What to expect with an Anterior Lumbar Interbody Fusion with Percutaneous Posterior Stabilization (ALIF/PSF):

The purpose of an ALIF/PSF is to fuse the segment in the lumbar spine that is causing pain with movement, if those segments are indeed degenerative. The idea behind the fusion is that stopping movement at that segment will no longer cause pain. Prior to surgery, proving that pain is coming from a specific level is usually confirmed with injections.

An ALIF/PSF (CPT code: 22558) is usually done for the last 2 levels in the lumbar spine, L4-5 or L5-S1. A vascular surgeon does the exposure for Dr. Brusovanik and accessing the spine from the front of the abdomen just below the navel. Once the spine is exposed the disc is removed and an interbody with bone graft is placed in the disc space. The incision is then cleaned and closed using a plastic surgery technique. Over the next few months, bone grows in the disc space connecting the two vertebrae causing a fusion.

The patient is then turned onto his/her stomach; small incisions are made in the back where the screws are passed through the muscle planes. This technique prevents muscle injury. Screws are inserted into both sides of each vertebrae (above and below) the disc space being fused. Rods are then placed on each side to connect the screws, stopping any movement at the painful level.

Patients are encouraged to walk the same night of surgery and are kept in the hospital for 1-2 nights. Patients are able to perform their daily activities once they are discharged home. They are able to go back to work within 1-2 weeks. Patients with labor intensive work can return in 3-4 weeks.

Getting an Epidural Injection

A common question many patients have prior to getting an epidural injection is “how long will the effects of the injection last”. It is a hard question to answer because everyone has a slightly different condition causing the pain. Pain varies from patient to patient. Therefore, it is hard to predict how long the effects of the injection will last and maybe more than one injection will be needed. Some patients can get full relief of their symptoms and avoid or postpone surgery all together. An epidural injection for back or neck pain is administered by a pain management physician who is usually dual certified in Anesthesiology. For more information, please do not hesitate to contact me at 305-467-5678 or private message me.

Leg Pain Symptoms that Indicate you need to Consult a Spine Doctor

As the human body ages, there are high chances of experiencing mobility problems, neck, and back pain that prevent you from enjoying a comfortable daily life. Whether you experience neck and back pain after lifting heavy objects, sleeping on hard surfaces, sitting in the chair for many hours, or bad postures, ultimately, you need to establish if the discomfort arises from lumbar spinal stenosis.

What is Spinal Stenosis?
Spinal stenosis is a common disorder that usually affects the neck, back, arms, and legs when the open spaces in your spinal canal begins to narrow. The narrowing of the cervical spine, or lumbar bones can put pressure on your spinal cord. Consequently, the spinal nerves will experience challenges.

How does Spinal Stenosis occur?
The narrowing of spinal spaces could take place in the cervical, thoracic, or lumbar regions but more commonly in the lumbar region. It is a narrowing of the spinal canal caused by disc herniation’s, injuries to the spine, changes in the spine related to age, or tumors which can cause pain, numbness or weakness in the legs.

When you experience numbness and pain in the legs, it is likely you suffer from spinal stenosis. A spinal specialist will want to find out if you experience any of the symptoms below:
+ Back pain.
+ Difficulties balancing the body while standing, bending, or walking
+ Leg cramps when you stand for long periods.
+ Numbness, tingling or burning sensation in the legs, lower back area, or buttocks.
+ Stiff thighs or legs.
+ Bladder issues or bowel dysfunction.
+ Weakness in the neck, clumsy hands

The Cure for Lumbar Spinal Stenosis and Leg Pain
Leaning forward and flexing the lower body part forward can temporarily relieve your painful symptoms by opening up your spinal canal.

If you have failed medications such as anti-inflammatories, or physical therapy has been ineffective, your doctor can also recommend an epidural steroid injections (ESI). If the conservative route does not alleviate your pain, there is a surgical procedure to open up your spine to offer a permanent cure for spinal stenosis. The most common type of surgery for spinal stenosis is called decompressive laminectomy, also known as spinal laminectomy or spinal decompression. This surgery is done to relieve pressure on the spinal nerve roots. During a laminectomy, the bony walls of the vertebrae, bone spurs or thick tissue, causing narrowing of the canal that allows compression of the spinal nerves are removed. This procedure is done to open the spinal canal and remove the pressure of the nerves.