This page contains a brief description of surgeries performed on the lumbar spine (low back).

Lumbar Microdiscectomy: Through a one inch midline incision a slip disc that is irritating the nerve root is shaved and the nerve root is decompressed. Usually patients are able to get up and about within 24 hours after surgery and could go home within 48 hours.

Lumbar decompression: This operation is done through a midline incision and involves trimming some bone and tissue overgrowth that may be pressing on the spinal cord or nerve roots. It may be done along with a microdiscectomy.

Posterolateral Fusion: Is performed for relief of back pain due to instability (slip), or arthritis. I prefer to do an "instrumented fusion", which involves insertion of screws into the vertebrae (bone of the back) and linking them with metal rods. This construct creates a metal scaffolding that locks the bones till bony fusion occurs. Chips of bone (called bone graft) are used to encourage bone formation betweeen the vertebrae. Chips may be taken from the patients own hip (autologous bone) or processed human bone (allograft). More commonly I use artificial bone graft (tricalcium phosphate) which is equally effective.

Interbody fusion (TLIF/PLIF/ALIF): May be combined with a posterolateral fusion. The disc in between two vertebrae is removed and a metallic or plastic cages with bone graft is inserted in its place. This encourages bony fusion to fully occur between the vertebrae and is effective if back pain is also arising from a wron out disc. Trans-foraminal interbody fusion (TLIF)  and posterior lumbar interbody fusion (PLIF) are doen through an incision in the back but anterior lumbar interbody fusion (ALIF) requires an incision in the front of the tummy.

Minimally Invasive Spine Surgery (MISS): In this technique screws, rods or cages are inserted through small incisions which reduce pain and tissue trauma and allow early mobilisation.