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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Posterior lumbar interbody fusion (PLIF)

The principle of this operation is similar to the anterior lumbar interbody fusion (ALIF) except that the implant (fusion cage or bone) is implanted through the back, instead of approaching through the abdomen.

On the left, a the fusion cages are seen from the posterior approach, in this translucent model.  On the right, they are seen from the side.

 

The advantage of this approach is that the nerves of the lumbar spine can be visualized, and decompressed, if needed.  Although they can be decompressed from the anterior approach (through the abdomen), this is a much more cumbersome and tedious process.

The disadvantage of this approach is that, in order to place the fusion, a substantial amount of bone, including part of the facet joint, must be removed.  This removal of supporting joint and bone acts to destabilize a spine we are trying to fuse and stabilize.  In addition, we know that the interbody method of fusion requires a relatively large cage be placed, in order to distract and spread the interspace apart as much as possible, without tearing the connecting ligaments.  From the posterior approach, this sometimes extensive bone removal, and often one is tempted not to place as large a cage as possible because of the nerve root retraction necessary.  From the anterior approach this is not an issue.

Another disadvantage of the posterior approach, alluded to in the previous paragraph, is that retraction upon the nerve roots in the lumbar spine is necessary in order to place the cage.  This places the nerve roots at some risk from stretching.

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