Our Summary

This research paper discusses a method in minimally invasive spine surgery known as the lateral transpsoas approach. This approach involves placing large grafts between the vertebrae of the spine, which allows for a strong fusion of the front part of the spine, relieves pressure, and restores the natural curve of the spine, all without disturbing the muscles or ligaments at the back of the spine. Traditionally, this surgery is performed with the patient lying on their side, but more doctors are starting to do it with the patient lying on their stomach because it can make the surgery quicker for patients who also need screws put into their spine. Both positions can be effective for the transpsoas approach, but surgeons need to understand the slight differences and considerations between them.

FAQs

  1. What is the lateral transpsoas approach in lumbar fusion surgery?
  2. What are the benefits of using the prone position in lumbar fusion surgery?
  3. What are the differences between lateral decubitus and prone positions in the transpsoas approach?

Doctor’s Tip

A doctor may advise a patient undergoing lumbar fusion to follow post-operative instructions carefully, including avoiding heavy lifting, bending, and twisting for a period of time to allow for proper healing of the fusion. They may also recommend physical therapy to help strengthen the muscles surrounding the spine and improve flexibility. It is important for the patient to communicate any persistent pain or discomfort to their doctor to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended for lumbar fusion include those with:

  1. Degenerative disc disease
  2. Chronic low back pain
  3. Spondylolisthesis
  4. Spinal stenosis
  5. Herniated discs
  6. Failed back surgery syndrome
  7. Instability or deformity of the spine

It is important for patients to undergo a thorough evaluation by a spine surgeon to determine if lumbar fusion is the most appropriate treatment option for their specific condition.

Timeline

Before lumbar fusion:

  • Patient undergoes a thorough evaluation by a spine surgeon to determine the need for surgery
  • Pre-operative testing, such as imaging studies and blood work, is conducted
  • Patient may undergo physical therapy or other conservative treatments in an attempt to alleviate symptoms
  • Patient receives education on the surgical procedure, potential risks and benefits, and post-operative care

After lumbar fusion:

  • Patient undergoes the lumbar fusion surgery, which typically involves removing damaged disc material and inserting bone grafts or implants to stabilize the spine
  • Patient is closely monitored in the hospital for a few days post-surgery
  • Patient may need to wear a back brace for a period of time to support the healing spine
  • Patient undergoes physical therapy to regain strength and mobility in the spine
  • Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns or complications

Overall, the timeline of a patient’s experience before and after lumbar fusion can vary depending on the individual case and recovery process. It is important for patients to closely follow their surgeon’s recommendations for optimal outcomes.

What to Ask Your Doctor

  1. What is lumbar fusion and why do I need it?
  2. What are the risks and benefits of undergoing a lateral transpsoas lumbar fusion procedure?
  3. How long is the recovery time for this procedure?
  4. What are the potential complications and how are they managed?
  5. How will this procedure affect my mobility and daily activities?
  6. Will I need physical therapy or rehabilitation after the surgery?
  7. What type of anesthesia will be used during the procedure?
  8. How many of these procedures have you performed and what is your success rate?
  9. What alternative treatment options are available for my condition?
  10. How long will the results of the fusion last and what can I do to optimize the outcome?

Reference

Authors: White MD, Uribe JS. Journal: Neurosurg Clin N Am. 2023 Oct;34(4):609-617. doi: 10.1016/j.nec.2023.06.008. Epub 2023 Jul 21. PMID: 37718107