Minimally-Invasive (MIS) Lumbar Discectomy

The spine is composed of vertebrae (bone) with flexible disks in between. When a disc is herniated, it may put pressure on the nerve roots, resulting in pain or numbness in the extremities. A discectomy is performed to remove the herniated disc material, alleviate the pressure, and resolve symptoms.

Case

The case below is that of a 35-year-old male who complained of severe pain in his left rear leg, weakness when toeing off his left leg, as well as numbness in the back of his left leg and the side of his left foot. Non-operative treatment was unsuccessful. Dr. Kaan conducted an Minimally Invasive Discectomy, resulting in complete relief of the patient's thigh, leg, and foot pain and resolution of his neurological symptoms. This surgery was performed as an outpatient through a 20mm incision.  

Degenerative Spondylolisthesis

Degenerative Spondylolisthesis is forward slip of one vertebral body on the adjacent vertebral body.  It is a result of degeneration of the facet joints and commonly causes spinal stenosis (narrowed nerve canal) with resulting pain in the legs (radicular pain).  The treatment is decompression and fusion if nonoperative treatment fails. 

CASE 1

The following patient is a 48 y.o. female who has complaints of longstanding severe low back pain and right back of thigh and leg pain.  She had previously underwent nonoperative treatment, and had a spinal cord stimulator inserted, to no avail.  She was seen by Dr. Kaan for definitive treatment.

Before: Radiographs show a 40% slip of L4 on L5 and severe disc degeneration. 

Before: CT scan shows narrowing of the nerve canal and pinching of the spinal nerves, causing right lower extremity pain.
Side view shows disk degeneration and spondylolisthesis (i.e. slipped spine) at L4-5 resulting in the patient's low back pain.

CASE 2

A 58 year-old woman had a 4-year history of severe pain in her lower back, as well as pain and numbness in her left thigh and leg. Her back pain was disabling, making her unable to work. Dr. Kaan performed a TLIF, posterolateral fusion, and decompressive laminotomy. Post-operation, the back and lower extremity pain were resolved.

Before: Slipped vertebrae visible in imaging