Lumbar

Lumbar Balloon Kyphoplasty

A minimally invasive procedure for stabilizing spinal fractures that may reduce back pain, correct angular vertebral deformity and restore vertebral body height.


Lumbar Discectomy (MLD)

One of the least invasive spine surgeries. A MLD involves removing all or part of a diseased or damaged intervertebral disc to relieve pressure on the spinal nerve(s) in the lumbar spine, or lower back. This procedure typically takes less than 30 minutes.


Lumbar Laminectomy

A lumbar laminectomy is a spine surgery that involves removing bone to relieve excess pressure on the spinal nerve(s) in the lumbar spine, or lower back. The term laminectomy is derived from the Latin words lamina (thin plate, sheet or layer), and -ectomy (removal). A laminectomy removes or “trims” the lamina (roof) of the vertebrae to create space for the nerves leaving the spine. Indication: lumbar stenosis.



Lumbar Interspinous Spacer (X-STOP / ASPEN)

A minimally invasive system that implants a spacing device between the spinous processes of two segments of the lumbar spine, which may potentially decrease spinal stenosis in certain candidates.

Lumbar Spinal Cord Stimulator

A device used to exert pulsed electrical signals to the spinal cord to control chronic pain, or motor disorders. Spinal cord stimulation (SCS), in the simplest form, consists of stimulating electrodes, implanted in the epidural space, an electrical pulse generator, implanted in the lower abdominal area or gluteal region, conducting wires connecting the electrodes to the generator, and the generator remote control. SCS has notable analgesic properties and, at the present, is used mostly in the treatment of failed back surgery syndrome, complex regional pain syndrome and refractory pain due to ischemia.


Minimally Invasive Lumbar Fusion Surgeries

Gaining clear access to the spine, for both visualization and treatment of the affected vertebrae, is one of the most critical aspects of spinal fusion surgery, and there are several different approaches a surgeon typically takes for an interbody-type procedure. They include approaching the spine from the front of the body through an incision in the patient’s abdomen (anterior lumbar interbody fusion [ALIF]); approaching the spine through an incision in the patient’s back over the vertebrae to be treated (posterior lumbar interbody fusion [PLIF]) or approaching the spine from the side through an incision in the patient’s back (transforaminal lumbar interbody fusion [TLIF]). Factors that influence a surgeon’s decision on which approach to take include the spinal condition to be treated, its location in the spinal column, available technology and the patient’s overall general health.



Lumbar Pedicle Screw Fixation


Anterior lumbar interbody fusion (ALIF)

A spine surgery that involves approaching the spine from the front (anterior) of the body to remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to create an “internal cast” to support the vertebral structure during the healing process. ALIF may be done alone or in conjunction with another spinal fusion approach.

Axial Lumbar Interbody Fusion (AxiaLIF)

A new, alternative approach to traditional fusion procedures. Access to the spine is made by an approximately 1-inch incision next to your tailbone. The center of the degenerated disc is removed, and bone material is inserted in its place. This material helps bone growth over time in order to “fuse” the spine. The AxiaLIF implant is inserted to stabilize the vertebrae while fusion is occurring. During insertion, it is also possible to restore disc height and alignment by adding posterior implants for further stabilization of your spine after the AxiaLIF procedure has been performed.

Direct Lateral Interbody Fusion (DLIF)

This is called the transpsoas, or direct-lateral, approach to interbody spinal fusion, because it involves entering the body for access to the spine through the psoas muscle and soft tissues of the patient’s side, rather than through the abdominal cavity or through a longer incision in the back.. A very small incision is made in the skin of the patient’s side. Then, using minimally invasive surgical dilation techniques, a narrow passageway is made through the underlying soft tissues and psoas muscle. Dilation provides gentle separation and weaving through the fibers of the psoas muscle, rather than cutting through it, such as in an “open” surgical approach. The muscle is separated in this fashion directly to the depth of the vertebra(e) and disc to be treated. Once at the appropriate level of the lumbar spine, Dr. Shiau will  remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine.  Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to create an “internal cast” to support the vertebral structure during the healing process.

Posterior lumbar interbody fusion (PLIF)

A type of spine surgery that involves approaching the spine from the back (posterior) of the body to place bone graft material between two adjacent vertebrae (interbody). This will promote bone growth that joins together, or “fuses,” the two structures (fusion). The bone graft material acts as a bridge, or scaffold, on which new bone can grow. The ultimate goal of the procedure is to restore spinal stability.

Transforaminal lumbar interbody fusion (TLIF)

A form of spine surgery in which the lumbar spine is approached through an incision in the back. The name of the procedure is derived from: transforaminal (through the foramen), lumbar (lower back), interbody (implants or bone graft placed between two vertebral bodies) and fusion (spinal stabilization).The TLIF is a variation of the posterior lumbar interbody fusion (PLIF), in that it provides 360-degree fusion, avoids anterior access and associated complications, decreases manipulation of neural structures, reduces damage to ligamentous elements, minimizes excessive bone removal, enhances biomechanical stability, and provides early mobilization.

Oblique Lateral Interbody Fusion (OLIF)

This revolutionary new procedure allows for psoas muscle preserving, while accessing the L2-L5 levels. The procedure leverages traditional anterior lumbar interbody fusion principles with the in-situ convenience of the less-invasive lateral approach. Using an oblique lateral trajectory away from the posterior nerves within the psoas muscle, this procedure is an alternative to approaches dependent on neuromonitoring to traverse the psoas muscle. In addition, the OLIF procedure allows for easier access around the iliac crest at L4-L5, and it is a step toward more reproducible lateral access to the L5-S1 disc space.