Article Featured on Spine Health
Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one or more of the L1-S1 levels. There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back:
Lumbar Decompression
The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis.
This type of pain is usually referred to as a radiculopathy, or sciatica.
A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.
There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.
Lumbar Fusion
The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back. Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or a spondylolisthesis.
A spinal fusion surgery involves using a bone graft to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. Spine surgery instrumentation (medical devices), bone graft procedures, and a bone stimulator are sometimes used along with spinal fusion.
There are also many surgical approaches to performing spinal fusion, such as ALIF, PLIF, XLIF, TLIF, posterolateral gutter fusion, anterior/posterior fusion, and certain minimally invasive approaches.
In addition to the above conditions, decompression and/or spinal fusion may be performed to address other types of lumbar spine pathologies, such as infection or tumors.
Lumbar Spine Surgery Alternatives
In addition to the traditional one-level fusion or decompression surgery that is done for lumbar degenerative disc disease or spinal stenosis, respectively, there are a number of surgical alternatives available. Several of the most common ones include:
Artificial Disc Replacement
Artificial disc technology can be used in specific cases of lumbar degenerative disc disease.
Motion Preservation Technologies
It should be known that while spinal fusion has been a classical treatment for ongoing pain and disability from the lumbar spine, alternatives to fusion do exist for posterior conditions (problems in the back of the lumbar spine) such as spinal stenosis. Inserting an interspinous process spacer, such as the X-STOP device, can actually preserve motion as opposed to stopping it via fusion.
Vertebral Augmentation
A surgery called vertebral augmentation may be done to treat pathological fractures from tumors or osteoporosis.
Multilevel Lumbar Fusion
Lumbar spine fusion surgery for symptomatic degenerative disc disease is typically done on one level of the spine (most commonly toward the bottom of the spine, at L5-S1 or L4-L5). In certain cases it may be done on two levels, and only very rarely would it be considered on 3 or more levels. Multilevel spine fusion may be indicated in cases of scoliosis.
There are only two things that surgery can do. Surgery can decompress a nerve root or it can stabilize a painful motion segment. So we have to identify a nerve root that’s pinched or we have to identify a painful motion segment. And if we can do that, that would make you a candidate for surgery. Just having pain and having failed conservative treatment is not an indication for surgery if there is no pathological cause of the pain – it doesn’t mean there’s not pain, but we have to identify the cause of pain in order to be able to correct it. The only thing surgery can do is actually correct an anatomical defect, so we have to be able to identify it.
Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
What Is Dupuytren’s Disease and How Is It Treated?
in Hand Diseases, Hand InjuriesArticle Featured on Michigan Hand & Wrist
If you begin to notice lumps on the palm side of your hand, then you might just have Dupuytren’s disease, and if left untreated, you could possibly lose motion in your fingers. While Dupuytren’s disease is called a disease, it is actually a genetic condition. You would need to have a physical exam to get tested for it. If you think you may have this disease, you should reach out to a hand specialist to look into treatment options as soon as possible.
Read more
5 Ways to Help Prevent Arthritis
in ArthritisArticle Featured on Michigan Hand & Wrist
While it may not be possible to completely get rid of your risk of developing arthritis, there are some things you can do to reduce your risk and delay the onset. Arthritis happens when cartilage wears away, causing your bones to rub against and damage each other, which is why you feel pain. There are some tips you can follow that may help arthritis from developing, which include:
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Did I Tear my Meniscus? Symptoms of a Torn Meniscus
in Knee Injuries, Knee Pain, Knee SurgeryArticle Featured on Brigham Health
What is a torn meniscus?
There are 3 bones in the knee. These are the femur, tibia, and patella. The ends of those bones are covered with cartilage. This is a smooth material that cushions the bone and allows the joint to move easily without pain. The cartilage acts as a shock absorber. Between the bones of the knees are 2 crescent-shaped disks of connective tissue, called menisci. These also act as shock absorbers to cushion the lower part of the leg from the weight of the rest of the body.
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How to tell if you have Whiplash
in Neck Injuries, Neck PainArticle Featured on Mayo Clinic
Overview
Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash most often occurs during a rear-end auto accident, but the injury can also result from a sports accident, physical abuse or other trauma.
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What are some common hand problems?
in Hand InjuriesArticle Featured on Johns Hopkins
Anatomy of the hand
The hand is composed of many different bones, muscles, and ligaments that allow for a large amount of movement and dexterity. There are 3 major types of bones in the hand itself, including:
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12 Ways to Have a Healthy Holiday Season
in Holiday HealthArticle Featured on cdc.gov
Brighten the holidays by making your health and safety a priority. Take steps to keep you and your loved ones safe and healthy—and ready to enjoy the holidays.
