WHAT is a FUSION of the LUMBAR SPINE ?

1. WHAT is a FUSIONof the LUMBAR SPINE? -OPEN- -MINIMALLY INVASIVE- -ANTERIOR APPROACH- -POSTERIOR APPROACH-

2. “Open” ApproachPosterior AccessInitial Exposure Midline incision through the skin down to then through the muscle to the bone of the spine

3. Open Surgical Exposure SHOWS VISUAL STRIPPING AWAY MUSCLE AT ITS ATTACHEMENT TO THE UNDERLYING BONE, BLEEDING IS OFTEN EXTENSIVE, MUSCLE IS PERMANENTLY DAMAGED

4. Open Spinal Boney Exposure EXPOSED BONE……MUSCLE LAYER IS HELD TO THE SIDE BY RETRACTORS THAT COMPRESSES ALREADY COMPROMISED TISSUES

5. OpenPosterior Lateral Fusion EXPOSED BONE HAS BEEN FURTHER STRIPPED OF ITS OUTER SURFACE (DECORTICATION) THEN PEDICLE SCREWS ARE INSERTED, BONE IS OOZING BLOOD CONTINOUSLY

6. Posterior Lateral Fusion BONE IS CRUSHED INTO A BLOODY THICKENED SLURRY AND APPLIED TO THE BONE SURFACES WHERE STRIPPED, WOUND IS CLOSED

7. Open TLIFwith Pedicle Screws and Interbody Cage THIS “TLIF” OPEN TECHNIQUE STRIPS LESS MUSCLE, AND USES THE DISC SPACE AS THE AREA FOR THE FUSION RATHER THAN THE BACK PART OF THE SPINE AS PREVIOUSLY SHOWN

8. -MINIMALLY INVASIVE- POSTERIOR FUSION TECHNIQUE “MAST TLIF” ONLY SKIN AND FAT LAYERS CUT. TUBES ARE INSERTED BETWEEN THE MUSCLE FIBERS. MUSCLES ARE NOT CUT OR STRIPPED.

9. -MINIMALLY INVASIVE- POSTERIOR FUSION TECHNIQUE “MAST TLIF” -DISC IMPLANTS ARE INSERTED THROUGH A TUBE- -SCREWS & RODS INSERTED VIA A PUNCTURE THROUGH THE SKIN-

10. ANTERIOR INTERBODY FUSION “ALIF” EXPOSURE INCISION THROUGH FRONT OF BELLY INVOLVES CUTTING THROUGH MUSCLES AVOIDING DAMAGE TO INTESTINES, VESSELS, NERVES, AND BLADDER STRUCTURES

11. “TWO-IN-ONE” ALIF Anterior Cage/Plate + Posterior Pedicle Screws NEEDS EXPOSURE SURGEON + FUSION SPINE SURGEON LONGER HOSPITIZATION + MORE SERVICES UTILIZIED FRONT AND BACK EXPOSURES

12. “MINIMAL ACCESS” Direct Lateral-DLIFAnterior Interbody Fusion ONE SURGEON MINIMAL BLOOD LOSS & MINIMAL MUSCLE DAMAGE HOME WITHIN 23-48 HOURS.

13. Lumbar Fusion Data

14. Lumbar Fusion Data(2010)