Kraus Back and Neck Institute in Houston, TX spinehealth.com

Relief from Lower Back and Neck Pain

 
surgery optionsavoid surgery
      At the Kraus Back and Neck Institute (KBNI), we specialize
                 in non-surgical as well as surgical treatments
                                of Back and Neck  Pain
     Conservative to Surgical Options: MINIMALLY INVASIVE SPINE SUGERY 
              
 "Applying Science to the Art of Medicine"                                                  
                              .....................................................................
  
                       
                 Dr. Kraus is available for Neurosurgery consultation (surgical and non-surgical) in Houston.
                      Offices:  1) West Houston Medical Center
                                    2) Memorial Hermann Memorial City Hospital
                                    3) Katy
           FILM REVIEW:  send an e mail                                       
                                                         
      To arrange  an appointment, call 281-870-9292,  visit  neurosurgerypa.com
or   send an e mail
              For national and international patients, we can help with  travel arrangements
                                
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                                         top doctors houston texas 2007 top docs united states neurosurgery spine   top doctors houston texas 2008 top docs united states neurosurgery spine  top doctors houston texas 2009 top docs united states neurosurgery spine   best doctors in america, united states neurosurgery spine
                                            Dr. Kraus is honored to be listed in
                                            "Best Doctors in America" (2001-2008) and
                                             "Top Doctors of Houston, Texas" (2007, 2008, 2009)     

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Low Back Pain, can be very debilitating.  The effects of Low Back Pain in the USA are staggering!!
    
 
   

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   last updated
  June 19, 2009

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houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryAnterior lumbar interbody fusion (ALIF)

 

 

Anterior lumbar interbody fusion, also known as ALIF, is an houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryhouston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryoperation primarily performed for the treatment of low back pain.  Often, a lumbar discogram is performed.  If the MRI picture showing degeneration of a disk space matches the level of pain produced during the discogram, then surgery will have a good chance of helping the pain.

This operation is mainly attempting to help low back pain, although lower extremity pain is occasionally improved, because the implant into the disk space spreads the vertebral bodies apart, opening the neural foramen through which the nerve roots leave the spinal canal.

This procedure is not a good option if a patient is suffering mainly from lower extremity pain because the nerve roots are not vusialized.  A surgery from a posterior approach is a better option.  This may be either a posterior lumbar interbody fusion (PLIF) or a pedicle screw fixation.

Procedure

 

houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryhouston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryThe initial portion (approach) is usually performed by a vascular surgeon, who exposes the anterior border of the lumbar spine for the neuro or orthopedic surgeon.  The pertinent vascular structures in this area are the aorta, vena cava, iliac arterieshouston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgery and iliac veins, as well as the pelvic veins.  The ureters are also in the vicinity.  Seen here is a typical retractor system, used by the vascular surgeon to expose the anterior aspect of the spine.  In the close us view, visible are the iliac arteries, and the anterior body of L5.

houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgeryhouston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgery houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgery

 

The instruments used for implantation are quite extensive. 

Once the front of the spine is exposed, the surgeon finds the midline, by using "C arm" (fluoroscopy), which essentially provides an x ray in real time.  The disk interspace is prepared, and then the implant is placed within the disk space.  The implant may be  a titanium cage (packed with houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgerycancellous bone from the iliac crest (hip)), threaded on the outside to prevent backout.  It might also be a threaded cadaver bone dowel, taken from the bone bank.  On the right, two cages are seen from the front, implanted in a translucent spine model.

Often this operation is a stand alone procedure, and the patient is kept in a lumbar brace for three months postoperatively.  On the other hand, it is occasionally necessary, either early or later on, to supplement the ALIF with a posterior lumbar fusion using pedicle screws.

houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgery

The C-arm provides real time imaging to tell the surgeon where the instruments are. 

 

 

 

houston, texas, river oaks, west houston, neurosurgeon, neurosurgery, surgery

Anterior lumbar interbody fusion surgery requires a team effort.  Involved in the case are two scrub nurses, a neuro or orthopedic surgeon, an anesthesiologist, and a C-arm technician. 

 

 

Complications

Significant complications are not frequent, but they certainly can occur.  There can be complications arising from the approach to the spine.  If there are injuries to any of the great vessels, significant hemorrhage may occur.  The retractors can occlude the blood supply to the lower extremities.  There is a 3-5% risk of injury to autonomic nerves lying on the front of the spine, resulting in retrograde ejaculation.  Males who intend to have children are given the option of giving to a sperm bank prior to surgery.  There is always a risk of pushing disk material into the nerves when the disk space is prepared.

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