placed into the vertebral body to stop the interbody device, also known as a cage, from moving or migrating.
Posterior Spinal Fusion (PSF) surgery involves removing bone to decompress the spine. The removal of this bone relieves stenosis(narrowing of the foramen) to open the central and lateral foramen, allowing the relief of the spinal cord and the lateral nerve roots. After the decompression, Pedicle screws are placed through the pedicles of the vertebral bodies and fixated with rods and set screws.
Posterior Lumbar Interbody Fusion (PLIF) surgery involves removing bone to decompress the spine. The removal of this bone relieves stenosis(narrowing of the foramen) to open the central and lateral foramen, allowing the relief of the spinal cord and the lateral nerve roots. A discectomy is performed to remove the damaged or herniated disc. After the decompression and discectomy, a bulleted PEEK or Titanium interbody device is placed at the level of the removed disc. Pedicle screws are placed through the pedicles of the vertebral bodies and fixated with rods and set screws at the level above and below the interbody device.
Transforaminal Lumbar Interbody Fusion (TLIF) surgery involves removing bone to decompress the spine. A discectomy, removal of disc, is performed through the lateral foramen to remove the damaged or herniated disc. After the discectomy, a straight or curved PEEK or Titanium interbody device is placed at the level of the removed disc. Pedicle screws are placed through the pedicles of the vertebral bodies and fixated with rods and set screws at the level above and below the interbody device.
Direct Lateral Interbody Fusion/Lateral Lumbar Interbody Fusion surgery starts with the placement of a retractor laterally or in the patient’s side. Neuromonitoring is used to verify neural safety while placing the retractor. The surgeon will begin by removing bone to decompress the spine. A discectomy, removal of disc, is performed through the lateral access to remove the damaged or herniated disc. After the discectomy, a straight PEEK or Titanium interbody device is placed at the level of the removed disc. Lordotic options are available to return the patient to a corrected anatomical curve. Pedicle screws are placed through the pedicles of the vertebral bodies and fixated with rods and set screws at the level above and below the interbody device.
Minimally Invasive Spinal Fusion (MIS) surgery involves the fixation of the spine with minimal damage to the surrounding muscle, tendons, and the surface of the skin. This procedure starts with the placement of a jamshidi needle, a hollow cannula with a needle insert, into the pedicle. The insert is removed exposing the hollow cannula. A guide wire is placed through the cannula into the vertebral body and advanced to the desired depth through fluoroscopy guidance. The jamshidi is then removed and a cannulated tap is placed on the guide wire. Through fluoroscopy, the surgeon advances the tap to the desired depth and removes the tap. A cannulated pedicle screw is placed on the guide wire and advanced. This is repeated at each level of desired fixation. Once all pedicle screws are in place a rod is placed through the pedicle screw tulips and is locked in place with set screws. This surgery can also be done using a cannulated dilating tube system.
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