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Lumbar spinal surgery - series - Normal anatomy

Normal anatomy:

The spine is made of bones (vertebrae) separated by soft cushions (intervertebral discs).

Indications:

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

Incision:

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.

Procedure:

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.

Aftercare:

Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.

Reviewed last on: 7/10/2009
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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