Anterior Lumbar Fusion
Introduction In 1969 and 1971, Coventry and Stauffer provided the first descriptions of anterior fusion for the treatment of failed posterior spine surgery, reporting overall good results. Since then, anterior…
Minimally Invasive Surgery and Navigation
Introduction Revision surgeries are more common than ever in the spine surgeon’s practice. Each case is unique, and the diagnostic and treatment considerations are more complicated than their primary counterparts….
Autograft/Allograft/Cage/Bone Morphogenetic Protein
The Use of Autograft and Allograft in Revision Lumbar Spine Surgery One of the major contributors to a solid spinal arthrodesis is the use of bone grafts. In selecting the…
Instrumentation Options
Introduction Despite excellent outcomes for carefully selected patients undergoing surgical management of lumbar spine pathology, a small but significant subset of patients will have persistent or recurrent symptomatology. Unfortunately, some…
Disc Herniation (Primary, Recurrent, Residual)
Introduction Lumbar intervertebral discs are complex structures subjected to significant axial compressive forces. Because of biomechanical demands and the inability to remodel as a result of an avascular nature, lumbar…
Decompression
Introduction Lumbar spine disorders and the disabling pain associated with these conditions are associated with significant healthcare resource use and costs in the United States. Of these patients, an estimated…
Dural Scarring and Repair Issues
Background A vast majority (up to 80%) of the US population are estimated to experience an episode of low back pain (LBP) during their lifetime. A subset of these individuals…
Imaging Considerations (Magnetic Resonance, Computed Tomography, Myelography, Plain)
Introduction Regardless of the presence of lumbar instrumentation, recurrent symptoms after a lumbar decompressive surgery are not uncommon; for example, after undergoing microlumbar discectomy up to 12% of patients may…
Indications
Background Revision lumbar spine surgery is predominantly associated with several distinct pathological processes resulting from an initial index surgery. For example, in the treatment of disc herniations, residual stenosis and…
Medical Fitness Evaluation
Introduction One major issue when considering reconstructive spinal surgery is medical fitness for surgery. This is defined as an individual’s ability to sustain the physiological stress of surgery and recovery….
