Minimally Invasive Spinal Fusion Surgery at India

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A person’s spine is subjected to a lot of forces throughout its lifetime. It
may be subjected to age related wear and tear or infections like
tuberculosis. As a result it undergoes degeneration which gives rise to a
variety of problems like spinal osteoarthritis, disc prolapse,
spondylolisthesis, osteoporotic fractures, vertebral collapse etc. All these
conditions manifest as severe pain in the back and radiating pain,
numbness, tingling in the upper or lower extremities (lower leg or arm) due
to compression of spinal nerves, spinal cord and spinal instability. When
these symptoms become debilitating enough to preclude the patient’s day
to day activity, a Spinal Fusion Surgery is advised.
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What is Spinal Fusion Surgery?
Spinal fusion (spondylodesis or spondylosyndesis) is the surgical
method of joining two or more verebrae. It is done most commonly in
the lumbar region of the spine, but it is also used to treat cervical and
thoracic problems. In this procedure, the damaged and painful
vertebrae are fused into a solid stable bone. Fusion of the spine is
used primarily to eliminate the pain caused by abnormal motion of the
vertebrae by immobilizing the faulty vertebrae themselves, which is
usually caused by degenerative conditions. However, spinal fusion is
also the preferred way to treat most spinal deformities, specifically
scoliosis and kyphosis. But, the results may vary according to the
individual. Some may not feel any improvement in their back pain
even after the surgery.
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When is Fusion Recommended
• Fracture
• Tumor
• Infection
• Spondylolisthesis
• Degenerative disc disease
• Scoliosis
• Spinal Stenosis
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Types of Spinal Fusion Surgery
Lumbar spinal fusion can be divided into two categories|
Posterolateral Fusion : In the back of the spine, the bone graft is placed in amid the transverse
processes. With the help of wires and screws, the vertebrae is carefully fixed throughout the
particles of every vertebrae. A rod is made up of metal which is attached on the side of vertebrae.
Interbody Fusion : In this, the graft of the bone is placed in between the vertebrae and the area
is generally engaged by the intervertebral disc. The disc is entirely removed in preparing for the
spinal fusion. In order to maintain the disc height and spine alignment, a device can be placed in
between the vertebrae. This device (intervertebral device) can either be prepared from titanium or
plastic. Then the fusion starts in between the vertebrae’s endplates. Interbody fusion is of 3 types-
o Posterior Lumbar Interbody Fusion (PLIF)
o Transforaminal Lumbar Interbody Fusion (TLIF)
o Anterior Lumbar Interbody Fusion (ALIF)
o Transpsoas Interbody Fusion (XLIF or DLIF)
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Posterior Lumbar Interbody Fusion (PLIF)
In Posterior lumbar interbody fusion, the spinal fusion is achieved through a
surgical incision made on the posterior (back) aspect of spine. It aims at
fusion of two adjacent vertebrae in cases of spinal instability and associated
back pain. It is a popular procedure as it gives excellent results. The
procedure provides almost complete relief of symptoms in 90-95% of the
cases and the patients are able to return to their daily activities within a few
weeks. The patients can also return to most of their recreational activities.
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Procedure for Posterior Lumbar Interbody Fusion (PLIF)
PLIF surgery aims at achieving spinal stability through bony fusion by two ways:
The Open PLIF is the traditional technique which is performed using general anesthesia.
The patient is made to lie down on his front side on the table with the low back exposed. A
3-6 inch long incision is made on the skin overlying the affected vertebrae. The skin and
the fascia are cut open. The underlying muscles are retracted and the affected vertebrae are
identified. Fluoroscopic X-ray is used to confirm the exact location of the affected
vertebrae. Then a complete laminectomy (removal of the lamina of the vertebrae) followed
by bilateral foraminotomy (enlargement of the foramen by removing the bony spurs)
and/or discectomy (removal of offending disc) are performed.
