In general there are two main approaches to spinal fusion a surgery designed to stop low back pain caused by painful motion of the vertebrae.
Posterolateral gutter spine fusion surgery.
In an attempt to improve the results of fusion surgery fusion of the disc has been performed to directly address the most common source of pain.
Posterior fusion the posterior structures of contiguous vertebrae are fused either the laminae facets transverse processes spinous processes or a combination of them.
Posterolateral gutter fusion surgery is the gold standard surgical approach to achieve spinal fusion.
Bone graft is taken from the pelvis and laid out in the posterolateral portion of the spine that is to be fused.
As the harvested bone graft grows and adheres to the transverse processes such as between l4 and l5 lumbar segment 4 and lumbar segment 5 the spinal fusion is achieved and motion at that segment is stopped.
Your doctor will talk with you about which one is appropriate in your situation.
One of the main differences between these two approaches is where the bone graft is laid in the spine to form the fusion.
In a posterolateral gutter fusion procedure the spine is approached from the back.
There are several different types of spinal fusion surgery.
A lumbar posterolateral gutter fusion is done in the lower back at l1 through l2 through l5 through s1 at the bottom of the spine.
In posterolateral gutter fusion surgery.
This surgical approach involves placing bone graft in the posterolateral portion of the spine area just outside the spine.
The posterolateral gutter fusion is considered by many surgeons as the tried and true method of spinal fusion.
In spinal fusion surgery the doctor implants either a device or bone material to help re stabilize the spine.
Just like in interbody fusion arthritic bone restricting and or compressing the spinal column and nerves may be removed with laminectomy laminotomy foraminotomy facetectomy or a combination see figure 4.
In a posterolateral gutter fusion the surgical approach to the spine is from the back through a midline incision that is approximately three inches to six inches long.
Posterolateral gutter spine fusion surgery description.
Unlike the posterolateral gutter fusion the plif achieves spinal fusion by inserting bone graft and possibly instrumentation.
The device is often a type of cage that mimics the build of a damaged disc.
An incision is made at the midline of the back and bone graft is placed underneath the large back muscles that attach to the transverse processes of the affected vertebrae.
This article focuses on posterolateral lumbar fusion the most common type of spinal fusion and discusses only the surgical component of the procedure.
First bone graft is obtained from the pelvis the iliac crest although some form of bone graft substitute may also be.
