Lumbar Spine Surgery

Question 1

Indications for surgery

Answer 1

• when clinical findings match the imaging and the patient hasn’t responded to conservative treatment
• progressive neurological signs and hasn’t repsonded to conservative treatment
• cauda equina compresison
• clinical instability

Question 2

Reasons for surgery

Answer 2

relieve trapped neural tissue 
improve stability 
fracture 
tumour 
unresolved disc conditions

Question 3

Adjacent Segment Degeneration

Answer 3

potential risk of surgery
segment above or below spine has some degeneration
not always symptomatic

Question 4

Microdiscectomy/Discectomy

Answer 4

removal of part of disc 
Complications 
- nerve damage 
- infection 
- blood clot 
- ongoing leg pain 
- dural tear
 - recurrence 
- GA complications

Question 5

Post Op Care

Answer 5

pain management follow surgical instructions
wound management 
ambulation and mobilisation 
education posture 
load management 
manual therapy 
HEP and self management 
functional activity - sport

Question 6

Laminectomy

Answer 6

removal of lamina to increase the size of the central canal

majority of individuals older - don’t need return to sport rehab

Question 7

Lumbar Fusion

Answer 7

improve stability and decompression
anterior or posterior approach
usually after another surgery done and failed

Question 8

Arthroplasty

Answer 8

replaces the intervertebral disc - not common

usually for young people to preserve movement

Question 9

SIJ Fusion

Answer 9

fusion of sacrum to pelvis
usually after significant trauma
not good outcomes - seem to get worse over time, opposite SIJ pain

Question 10

Vertebroplasty/Kyphoplasty

Answer 10

VP - gluing of fracture bone using cement
KP - restoration of disc height via cement
Usually after vertebral compression fracture