Spectrum of surgery for degenerative conditions in the elderly

Dr Paul Licina – Spine Surgeon

STABILITY

RESTABILISATION

INSTABILITY

DESSICATION  

OSTEOPHYTES  

STABILITY

RESTABILISATION

INSTABILITY

DESSICATION  

OSTEOPHYTES  

DISC HERNIATION

LOW BACK PAIN

STABILITY

RESTABILISATION

INSTABILITY

DESSICATION  

OSTEOPHYTES  

STENOSIS

DEFORMITY

SPINAL STENOSIS

narrowing of the spinal canal with nerve compression What is it ?

leg pain and neurogenic claudication

What does it cause ?

SPINAL STENOSIS

when symptoms severe When do we operate ?

SURGERY IN THE FORM OF DECOMPRESSION

nonoperative treatment unsuccessful

Why do we operate ?

SPINAL STENOSIS

stenosis with instability • degenerative spondylolisthesis • degenerative scoliosis

When do we add fusion ?

SPONDYLOLISTHESIS SCOLIOSIS

Aetiology • due to degeneration of

facet joint • facet joint stability fails

and L4 slips forward on L5 • leads to spinal stenosis

DEGENERATIVE SPONDYLOLISTHESIS

DEGENERATIVE SCOLIOSIS

Aetiology • due to asymmetric

degeneration of disc and facet joint

• vertebral tilt leads to spinal deformity and

accelerated degeneration • associated spinal stenosis

Thank you