Benefits of Lateral Lumbar Interbody Fusion

A member of the North American Spine Society, Dr. Jamie Gottlieb currently works as a spine surgeon at Orthopedic Specialists of North Texas. In his work with the Denton, TX, practice, Dr. Jamie Gottlieb draws on over a decade of experience in the surgical treatment of various spine diseases and injuries. He is proficient in innovative surgical techniques, including lateral lumbar interbody fusion, a recently developed, minimally invasive technique to fuse bones in the lower back region of the spine.

Lateral interbody fusion involves a tiny incision at the side of the patient's waist. Through the incision, a defective disc is removed from the spine and replaced by a bone graft, called a spacer graft, to facilitate fusion while restoring the height between two vertebrae.

Used when conservative techniques have failed to result in improvement, this procedure efficiently treats lower back and leg pain that results from a degenerative disc or abnormal forward flip of a vertebra, known as spondylolisthesis. It also can help correct mild sideways curvature of the spine, known as scoliosis.

Benefits of lateral interbody fusion, as compared to traditional lumbar fusion procedures, include less blood loss and scarring, shorter duration of surgery, decreased post-operative pain, and faster recovery. Patients often are able to walk the same day they had the surgery, and may only be required to spend a single night at the hospital.

What Is Failed Back Surgery Syndrome?

Denton, TX-based spine surgeon Dr. Jamie Gottlieb delivers orthopedic care at clinics in Indiana and Texas. Working closely with patients to prevent postsurgical complications, Dr. Jamie Gottlieb also treats patients who experience failed back surgery syndrome (FBSS).

Despite the condition’s name, FBSS is not always caused by surgery. Several risk factors can increase the likelihood of post-surgical complications. For example, patients with existing chronic back pain cannot benefit from a spinal surgery. To avoid this, surgeons review every patient’s medical history to ensure that invasive surgery is the best solution.

Other patient-related risk factors include smoking and obesity. Sometimes, symptoms return after surgery because of postsurgical conditions. For instance, a build-up of scar tissue or infection may result in symptoms such as radiating pain or weakness.

FBSS is usually addressed with a holistic treatment approach designed specifically for each patient. This includes physical therapy, pain management, and possibly, additional surgery. 

Sacroiliac Joint Dysfunction Causes and Treatments

Dr. Jamie Gottlieb is a spine surgeon who meets the needs of patients in the Denton, TX, community. Committed to personalized treatment, Dr. Jamie Gottlieb has an extensive background in assessing and correcting complex conditions such as sacroiliac joint (SIJ) dysfunction.

Located at the base of the spine, the sacroiliac joints are firm and provide stability when a person engages in activities such as walking. Characterized by a limited range of motion, they absorb impact and serve to redistribute the weight of the upper body in the lower body.

SIJ hypermobility involves too much joint movement, which is associated with pain and instability in the hip and lower back. SIJ that become irritated and inflamed are known as sacroiliitis. Relatively common, SIJ dysfunction has a variety of other causes, including pregnancy, which involves a combination of extra weight and stretching of the ligaments, such that the pelvis can widen. Another common cause is forceful impact, such as a car accident, sports injury, or a direct fall on the buttocks. In addition, arthritis and other degenerative joint diseases may result in SIJ deterioration.

There are several therapeutic pathways, such as physical therapy, SIJ injections, and oral anti-inflammatory medications. In addition, a surgical fusion of the SIJ can be undertaken to relieve pain.

 

XLIF Lateral Lumbar Interbody Fusion Basics

A graduate of Cornell University Medical College, Dr. Jamie Gottlieb has worked at several high-profile institutes and clinics. Currently, he is the principal spine surgeon at i-Spine Institute in Denton, TX. One of the procedures Dr. Jamie Gottlieb performs at the institute is extreme lateral interbody fusion (XLIF).

While the standard ALIF (anterior lumbar interbody fusion) procedure uses anterior access, the XLIF procedure accesses the spine from the patient’s side, avoiding major muscle groups in the back. Typically, patients with a spinal tumor, scoliosis, kyphosis, or degenerative disc disease undergo the latter.

Surgeons performing the procedure test the spinal nerves with a probe. They use fluoroscopic X-ray images to guide them to avoid injuring nerves. When they locate the problem, surgeons move the back muscles aside with a retraction device to reach the spine.

After that, surgeons remove the degenerated disc and insert a bone graft-filled implant in its place. If needed, surgeons may also apply bone morphogenetic protein to speed the recovery.