Our Summary

The researchers looked at the effectiveness of a minimally invasive spine surgery procedure using a special type of implant (an expandable cylindrical fusion cage). They examined data from patients who had undergone this surgery between August 2018 and April 2019. The surgery was performed through two different approaches. One group had the procedure done through the side of the spine (transforaminal), while the other had it done through the layers of the spine (interlaminar).

In total, 32 patients were included in the study. The researchers found that the reasons for having the surgery differed significantly between the two groups. Regardless of the approach used, all surgeries were successful and there were no complications.

One year after surgery, patients were evaluated using several measures. Magnetic resonance imaging (MRI) showed that the surgery had effectively relieved pressure on the nerves in all patients. Patients also reported less back and leg pain, improved sensory and muscle strength, and less disability after the surgery. Ratings of patient satisfaction were also high in both groups.

A year after surgery, a type of scan called computed tomography (CT) showed that the fusion of the spine had been fully achieved in both groups. The researchers concluded that this type of surgery is a safe and effective way to treat certain conditions of the lumbar spine (the lower part of the back).

FAQs

  1. What is a minimally invasive spine surgery procedure using an expandable cylindrical fusion cage?
  2. What were the results of the study on the effectiveness of this type of surgery?
  3. What changes were observed in the patients a year after the surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumbar fusion is to follow post-operative instructions carefully, including proper lifting techniques, avoiding twisting motions, and attending physical therapy as recommended. This will help ensure a successful recovery and long-term fusion of the spine. It is also important to maintain a healthy lifestyle with regular exercise and good nutrition to support the healing process.

Suitable For

Patients who are typically recommended for lumbar fusion surgery include those who have:

  1. Degenerative disc disease
  2. Spinal stenosis
  3. Spondylolisthesis
  4. Herniated discs
  5. Fractures or instability of the spine
  6. Failed previous non-surgical treatments such as physical therapy or medications

These patients may experience symptoms such as chronic back pain, leg pain or weakness, numbness or tingling in the legs, difficulty walking, and loss of bowel or bladder control. Lumbar fusion surgery can help alleviate these symptoms by stabilizing the spine and reducing pressure on the nerves.

Timeline

  • Before lumbar fusion:
  1. Patient experiences chronic back and leg pain, possibly due to conditions such as degenerative disc disease, spinal stenosis, or spondylolisthesis.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the cause of their pain.
  3. Patient may try conservative treatments such as physical therapy, medications, or injections to manage their symptoms.
  4. If conservative treatments are ineffective, patient and their healthcare provider may decide that lumbar fusion surgery is necessary.
  • After lumbar fusion:
  1. Patient undergoes minimally invasive spine surgery with an expandable cylindrical fusion cage, either through the side of the spine (transforaminal) or through the layers of the spine (interlaminar).
  2. Surgery successfully relieves pressure on the nerves and achieves fusion of the spine.
  3. Patient experiences less back and leg pain, improved sensory and muscle strength, and reduced disability after surgery.
  4. Patient undergoes follow-up evaluations, including MRI and CT scans, to confirm the success of the surgery and monitor their progress.
  5. One year after surgery, patient reports high satisfaction with the results and overall improvement in their quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumbar fusion surgery include:

  1. What are the specific reasons for recommending lumbar fusion surgery in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time after lumbar fusion surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How will my pain and mobility be affected after the surgery?
  6. What type of implant will be used during the surgery and why?
  7. What is the success rate of this type of surgery for my specific condition?
  8. Will I need any additional imaging tests or follow-up appointments after the surgery?
  9. Are there any lifestyle changes or restrictions I should follow post-surgery?
  10. What is the long-term prognosis for my condition after lumbar fusion surgery?

Reference

Authors: Wang JC, Li ZZ, Cao Z, Zhao HL, Zhang M. Journal: World Neurosurg. 2022 Feb;158:e618-e626. doi: 10.1016/j.wneu.2021.11.030. Epub 2021 Nov 12. PMID: 34775095