Operations on the lumbar spine
There is a wide variety of different surgical techniques for the lumbar spine. Primarily the choice of method is directed to the disease. But even for the same problem, there are several solutions. In general, minimally invasive methods have the priority. If these fail, the next step has to be taken. Thus, a herniated disc is removed endoscopically, whenever possible. This leaves the smallest scar and reduces the risk of late complications. For advanced suffering, problems must be resolved comprehensively. Often the question: "Must we ankylose?" comes up. This used to be the method of choice for many problems. Today, a more sophisticated approach is necessary because there are several motion-preserving techniques such as artificial discs, but also dynamic stabilization from behind. Similar decisions must be made for the need of an extension of the spinal canal. Is the sole extension enough or must additionally be stabilized? And how can we stabilize? Dynamic or rigid? Is an interspinous spreader sufficent or does a screw-rod system have to be used.
Stabilisation operations can now be performed minimally invasive. But the opportunities for reposition and axis correction are restricted. Thus again it is to decide, whether a minimally invasive or an open stabilisation is necessary. In many stabilisation operations, placeholders (cages) must be introduced into the disc space. Here too, there are several access routes from the front, rear or side.
The variety of options allows the choice of a tailor-made method for a specific disease. But only those who know and practice the variety of options, can make the best choice.