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Dynamic Interlaminar Stabilization of the Lumbar Spine: Lower Back Pain

By Editorial Team (2)
January 31, 2022

What Is the Importance of Getting Spinal Stabilization Surgery?

Spinal stabilization surgery is a procedure that restores spinal stability and removes pressure from damaged discs and joints without performing a fusion. As a result of spinal fusion, the spine is no longer flexible at the fusion point. Notably, after spine stabilization surgery, the spine remains mobile.

The technique was initially designed in Switzerland and then developed in Germany. It has been used on patients since the mid-1990s, so it is a relatively new procedure.

Who Needs Spinal Stabilization Surgery?

This procedure is beneficial for patients who have tried non-surgical treatments for spinal stabilization without success. If patients are young or have non-painful damage to nearby vertebrae, they may want their spine to remain mobile. In this case, they can choose spine stabilization surgery. In addition, this procedure may be beneficial for the elderly, in whom spinal fusion may not be successful due to the poor quality of their bones.

Rarely occurs that after the removal of one disc bulge, another piece of the disc bulges out. Spinal stabilization surgery can be used to remove the remaining disc material and prevent future problems. In some patients, the spinal canal is too narrow, resulting in nerve compression. If this is the case, the technique can be used to slightly alter the spine’s position and stabilize it. It makes more space and removes the pressure from the nerves.

Pre-Operative Advice

Two days before your surgery for spinal stabilization, take a gentle laxative, such as Colace or Senna. It will help ensure your bowels are open the day you have surgery. It is important that you do not eat anything the day of your surgery. In addition, do not eat anything after midnight on the night before surgery. Doctors and hospitals vary on how long you need to stop drinking water before surgery. You will be given pre-operative instructions that explain this. If you don’t understand something, be sure to ask your doctor. All of your medications will be supplied by the hospital while you are a patient, so you do not need to take your medicines with you. However, do take along a list of the names and the doses of the medications you take. If you have had any scans or tests, take those to the hospital with you too.

The Procedure of Spinal Stabilization Surgery

General anesthesia is required for spinal stabilization surgery. The patient is positioned face down on the operating table during the operation.
Two different surgical approaches can be used: the midline and the Tramline (Wiltse) approach. In the midline approach, the surgeon makes only one incision over the affected area of the spine after confirming by an x-ray. The spine’s bones can easily be seen after the muscles are moved out of the way. Tiny instruments and a microscope are used to remove the pressure. Then the dynamic stabilizer is inserted under very controlled conditions, so the normal structures are not distorted. The wound is then closed.

Post-Operative Care

You will wake up from spinal stabilization surgery in the recovery room. You will spend a short amount of time there, so the doctor can ensure your condition is stable. Depending on your physician’s orders, you may be sent home on the same day, or you may stay in the hospital for a few days. It would be best for you to avoid drinking or eating too quickly after surgery to prevent nausea. You will receive intravenous fluids to prevent dehydration.

Soon after spinal stabilization surgery, you will start physical therapy. Skilled therapists will teach you how to safely get in and out of bed and help you start walking. You may feel dizzy or lightheaded the first few days when you get up. It is normal and will go away as you get stronger. You may also be fitted with a brace to help support your back. Your doctor will explain how long and when you should wear this for spinal stabilization. The nursing staff will care for your incisions while you are in the hospital, dressing them as needed. In addition, the nurses will provide you with instructions and information to prepare you for discharge.

Results of the Spinal Stabilization Surgery

Most patients notice a significant improvement in their symptoms following this surgical procedure for spinal stabilization. However, recovery time from the operation may be several weeks. At the six-week follow-up appointment, many physicians or surgeons refer their patients to a physical therapy program to help retrain the back and abdominal muscles and improve their posture and spinal stabilization.

During follow-up appointments, patients are carefully examined, and their results are audited. In addition, X-rays are taken to ensure the hardware position is satisfactory and that healing has occurred.

The system and the techniques have been extensively tested. The long-term clinical results are beginning to come through and look very promising. On-going studies will hopefully prove the value of this technique over the coming years.

Lumbar Spinal Stabilization Exercise

The lumbar spine stabilization exercise program consists of various exercises that typically progress from beginner to advanced. Maintaining a neutral spine position is crucial when performing spinal stabilization exercises of any level. What’s more, learning to maintain a neutral spine during the current exercise usually determines whether you can progress to the next one.

Physical therapists or exercise therapists are trained to assist patients in learning the correct technique. Generally, spinal stabilization exercises may include:

  • pelvic tilt
  • hamstring stretch
  • raising arms or legs
  • bridge exercise with ball

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