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Lumbar Interlaminar Instrumented Fusion

What does “Interlaminar Lumbar Instrumented Fusion” mean?

Here is the meaning of each word:

  1. Interlaminar: between the lamina bones of the spine
  2. Lumbar: area of the spine located in the low back
    1. Instrumented: using implants in the spine
    2. Fusion: to mend two or more vertebrae together

Altogether, “Interlaminar Lumbar Instrumented Fusion” means to mend tow or more vertebrae in the low back together using implants to connect the lamina bones on the back of the spine.

What is an Interlaminar Lumbar Instrumented Fusion?

The spine is opened with a minimally invasive technique. The spinal nerves are freed up. Room is made between the lamina by removing small portions of it. This procedure then connects the lamina bones on the back of the spine using a piece of bone and a metal clamp.

Why is an Interlaminar Lumbar Instrumented Fusion done?

This procedure is done to relieve pain from degenerated discs, relieve nerve compression and to provide stability for a diseased spinal segment.

What is different about an Interlaminar Lumbar Instrumented Fusion from other spine fusions?

The main difference is that this type of fusion is minimally invasive and does not use screws and rods to connect the vertebrae together. Rather, it uses a small piece of cadaver bone (allograft) and a small metal clamp to keep the piece of bone locked between the vertebrae.

How is an Interlaminar Lumbar Instrumented Fusion done? 

Here are some of the steps of how this procedure is done:

  1. This surgery is done in an Operating Room.
  2. An intravenous catheter (IV) is placed before surgery and antibiotics are given.
  3. In the Operating Room, the patient is initially place on the back (supine) and a General Anesthetic is given.
  4. The patient is then carefully placed on the stomach (prone).
  5. The low-back (lumbar spine) is cleaned with a sterile surgical solution and sterile sheets (drapes) are placed around the surgical site.
  6. The surgeon makes a cut (incision) over the spine.
  7. The tissue and muscles under the skin are freed up from the bone and moved to the side.
  8. An X-Ray machine is used to verify the correct level in the spine.
  9. The lamina bone on the back of the spine is seen and a portion removed.
  10. The ligament under the lamina (ligamentum flavum) is now seen and a portion of it removed.
  11. The spinal nerve and dura (lining of the spinal cord and spinal fluid, which contains the cauda equina) is now seen.
  12. Any obstruction of the nerves or dura are removed.
  13. The lamina bones, facet joints and the spinous processes are now prepared for the implant.
  14. A pre-made piece of cadaver bone in the shape of an “H” is now placed over the lamina bones.
  15. A two-piece metal clamp is placed of the sides of the spinous processes to lock the piece of cadaver bone in place and prevent it from moving. The two pieces are locked together to form a solid clamp.
  16. Small bone chips and possibly other bone fusion materials are placed over the fusion area.
  17. The fascia, tissue and skin are then closed.
  18. The patient is carefully turned on the back (supine) and awoken from Anesthesia.
  19. The patient is brought to the Recovery Area for observation.

How long does it take to perform an Interlaminar Lumbar Instrumented Fusion?

This surgery can take about 1-2 hours to perform.

What is the recovery from an Interlaminar Lumbar Instrumented Fusion like?

    1. The patient is usually admitted to the hospital for at least an overnight stay.
    2. A low back brace may be used.
    3. A physical therapist may help with the initial recovery after surgery.
    4. After discharge from the hospital, specific instructions on activity are given. Lifting, bending, and twisting are often limited.
    5. A low back brace will often be recommended for several weeks or more after the surgery.
    6. The cut (incision) often take 4-6 weeks to heal.
    7. The surgeon will usually reevaluate the patient within several weeks. Often new X-Rays are taken at that time.
    8. The process of a full spinal fusion to develop may take 6 months to 1 year to complete. This does not mean that a patient would necessarily have pain during that process.

What type of benefit can patients gain from an Interlaminar Lumbar Instrumented Fusion?

The benefit from a Lumbar Fusion depends on the original problem for which the spinal fusion was done for. Here are some possible improvements:

  1. Improved leg pain, numbness or weakness
  2. Improved stability of the low back
  3. Improved low back pain after the healing is complete

Even after a complete bone fusion of the spine has occurred, some of the original symptoms may remain. Some patients develop new spine symptoms.