Dr. Ratish Kumar Mishra is a highly skilled and dedicated Consultant Orthopaedic and Spine surgeon currently associated with Sanjivini Hospital in Gomti Nagar, Lucknow. His areas of expertise include Neck Pain, Back Pain, Sciatica Pain, Slipped Disc, Lumbar Canal Stenosis, Spondylolisthesis, Fractures in the Spine, Spinal Cord Injury, Spine Tumors, and infections in the spine. He is also skilled in Scoliotic spine surgery and Deformity correction surgeries. He is well-versed in open, Minimally Invasive, and Endoscopic spine surgeries. He can perform anterior and posterior Cervical, Thoracic, and Lumbar spine surgery.”

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Lumbar spinal fusion

Lumbar spinal fusion

Lumbar spinal fusion is a surgical procedure designed to address various spinal conditions, including instability, degenerative disc disease, or deformities, by promoting the fusion of two or more vertebrae. This comprehensive overview explores the principles, indications, surgical techniques, and expected outcomes associated with lumbar spinal fusion.

Principles of Lumbar Spinal Fusion:

  1. Stabilization:
    • The primary goal of lumbar spinal fusion is to stabilize the spine by promoting the fusion of adjacent vertebrae, limiting motion and reducing pain.
  2. Fusion Techniques:
    • Different fusion techniques exist, including interbody fusion (placing a bone graft or spacer between vertebrae), posterolateral fusion (fusion through the back of the spine), and transforaminal lumbar interbody fusion (TLIF), among others.

Indications for Lumbar Spinal Fusion:

  1. Degenerative Disc Disease:
    • Lumbar spinal fusion is often recommended for individuals with degenerative disc disease, where the discs between vertebrae break down, leading to pain and instability.
  2. Spinal Instability:
    • Conditions such as spondylolisthesis, where one vertebra slips forward over another, can be treated with lumbar spinal fusion to restore stability.
  3. Disc Herniation:
    • Lumbar fusion may be considered for individuals with persistent symptoms from disc herniation that haven’t responded to conservative treatments.
  4. Fractures or Trauma:
    • Spinal fractures or traumatic injuries that result in instability may require lumbar spinal fusion for stabilization.

The Surgical Process:

  1. Incision:
    • Lumbar spinal fusion is typically performed under general anaesthesia. An incision is made over the affected area of the spine.
  2. Disc Preparation:
    • The surgeon removes the damaged or degenerated disc material, creating space for the bone graft or interbody spacer.
  3. Bone Graft and Cage Placement:
    • A Metallic cage filled with bone graft, often sourced from the patient’s own hip (autograft) is placed between the vertebrae to facilitate fusion.
  4. Instrumentation:
    • Metal screws, rods, or plates may be used to provide stability and support during the fusion process.
  5. Closure:
    • The incision is closed with stitches or staples, and the patient is monitored during the postoperative period.

Expected Outcomes:

  1. Stabilization:
    • Lumbar spinal fusion aims to stabilize the spine, reducing or eliminating pain associated with instability.
  2. Fusion Success:
    • Successful fusion typically occurs within a few months, leading to a solid connection between the fused vertebrae.
  3. Pain Relief:
    • Lumbar fusion is often effective in alleviating chronic back pain associated with the underlying spinal condition.

Risks and Considerations:

  1. Infection:
    • As with any surgical procedure, there is a risk of infection at the surgical site.
  2. Bleeding:
    • Excessive bleeding is a potential risk during surgery.
  3. Pseudarthrosis:
    • In some cases, the fusion may not fully succeed, leading to a condition known as pseudarthrosis. This may necessitate additional interventions.
  4. Hardware Issues:
    • Complications related to the hardware, such as screws or plates, may occur and may require additional procedures.

Conclusion:

Lumbar spinal fusion is a well-established surgical procedure aimed at addressing spinal instability and chronic pain. While the surgery carries certain risks, the potential benefits in terms of stabilization and pain relief can be significant. Patients considering lumbar spinal fusion should engage in thorough discussions with their healthcare team to understand the procedure, potential risks, and expected outcomes based on their specific condition.

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    Patient’s Reviews

    Dr. Ratish is an exceptional Orthopedic Surgeon whose expertise and dedication truly stand out. His meticulous attention to detail, coupled with his compassionate patient care, make him a remarkable choice for anyone seeking orthopedic treatment. With a deep commitment to improving his patients' quality of life, Dr. Ratish’s skill and professionalism are truly admirable.

    Shefali Chimnani

    Patient

    Dr Ratish is an exceptional specialist in spine care. His expertise is evident in his precise diagnoses and effective treatments. His dedication to patient well-being and extensive experience makes him a top choice for anyone seeking spine-related medical assistance.

    Aman Ahuja

    Patient