Minimally Invasive Lumbar Fusion

Minimally invasive lumbar fusion is indicated for a range of spinal disorders including:

• Degenerative Disc Disease: When the intervertebral discs, which act as cushions between the vertebrae, degenerate to the point of causing pain and instability.
• Degenerative Spondylolisthesis: Where one vertebra slips forward over the one below it.
• Spinal Stenosis: Narrowing of the spinal canal that causes nerve pain.
• Fractures: Traumatic vertebral fractures that may cause instability.
• Tumors: When a tumor causes structural issues or instability in the spine.
• Scoliosis or Kyphosis: Severe cases of spinal deformities that cannot be managed non-surgically.

Good candidates for this procedure are typically individuals who have pain that is caused by a structural instability of the spine, have tried and not benefited from nonsurgical interventions, have good health and realistic expectations. Only Dr. Ball can determine who is a good candidate for this procedure after a thorough evaluation.

The minimally invasive lumbar fusion procedure is typically performed from the side.

1. The patient is administered general anesthesia to ensure they are unconscious and pain-free during the procedure.
2. Ball will make one or more small incisions, typically less than a few centimeters each. He then inserts a device called a tubular retractor to create a clear path to the targeted area with minimal disruptions to surrounding soft tissues.
3. All structures that are compressing the spinal cord or spinal nerves are removed. This includes herniated disc material, bone spurs or thickened ligaments.
4. The vertebra on either side of the disc space are prepared to be fused. Then bone graft material is placed between the vertebrae. The graft material may come from the patient (an autograft) or a donor (an allograft) or synthetic substances.
5. Metal screws and rods are inserted to immediately stabilize the vertebrae while the bone graft helps the bones grow together with time. The hardware ensures that the vertebrae maintain proper alignment and do not move, which could interfere with the fusion process.
6. Once the fusion hardware and bone graft are securely in place, the tubular retractor is carefully removed, allowing the muscles to move back into place naturally. The incisions are then closed with sutures or staples.

The risks of minimally invasive lumbar spinal fusion are the same as traditional lumbar spinal fusion including infection, blood clots, nerve damage, hardware failure, and a failure of the vertebrae to fuse.

After surgery, the patient is moved to a recovery area where they are closely monitored as they wake up from anesthesia. Pain management is a critical part of immediate postoperative care. Recovery and rehabilitation begin under the guidance of medical professionals. Physical therapy is typically recommended to help strengthen the back and improve mobility.

Sometimes, minimally invasive lumbar fusion is an outpatient procedure. Other times the patient may have a short hospital stay. Complete fusion of the vertebrae can take several months, during which time patients are advised to avoid activities that put excessive strain on the back.