The spine is made of bones (vertebrae) separated by soft cushions (intervertebral disks).

Lumbar (lower back) spine disease is usually caused by herniated intervertebral disks, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord.

Symptoms of lumbar spine problems include:

• Pain that extends (radiates) from the back to the buttocks or back of thigh
• Pain that interferes with daily activities
• Weakness of legs or feet
• Numbness of legs, feet, or toes
• Loss of bowel of bladder control

The surgery is done while the patient is deep asleep and pain-free (general anesthesia). An incision is made over the lower back, in the midline.

The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy) and the tissue that is causing pressure on the nerve or spinal cord is removed. The hole through which the nerve passes can be enlarged to prevent further pressure on the nerve. Sometimes, a piece of bone (bone graft), interbody cages, or pedicle screws may be used to strengthen the area of surgery.

Patients usually require physical therapy to optimize spinal mobility after lumbar spine surgery. Results are variable depending on the disease treated.

The vertebrae are the bones that make up the spinal column, which surrounds and protects the spinal cord. The intervertebral disks are soft tissues that sit between each vertebrae and act as cushions between vertebrae, and absorb energy while the spinal column flexes, extends, and twists. Nerves from the spinal cord exit the spinal column between each vertebra.

Spinal fusion is a surgical technique in which one or more vertebrae are fused together to stop the motion between them.

Spinal fusion may be recommended for:

• Abnormal curvature of the spine (scoliosis or kyphosis)
• Injury to the spinal vertebrae
• Protrusion of the cushioning disk between vertebrae (slipped disk, herniated nucleus pulposus)
• Weak or unstable spine caused by infections or tumors

Different incisions are made depending on the area to be treated. The approach can be made either from the front (anterior), from the back (posterior), or both.

In a posterolateral gutter fusion procedure, the spine is approached from the back. Bone graft is taken from the pelvis and laid out in the posterolateral portion of the spine that is to be fused. The back muscles hold the graft in place until it fuses with the vertebrae. A fusion will setup within three months and will continue to get stronger for one to two years.

Interbody cage fusion uses a hollow threaded titanium or carbon fiber cylinder to fuse two vertebrae together. The diseased disk is removed and two interbody cages are placed in the opening where the diseased disk has been removed. The cages are filled with bone graft. The bone grows through the holes in the cages fusing the vertebrae.

Pedicle screws are used sometimes in a spinal fusion to add extra support and strength to the fusion while it heals. Pedicle screws are placed above and below the vertebrae that were fused. A rod is used to connect the screws which prevents movement and allows the bone graft to heal. After the fusion is completely healed, the screws and rods can be removed. Removal isn't necessary unless they cause the patient discomfort.

The cervical spinal column is made up of vertebral bodies which protect the spinal cord.

Cervical spine disease is usually caused by herniated intervertebral discs, abnormal growth of bony processes on the vertebral bodies (osteophytes), which compress spinal nerves, trauma, and narrowing (stenosis) of the spinal column around the spinal cord.

Symptoms of cervical spine problems include:

• Pain that interferes with daily activities
• Neck pain that extends (radiates) to the shoulder or arm
• Weakness of arms or legs
• Numbness of arms, hands, or fingers

The surgery is done while the patient is deep asleep and pain-free (general anesthesia). For the neck (cervical spine), an incision may be made either in the back of the neck (posterior cervical) or in the front side of the neck (anterior cervical), depending on the location of the problem.

The bone that curves around and covers the spinal cord (lamina) is removed (laminectomy) and the tissue that is causing pressure on the nerve or spinal cord is removed. The hole through which the nerve passes can be enlarged to prevent further pressure on the nerve.

If an intervertebral disc herniation is present, the intervertebral disc is removed. Sometimes, a piece of bone (bone graft) or metal rods (such as Harrington rods) may be used to strengthen the area of surgery.

Depending on the disease present and the surgery performed, mobility of the cervical spine may be limited after cervical spine surgery. Physical therapy is often indicated after surgery.

A normal intervertbral disk is compared to a herniated disk.

A small incision is made over the spine.

After identifying and moving the nerve root, the surgeon identifies the injured disk tissue.

The surgeon removes the injured disk tissue and fragments.

The back muscles are moved back into their normal position, and the wound is closed with stitches or staples.