Rather than cutting through paraspinal (back) muscles, the surgeon spreads and dilates the muscles to obtain access to the lumbar (lower back) spine. One such operation is called a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).
It’s a complex procedure with a steep learning curve, said Loyola University Medical Center spine surgeon Beejal Amin, MD, who has given talks about the procedure around the country. Dr. Amin is first author of an abstract and surgical video about the procedure in Neurosurgical Focus, a publication of the American Association of Neurosurgeons. (Watch the 3D video.)
Dr. Amin learned the procedure while completing a fellowship in minimally invasive and complex spine surgery at the University of California at San Francisco Medical Center.
Patient William Hoecker is among Dr. Amin’s patients who have greatly benefited from the procedure. Mr. Hoecker suffered debilitating leg pain and numbness due to degenerative spondylolisthesis and spinal stenosis. One vertebra had slipped forward over the vertebra below it, pinching the nerve root and causing pain in the left leg. For Mr. Hoecker, walking just 25 feet was so painful he would have to sit or lie down. He was unable to drive for more than 20 minutes. “I was stuck in my house,” he said.
Dr. Amin fused the L4 and L5 vertebrae in Mr. Hoecker’s lower back. First, he decompressed the spinal nerve roots. Next, he removed the degenerated disc between the two vertebrae. Then an implant filled with bone graft was placed in the empty disc space between the vertebrae. Dr. Amin implanted rods and screws to hold the vertebrae together. As the bone graft healed, it fused the two vertebrae together, resulting in a single bone.
The surgery dramatically improved Mr. Hoecker’s quality of life. He now can walk or drive without limitations. Indeed, he’s planning a road trip to Disneyworld, and is confident he will be able to keep up with his grandchildren.
Dr. Amin is an assistant professor in the Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine. In addition to minimally invasive spine surgery, Dr. Amin’s specialties include back pain, cervical spine, complex spinal disorders, general neurosurgery, herniated disc, lumbar disc surgery, neck pain, peripheral nerve, spinal cord injury, spinal deformities and spinal tumors.
Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children’s Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola’s Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.