Posterior Decompression and Instrumented Fusion

A fusion can be indicated for spinal stenosis, disc herniation, extruded disc fragments, nerve root compression, stenosis, instability of the spine, spondylolithesis, degenerative Disc Disease, internal Disc Derangement, and correction of Spinal Deformities.

A decompression involves removing the spinous process and lamina of the spine to give the spinal cord more room. This is referred to as “unroofing” the spinal cord. When the spine is so degenerative that the decompression makes it unstable then a fusion must also be performed to stabilize it. This involves inserting screws and rods to hold the spine steady.

The surgery is performed by making an incision in the back. The length of the incision depends on how many levels are being fused. Retractors are placed to hold the soft tissue and muscle back. The spinous process and lamina is removed. Since the spinal cord is now open the nerves are checked to make sure there is no pressure. This is done so by intraoperative nerve monitoring throughout the entire case. Finally the screws are placed through the pedicle and a rod to connect them.  Sometimes a drain is placed to prevent any pooling of blood. This will be removed the day after surgery or post operative day two. Patient will be given a TLSO brace to be worn at all times when up and out of bed. This is typically removed 8 weeks post operative and x rays will be performed at each follow up visit.