Surgical Treatment Options for Back and Leg Pain

A microdecompression or microdiscectomy stands for a spinal decompression from a posterior approach with the use of a microscope.  The goal of a microdecompression/microdiscectomy is to remove any material compressing the spinal canal or nerve roots with the least disruption to the tissues and least risk of spinal instability.  It is usually indicated for patients with intractable back and leg pain with stenosis and/or disc herniation.

The surgeon shaves the edges of the bone to gain access to the spinal canal and nerves.  He then decompresses the spinal canal and nerves by removing thick ligament, bone and/or disc material that is compressing the nerves. 

Lumbar ADR stands for artificial disc replacement in the lumbar spine. It is a motion preservation technique that allows for decompression of the spinal canal and nerve roots and maintains the natural movement of the back. It is usually indicated for patients with intractable back and leg pain with disc degeneration, stenosis or a disc herniation.

The surgeon accesses the spine from an anterior approach through the abdomen and uses a series of tools to remove the disc between the two vertebral bodies.  He then carefully decompresses the spinal canal, effectively removing any compressive material, and prepares the vertebral endplates for the device.  The artificial disc is then implanted into the disc space.

ALIF stands for anterior lumbar interbody fusion. It is a type of spinal fusion that decompresses nerves and stabilizes the spine from an anterior approach. It is usually indicated for patients with intractable back and leg pain with stenosis, disc herniation, and/or instability of the spine.

The surgeon accesses the spine from an anterior approach through the abdomen and uses a series of tools to remove the disc between the two vertebral bodies.  He then carefully decompresses the spinal canal, effectively removing any compressive material.  He then inserts a spacer into that space, which reestablishes the height of the disc and creates a surface area for the fusion.

TLIF stands for transforaminal lumbar interbody fusion. It is a type of spinal fusion that decompresses nerves and stabilizes the spine from a posterior approach. It is usually indicated for patients with intractable back and leg pain with stenosis, disc herniation, and/or instability of the spine. Dr. Anand specializes in minimally invasive TLIFs.

The surgeon works through the tubes to expose the bone and establish an approach to the spinal canal and nerves. He shaves the edges of the lamina and facets around the foramen (the channel where the nerve exits), thus creating the transformational approach to the disc space. He then decompresses the spinal canal and nerves by removing thick ligament and/or disc material that is compressing the nerves.  After that, he enters into the disc and removes the disc material. He then inserts a spacer into that space, which reestablishes the height of the disc and creates a surface area for the fusion.

The surgeon then focuses on stabilizing the spine by placing screws into the bones at each level and locking the alignment in place with rods and locking nuts. The screws and rods are placed through tubes so as to preserve the muscle attachments, further contributing to the minimally invasive approach. The procedure usually takes about 2-3 hours to complete for a one level TLIF.

The goal of a posterior instrumentation and fusion is to stabilize the spine, reduce the curvature, and preserve the alignment.  This is achieved with a pedicle screw and rod system, which is implanted using a minimally invasive approach.  Multiple small incisions are made on the back, through which dilating tubes are placed.   The screws and rods are passed through tubes so as to preserve the muscle attachments, contributing to the minimally invasive approach.  The surgeon corrects the curve and alignment of the spine as he locks the rods into place.  By using this minimally invasive approach, patients do not need to go to ICU, lose less blood/require fewer blood transfusions, and recover much faster, allowing them to get back to their daily activities sooner. 

A deformity reconstruction procedure entails the use of multiple spinal techniques to reestablish an appropriate spinal alignment. It often combines lateral and anterior interbody fusions with a posterior instrumentation and fusion to decompress nerves and stabilize the spine. It is usually indicated for patients with intractable back and leg pain with scoliosis, kyphosis, flat back syndrome and/or multiple levels of spinal instability. Dr. Anand specializes in minimally invasive (muscle sparing) techniques for deformity reconstruction.