Spinal stabilization procedures may be necessary when the spine (in particular the weight bearing vertebral body and disc) are affected in diseases like spinal injury, severe degenerative disease, tumor or infections, and are considered to be unstable. It is then necessary to stabilize the spine to relive the back pain, and an unstable spine may compress the spinal cord and nerves leading to neurological deficit.
The spine may be stabilized anteriorly (front of the spine) or more commonly posteriorly (the back of the spine). Titanium screws, cage and/or plates are used to stabilize the spine.
Screws may be placed at the time of open surgery or percutaneously (MISS).
Stabilization may be dynamic where the spine is allowed some degree of mobility (dynamic stabilization). More rigid stabilization is performed in the operation of spinal fusion.
Spine stabilization may be necessary in the cervical, thoracic or lumbar spine.
Titanium implants allow for MRI to be done safely and with minimum artefact.
CASE STUDY 1
Discogenic back pain treated by spine stabilizing using percutaneous screws
A 34-year-old lady with chronic severe back pain underwent L4/5 percutaneous stabilization with pedicle screws under GA.
Patient's wound post-op showing 4 small incisions through which
spine has been stabilized using pedicle screws.
X-Ray post-op showing percutaneous pedicle screws
CASE STUDY 2
A 51 yrs old lady was a known case of follicular carcinoma thyroid. She presented with progressive weakness of both the lower limbs with pain in the back. She was diagnosed to have thoracic (D11) epidural cord compression on MRI. She underwent surgical decompression and stabilization both anteriorly and posteriorly.
Post op X-ray Images following spine decompression and stabilization:
CASE STUDY 3
A 43 year old overweight male (110Kg) presented with complaint of low back pain for 6 years. He was diagnosed to have discogenic back pain arising from the L4-L5 disc. He underwent X-ray, MRI and finally lumbar discography which confirmed that his pain was arising from the L4-L5 disc. Because of the severe disc degeneration and being overweight, he was not a candidate for artificial lumbar disc replacement. We therefore chose to fuse his spine at L4-L5 both anteriorly and posteriorly (ALIF and posterior pedicle screw stabilization) following spine stabilization, he relieved of his low back pain.
Pre-op MRI Images