• What makes up the lumbar spine surgery?
• What conditions lead to pain in the lumbar spine?
• What happens during lumbar spine surgery?
• What are the possible risks and complications of lumbar spine surgery?
• How do I recover from lumbar spine surgery?

What makes up the lumbar spine surgery?

The lumbar spine, also known as the lower back, includes the lumbar vertebrae and the sacrum. It consists of 5 lumbar vertebrae, numbered L1 to L5, which bear the weight of the upper body, including the head and neck, making them specifically designed for weight-bearing. These vertebrae are the largest in the spine, with thick, wide, kidney-shaped vertebral bodies. The pedicles, lamina, articular processes, facet joints, and transverse processes are all larger and stronger than the rest of the spine, providing stability and support. Proper care and treatment, including advanced Lumbar Spine Surgery, are crucial when these structures are affected by injury, degeneration, or other spinal conditions.

Below the lumbar spine you have the sacrum, which is made up of 5 vertebrae fused together forming a single bone. The sacrum then fuses with the pelvic bones on either side, at the sacroiliac joint.

In between these vertebrae you get the intervertebral discs, which are rounded structures which act as shock absorbers and flexible pivots for movement. The discs are made up of two components, the outer fibrous part called the annulus fibrosus and the inner gel like substance called nucleus pulposus. The lumbar intervertebral segments are named according to the vertebrae they are found between.

What conditions lead to pain in the lumbar spine?

Lower back pain is a condition which plagues people of all ages. And you will find that the majority of individuals have persistent, chronic lower back pain, which they have gotten used to living with. There are many different causes for lumbar spine pain, which include:

• Muscle pain

  – problems with the musculature which surround and support the lumbar spine is a common cause of lower back pain. Strenuous exercise or lifting of heavy objects can lead to what is known as muscle spasm or strain, commonly referred to as a pulled back muscle.

• Disc degeneration

  – which occurs as a result of wear and tear in the discs. This causes disc shape and structure abnormalities, resulting in irregular lumbar spine movements that ultimately lead to pain and discomfort.
  Lumbar disc herniation

• is a condition where part of the intervertebral disc is pushing into the spinal canaland pressing on the nerves which are exiting the vertebral column leading to pain. This herniation can occur as a result of degeneration or due to sudden lifting of a heavy weight.

• Sacroiliac joint dysfunction

  Joint space abnormalities, like narrowing or bony surface issues, can cause restricted or excessive movement, leading to pain and discomfort.

• Spondylolisthesis

  – is the slipping of one vertebral body in front of the other. This slipping usually occurs in the vertebra which lies below and leads to narrowing of the lateral foramina. This leads to nerve compression and pain.

• Osteoarthritis

  Facet joint arthritis occurs when cartilage wears down, causing friction, bone spurs, swelling, nerve compression, tenderness, and restricted joint movement.

• Lumbar stenosis

  – is the narrowing of the spinal canal in the lumbar region which can be caused as a result of disc herniation, or swelling and bone spur formation due to osteoarthritis. Stenosis will lead to nerve compression and pain.

In most of the above mentioned conditions it is the spinal nerves which become compressed. These nerves serve to supply the motor and sensory function of the lower limbs. Therefore, when they are compressed, along with lower back pain, most people complain of pain at the back of the thigh radiating to the sole, a condition termed as sciatica.

What happens during lumbar spine surgery?

The different surgical approaches to lumbar spine surgery include:

• Fusion surgeries

  – are surgeries where two or more vertebrae that make up the column are joined together. It involves the preparation of the intervertebral disc space by removing the disc and replacing it with bone cement, allograft or other implants which will hold the adjacent vertebrae in place. Rods and screws might also be used following this in order to provide further stability. There are three common approaches to this surgery, which include:

  • Posterior Lumbar Interbody Fusion (PLIF) – where the incision is made on the patient’s back
  • Anterior Lumbar Interbody Fusion – where the incision for access to the vertebrae is made on the patient’s abdomen anteriorly
  • Transforaminal Lumbar Interbody Fusion – where the incision is made on the patient’s back, but the vertebral column is approached from the side.
  • Pedicle screw fixation – which makes use of metal rods and pedicle screws that are used to stabilize the various segments of the spine, and helps to keep the bone cement which has been inserted in place, in order to help the healing process of the bone as well. The rods and screws which are inserted can be later removed once healing is completed and your doctor is certain that your spine is stable. But usually they are not removed unless pinching your nerves.

• Microdisectomy

  – which is used to treat disc herniation causing pain, by removing the part of the disc which has herniated and is causing the compression of the spinal nerves.

• Minimally Invasive Spine Surgery (MISS)

  It’s a minimally invasive procedure treating canal stenosis, degenerative disc disease, and herniated discs, causing less tissue damage than open surgery.

  Foraminotomy

•  – is a procedure which is carried out in the case of nerve compression at the transverse foramen where the nerves exit the vertebral column. During this procedure, this foramen is enlarged by removing bone material.
• Vertebroplasty and Kyphoplasty,

  These procedures treat vertebral fractures by using bone cement to correct defects, stabilize the bone, and restore backbone support effectively.

What are the possible risks and complications of lumbar spine surgery?

As with any major surgery lumbar spine surgery also has its potential risks and complications, which include:

• Damage to nerves, which can lead to numbness or weakness of the lower limbs
• Damage to major vessels in that region
• Formation of blood clots
• Infection at the surgical site

How do I recover from lumbar spine surgery?

The recovery from lumbar spine surgery depends on individual factors. Usually you will have a hospital stay of about 5-7 days, during which you will be introduced to a physical therapist, who will help you with mobility.If a MISS procedure is done without screws, your doctor usually encourages walking the next day, but advises caution for 4–6 weeks. If you have been treated with screws, under cover of analgesics, mobility usually starts on 3rd day. Follow-up investigations such as X-rays and other imaging studies will be done in order to determine the success of surgery.

Conclusion

Lumbar Spine Surgery is an effective solution for treating conditions that affect the lower back, including herniated discs, spinal stenosis, and degenerative disorders. With proper diagnosis and advanced surgical techniques, patients can experience significant pain relief, improved mobility, and enhanced quality of life. Consulting an experienced spine specialist ensures personalized care and the best possible outcomes.

Contact Dr. Vikas today for expert Lumbar Spine Surgery and take the first step toward a pain-free, active life.