Spondylolisthesis( slippage of vertebrae) or spinal canal stenosis (narrowing) with instability between the vertebrae can cause shooting pain down the legs or sensation of heaviness numbness and tingling on walking certain distance which is usually relieved by rest.

We normally get a MRI to see the details of the nerves and a flexion and extension Xray of the Lumbar spine to see the slippage and  instability in the bones.

Initially we treat such conditions with medicines and physiotherapy and if symptoms donot improve satisfactorily with conservative treatment we offer microsurgical decompression and fusion of the lumbar spine if the Xrays show any unstable slip between the vertebrae.

Procedure of surgery

Transforaminal lumbar interbody fusion can be performed using minimally invasive technique also which caused less post operative pain compared to open surgery and allows early mobilisation and less hospital stay. It can be performed through 3 small skin cuts using operating microscope and special minimally invasive spinal instrumentation system. The patient usually needs to be admitted in hospital one day prior to surgery for preoperative tests and presurgical assessment by the anaesthetic team. The surgery usually takes about 2 to 3 hours.

The patient is mobilised out of bed  the next morning and usually can be discharged from the hospital 2 to 3 days after the surgery.

Home care after surgery

The patient is shown some simple exercises to carry out at home and is encouraged to walk and gradually return to normal activities over the next 4 to 5 weeks. We ask for a follow up visit with the doctor 4 weeks after the surgery

Images showing minimally invasive TLIF done on a patient with L4L5 spondylolisthesis with canal stenosis using small holes in the skin