What Methods of Surgery are Effective for the Lumbar Spine? Taking into Account the Aetiology, Imaging Results and Risk of Complications

Shokil Hiu^*
*Correspondence: Shokil Hiu, Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City 514-8507, Japan, Email:

Introduction

Disorders of the lumbar spine can cause significant pain and disability, necessitating surgical intervention when conservative treatments fail. The selection of appropriate surgical methods is crucial for achieving optimal outcomes while considering the underlying etiology, imaging findings, and potential risk of complications. This article aims to explore effective surgical methods for the lumbar spine, taking into account these important considerations. The lumbar spine is susceptible to various pathologies, including degenerative disc disease, herniated discs, spinal stenosis, spondylolisthesis, and spinal tumours. Each pathology requires a tailored approach to address the specific anatomical abnormalities and clinical manifestations. Imaging plays a crucial role in assessing the pathology, confirming the diagnosis, and guiding surgical decision-making. Modalities such as X-rays, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) scans provide valuable information regarding the extent and nature of the spinal pathology. Integration of imaging findings with clinical symptoms and patient history is vital for selecting the most appropriate surgical method [1,2].

Description

Discectomy is a common surgical method for lumbar disc herniation. It involves removing a portion of the herniated disc material that is compressing the nerve root, relieving pain and improving function. Traditional open discectomy and minimally invasive techniques, such as microdiscectomy, are effective approaches. Decompression procedures aim to relieve neural compression in conditions such as spinal stenosis or foramina stenosis. Laminectomy, laminectomy, and laminoplasty are commonly performed techniques that create more space for the nerve roots, alleviating symptoms [3]. Spinal fusion is indicated in conditions where instability or segmental deformity is present. It involves joining two or more vertebrae to promote spinal stability and alleviate pain. Techniques such as posterolateral fusion, Anterior Lumbar Interbody Fusion (ALIF), and Transformational Lumbar Interbody Fusion (TLIF) are commonly utilized [4].

Surgical procedures for the lumbar spine, like any surgical intervention, carry inherent risks and potential complications. Factors such as patient age, comorbidities, and the complexity of the pathology should be considered to assess the risk-benefit ratio. Potential complications include infection, bleeding, nerve damage, dural tears, hardware failure, and pseud arthrosis. Preoperative patient counselling and thorough surgical planning help minimize these risks [5,6].

Conclusion

Effective surgical methods for the lumbar spine are diverse and tailored to the specific pathology and individual patient characteristics. Careful consideration of the underlying etiology, imaging findings, and potential risks of complications is crucial for selecting the most appropriate surgical approach. Surgeons should stay updated with the latest advancements and individualize treatment plans to optimize outcomes for each patient. With continued research and technological advancements, the field of lumbar spine surgery will continue to evolve, providing improved options for patients suffering from lumbar spine pathologies.

Acknowledgement

None.

Conflict of Interest

None.

References

1. Aguirre, Alexander O., Mohamed AR Soliman, Shady Azmy and Asham Khan, et al. "Incidence of major and minor vascular injuries during lateral access lumbar interbody fusion procedures: A retrospective comparative study and systematic literature review." Neurosurg Rev 45 (2022): 1275-1289.

Google Scholar, Crossref, Indexed at

2. Ruffilli, Alberto, Marco Manzetti, Francesca Barile and Marco Ialuna, et al. "Complications after posterior lumbar fusion for degenerative disc disease: Sarcopenia and osteopenia as independent risk factors for infection and proximal junctional disease." J Clin Med 12 (2023): 1387.

Google Scholar, Crossref, Indexed at

3. Fujimori, Takahito, Tadashi Watabe, Yasuo Iwamoto and Seiki Hamada, et al. "Prevalence, concomitance, and distribution of ossification of the spinal ligaments: Results of whole spine CT scan in 1500 Japanese patients." Spine 41 (2016): 1668-1676.

Google Scholar, Crossref, Indexed at

4. Nakajima, Hideaki, Kazuya Honjoh, Shuji Watanabe and Akihiko Matsumine. "Prognostic factors and optimal surgical management for lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis." J Clin Med 11 (2022): 4133.

Google Scholar, Crossref, Indexed at

5. Imai, Takaya, Sota Nagai, Takehiro Michikawa and Risa Inagaki, et al. "Impact of lumbar surgery on pharmacological treatment for patients with lumbar spinal canal stenosis: A single-center retrospective study." J Clin Med 12 (2023): 2385.

Google Scholar, Crossref, Indexed at

6. Eun, Dong-Chan, Yong-Ho Lee, Jin-Oh Park and Kyung-Soo Suk, et al. "A comparative analysis of bi-portal endoscopic spine surgery and unilateral laminotomy for bilateral decompression in multilevel lumbar stenosis patients." J Clin Med 12 (2023): 1033.

Google Scholar, Crossref, Indexed at