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Can orthopedic surgeons repair cartilage damage?
in Cartilage RepairArticle Featured on OrthoInfo
Because cartilage does not heal itself well, doctors have developed surgical techniques to stimulate the growth of new cartilage. Restoring articular cartilage can relieve pain and allow better function.
Read more
ACL Injuries in Children and Adolescents
in ACL Injuries, Junior Sports, Knee Pain, Sports Medicine, Sports Related InjuriesArticle Featured on Nationwide Children’s
It has been frequently emphasized that children are not simply “small adults.” Children and adults are different anatomically and physiologically in many ways. Knee injuries in children and adolescents frequently demonstrate these differences.
Read more
Lumbar Spine Surgery
in Back Pain, Disk Injuries, Spinal SurgeryArticle Featured on Spine Health
Lumbar surgery refers to any type of surgery in the lumbar spine, or lower back, between one or more of the L1-S1 levels. There are two general types of lumbar spine surgery that comprise the most common surgical procedures for the lower back:
Lumbar Decompression
The goal of a decompression surgery is usually to relieve pain caused by nerve root pinching. There are two common causes of lumbar nerve root pressure: from a lumbar herniated disc or lumbar spinal stenosis.
This type of pain is usually referred to as a radiculopathy, or sciatica.
A decompression surgery involves removing a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve pinching of the nerve and provide more room for the nerve to heal. The most common types of decompression surgery are microdiscectomy and laminectomy.
There are also a few alternatives available to the above two standard procedures, such as an X-STOP which is a possible option instead of a laminectomy for lumbar spinal stenosis.
Lumbar Fusion
The goal of a lumbar fusion is to stop the pain at a painful motion segment in the lower back. Most commonly, this type of surgery is performed for pain and disability caused by lumbar degenerative disc disease or a spondylolisthesis.
A spinal fusion surgery involves using a bone graft to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. Spine surgery instrumentation (medical devices), bone graft procedures, and a bone stimulator are sometimes used along with spinal fusion.
There are also many surgical approaches to performing spinal fusion, such as ALIF, PLIF, XLIF, TLIF, posterolateral gutter fusion, anterior/posterior fusion, and certain minimally invasive approaches.
In addition to the above conditions, decompression and/or spinal fusion may be performed to address other types of lumbar spine pathologies, such as infection or tumors.
Lumbar Spine Surgery Alternatives
In addition to the traditional one-level fusion or decompression surgery that is done for lumbar degenerative disc disease or spinal stenosis, respectively, there are a number of surgical alternatives available. Several of the most common ones include:
Artificial Disc Replacement
Artificial disc technology can be used in specific cases of lumbar degenerative disc disease.
Motion Preservation Technologies
It should be known that while spinal fusion has been a classical treatment for ongoing pain and disability from the lumbar spine, alternatives to fusion do exist for posterior conditions (problems in the back of the lumbar spine) such as spinal stenosis. Inserting an interspinous process spacer, such as the X-STOP device, can actually preserve motion as opposed to stopping it via fusion.
Vertebral Augmentation
A surgery called vertebral augmentation may be done to treat pathological fractures from tumors or osteoporosis.
Multilevel Lumbar Fusion
Lumbar spine fusion surgery for symptomatic degenerative disc disease is typically done on one level of the spine (most commonly toward the bottom of the spine, at L5-S1 or L4-L5). In certain cases it may be done on two levels, and only very rarely would it be considered on 3 or more levels. Multilevel spine fusion may be indicated in cases of scoliosis.
There are only two things that surgery can do. Surgery can decompress a nerve root or it can stabilize a painful motion segment. So we have to identify a nerve root that’s pinched or we have to identify a painful motion segment. And if we can do that, that would make you a candidate for surgery. Just having pain and having failed conservative treatment is not an indication for surgery if there is no pathological cause of the pain – it doesn’t mean there’s not pain, but we have to identify the cause of pain in order to be able to correct it. The only thing surgery can do is actually correct an anatomical defect, so we have to be able to identify it.
Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.
Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.
Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.
If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.
Phone:
503-224-8399
Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209
Hours
Monday–Friday
8:00am – 4:30pm
What Is Degenerative Disc Disease?
in Back Pain, Disk Injuries, Spinal SurgeryBy Brian McHugh, MD | Featured on Spine Health
Degenerative disc disease is one of the most common causes of low back and neck pain, and also one of the most misunderstood.
Read more