Lumbar spinal surgery
The spine is made of bones (vertebrae) separated by soft cushions (intervertebral discs).
Lumbar (lower back) spine disease may be caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, or narrowing (stenosis) of the spinal column around the spinal cord.
Symptoms of lumbar spine problems include:
- Pain that extends (radiates) from the back to the buttocks or back of thigh (sciatica)
- Pain that interferes with daily activities
- Weakness of legs or feet
- Numbness of legs, feet, or toes
- Loss of bowel of bladder control
The surgery is done while the patient is deep asleep and pain-free (general anesthesia). An incision is made over the lower back, in the midline.
The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy) and the tissue that is causing pressure on the nerve or spinal cord is removed. The hole through which the nerve passes can be enlarged to prevent further pressure on the nerve. Sometimes, a piece of bone (bone graft) or metal rods (such as Harrington rods) may be used to strengthen the area of surgery.
Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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