Under general anesthesia and through a miniopen approach, the surgeon makes a small incision, usually on the left side of the lower abdomen, to expose the front part of the spine by going around the back of the abdominal cavity along the back wall without having to go through the abdominal cavity or cut through any of the back muscles. After disc material is removed from the front of the spine, a synthetic cage with bone graft and screws are inserted into the empty disc space and bone to support, stabilize and create lumbar fusion, and at the same time restoring disc height and spinal alignment into its natural lumbar curvature. Surgery usually takes about 2 to 3 hours to perform for a one or two-level procedure.

Spinal disc degeneration and micro-instability of the lumbar spine can cause mechanical back pain, buttock, groin and hip pain, and nerve root irritations resulting in leg pain. This procedure is designed to stabilize the spine by achieving higher fusion rates to relieve back pain and their associated symptoms, without interfering with nervous tissues thereby avoiding scar formation around nerve roots.

• Discogenic back pain (single or multiple level, including L5/S1)
• Low grade lumbar spondylolisthesis- bone slip
• Spinal instability
• Lumbar spondylosis
• Degenerative disc disease
• Failure of previous posterior lumbar fusion surgery with pseudoarthrosis
• Combined with posterior procedure to enhance bone fusion
• Correction of lumbar deformity

• Conservative
  • Weight loss
  • Medications
  • Back exercises
  • Physical therapy and rehabilitation program
  • Hot/cold therapy
  • Acupuncture
  • Ultrasound therapy
  • Spinal traction
• Interventional
  • Epidural steroid injections
  • Nucleoplasty
  • Facet or SI joint block
  • Radiofrequency treatment

As with any spinal surgery, the risks include:

• Bleeding from blood vessels
• Nerve injury causing leg pain, weakness and numbness, or urinary and defaecation problems
• Retrograde ejaculation/infertility in men
• Wound Infection
• Complication related to instruments
• Blood clot in the legs (deep vein thrombosis), and pulmonary embolism