Lumbar disc prolapse

Herniation(prolapse) describes an abnormality of the intervertebral disc that is also known as a “slipped,” “ruptured” or “bulging” disc. This process occurs when the inner part (nucleus pulposus) of the intervertebral disc bulges out. It usually happens through the outer, more fibrous layer that surround the disc (annulus fibrosis).

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Lumbar canal stenosis

Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. These changes are commonly seen in people who have spinal degeneration that occurs with aging

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Spondylolisthesis is the displacement of one spinal vertebra compared to adjacent vertebrae.The displacement may be anterior or posterior. Spondylolisthesis is graded between grade 1-4 based upon the degree of slippage of one vertebral body relative to the subsequent adjacent vertebral body.

listhesis is classified as one of the six major etiologies:

  • degenerative
  • traumatic
  • dysplastic
  • isthmic
  • pathologic
  • Iatrogenic

Spondylolisthesis most commonly occurs in the lumbar spine, primarily at the L5-S1 level, with the L5 vertebral body anteriorly translating over the S1 vertebral body.

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Spinal tumours

Tumours may be Primary or secondary. It may be extradural,Intradural extramedullary tumours.

The most common are bony tumours, meningioms, schwanommas, ependymomas, Astrocytomas.

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Spinal trauma

A traumatic spinal cord injury can stem from a sudden, traumatic blow to your spine that fractures, dislocates, crushes or compresses one or more of your vertebrae.

Clinical features

All these conditions causes variable symptoms depending of level and degree of compression and

  • involvement of spinal cord and exiting nerve roots.
  • Symptoms may vary from
  • Low back pain
  • Pain radiating to lower limbs
  • Weakness of lower limbs
  • Bowel and bladder complaints
  • Sensory abnormality like numbness, tingling sensations
  • Thinning of muscles
  • Claudication pain – appearance of lower limb pain on walking for a while.


  • MRI Lumbosacral spine
  • X-ray Lumbar spine dynamic view


-Depending on the symptoms,duration and amount of compression on nerves and condition of the spine treatment is planned

  • Conservative management includes
  • Bed rest
  • Avoid forward bending ,lifting heavy weight and squatting
  • Low back physiotherapy
  • Stop Smoking

Surgical management

Micro Discectomy and Microlumbar decompression

Micro Lumbar Discectomy is a an advanced minimally invasive surgery for patients with lumbar disc herniation.As ccompared to traditional open decompression surgery the recovery is faster and the patient is back to his normal activities as early as possible.

The goal of a micro-discectomy is to remove the disc material placing pressure on the nerves.

A small incison is taken over back and with the help of operating microscope ,minimal bony parts are removed and the disc which is compressing the nerves is removed.

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Lumbar fusion procedures including Transforaminal Lumbar Interbody Fusion (TLIF) and minimally invasive TLIF

Transforaminal lumbar interbody fusion can be performed using open or minimally invasive technique. MIS techniques causes less post operative pain compared to open surgery and allows early mobilisation and less hospital stay.

In this procedure titanium screws are placed above and below vertebral bodies followed by removal of complete disc. Cages/Spacer are placed in the disc space and fixed.

In spondylolisthesis reduction of listhesis is done followed by TLIF.

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Excision of Spinal tumours

Kyphoplasty and Vertebroplasty

  • Surgeries for congenital spinal anomalies like tethered cord
  • Surgeries for spinal injuries
  • Surgeries for Spinal infection like Spinal tuberculosis
  • Scoliosis coreection
  • Kyphosis correction
  • Surgeries for congenital spinal deformities like teethered cord,Meningocele,Meningo myelocele

Peripheral Nerve surgeries

  • Carpal tunnel release
  • This procedure is done for patients suffering from carpal tunnel syndrome.A small incision is taken over wrist and median nerve decompression is done.

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Dr Sandeep