This relieves the compression off the spinal nerves, allowing them to come to their normal
size and shape. The area is checked for any remaining bony outgrowth or disc fragments
that may compress the nerves. Autogenic bone grafts or Metal or plastic implants are fitted
in the empty disc space for initiating bone growth.
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Minimally Invasive Posterior Lumbar Interbody Fusion (PLIF) in India
The other method is the Minimally Invasive PLIF procedure which is performed
using x-ray guidance. 2.5-cm incisions are made on either side of the lower back The
muscles are gradually dilated and tubular retractors inserted to allow access to the
affected area of the lumbar spine. The lamina is removed to allow visualization of
the nerve roots. The offending disc material is removed from the spine and replaced
with a bone graft and structural support from a cage made of bone, titanium, carbon-
fiber, or a polymer, followed by placement of rod and screws. The tubular retractors
are removed, allowing the dilated muscles to come back together, and the incisions
are closed.
This procedure typically takes about 3 to 3 ½ hours to perform. There was less blood
loss,tissue trauma, operative time, and quick recovery in this procedure as compared
to the traditional one.Generally the patients can go home within 3-5 days after
traditional PLIF and within 1-2 days after a minimally invasive PLIF.
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Extreme lateral Interbody Fusion (XLIF)
The XLIF (Extreme Lateral Interbody Fusion) is an approach to spinal fusion
in which the surgeon accesses the intervertebral disc space and fuses the
lumbar spine (low back) using a surgical approach from the side (lateral) rather
than from the front (anterior) or the back (posterior).
The XLIF is one of a number of spinal fusion options that a surgeon may
recommend to treat specific types of lumbar spinal disorders, such as lumbar
degenerative disc disease, spondylolisthesis, scoliosis and deformity and some
recurrent lumbar disc herniations and types of lumbar stenosis. It cannot be
used for all types of lumbar conditions for which spinal fusion is a treatment
option. For example, it cannot treat conditions at the lowest level of the spine,
L5-S1 or for some people at L4-L5.
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What are the Advantages of Spinal Fusion Surgery?
In most cases, spinal fusion can eliminate the pain and other symptoms. It is important
for a surgeon to explain the options, and benefits of spinal fusion surgery. There are
many advantages of Spinal fusion surgery such as:
• By fusing the level, there is less concern that the patient will need surgery again at
that level. If the discs and/or facets are pain generators, as is often the case, a fusion
will ensure that motion at the level is stopped, potentially eliminating the low back
pain.
• A second advantage of spinal fusion surgery is that it reduces post-decompressive
deformity. Some patients develop post-laminectomy kyphosis, which is an abnormal
alignment of the spine. This too can often lead to additional surgery. Similarly, a
fusion can correct any deformity the patient had before surgery and ensure that the
normal alignment of the spine is restored. This may reduce wear and tear (and need
for future surgery) on the neighboring levels.
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FAQ - Spine Surgery and Treatment in India
When is Spine Fusion surgery recommended?
The potential reasons for a surgeon to recommend this procedure are: treatment of a fractured
vertebra; correction of deformity (spinal curves); getting rid of pain due to painful vertebral motion;
treatment of spinal instability and treatment of some cervical disc hernia.
What are the benefits of getting Spine Surgery in India?
Spine Hospitals in India are equipped with the most advanced medical treatment. They have the most
extensive Spine -diagnostic and imaging facilities including Asia’s most advanced MRI and X-rays
technology. Personalized care and attention is provided with value added services besides results of
world class standard at a very low cost affordable to all sections of society.
Which is the Best Hospital in India for treatment of Spine?
India has not one but many better than the best hospitals for Spine r treatment. Mail us your medical
report and we will find the hospital most suitable to treat your medical condition.
Is it safe to get Spine Treatment and Surgery in India?
The medical fraternity in India is famed for excellence, and leads in Spine surgeries. Thousands of
Spine operations are performed in India each year with maximum success rate, making the safety
obvious.
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Minimally Invasive Spinal Fusion Surgery at India

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Minimally Invasive Spinal Fusion Surgery at India