Lumbar Conditions in Carmel, IN Failed Back Surgery

A microdiscectomy may be considered when a recurrent or residual herniated disc is compressing a spinal nerve. This removes the portion of disc material that is pressing against the nerve.

If you have already had back surgery, Dr. Swiatek will check if a herniated disc is causing your symptoms again. If so, a revision microdiscectomy might ease nerve pressure without needing a bigger fusion surgery. In cases of multiple recurrent herniations requiring surgery, a fusion may be indicated.

A lumbar laminectomy is a decompression procedure designed to create additional space for spinal nerves.

​During this surgery, part of the lamina and other tissues pressing on nerves are removed. A laminectomy may be an option if spinal stenosis or narrowing happens after a previous surgery.

For revision surgeries, Dr. Swiatek checks your spine’s structure and stability before suggesting decompression alone. If taking out more bone could make your spine unstable, a fusion or another type of reconstruction may be needed.

Posterior lumbar decompression and fusion, or PLDF, combines nerve decompression with stabilization of the affected spinal segment.

The decompression part of the surgery removes anything pressing on spinal nerves. Fusion then uses bone grafts and hardware to steady the vertebrae and help them heal as one.

PLDF may be used in revision surgery if a previous operation caused or did not fix spinal instability, narrowing, deformity, or other structural issues.

Transforaminal lumbar interbody fusion, or TLIF, is a fusion technique that approaches the affected disc space from the back and side of the spine.

​In this surgery, the damaged disc is taken out and replaced with an implant. Bone grafts help the vertebrae fuse, and screws and rods are added for extra support.

​For patients needing revision, TLIF may be an option if a previous surgery left a disc space unstable or if more decompression and support are needed. The best approach depends on your anatomy, past surgeries, and current spine health.

Lateral lumbar interbody fusion, or LLIF, approaches the spine from the side of the body. Other names for this procedure are DLIF, XLIF, and PTP lateral surgery.

​The damaged disc is taken out and replaced with an implant. Restoring the disc’s height can improve spine alignment and give nerves more space in the right patients.

​A side (lateral) approach can help in some revision cases because it lets the surgeon reach the disc space without going through scar tissue from a previous back surgery.

​LLIF is not right for every patient or every part of the spine. Dr. Swiatek will review your anatomy and past surgeries to see if this approach is a good fit for you.

Anterior lumbar interbody fusion, or ALIF, approaches the spine from the front of the body.

​In an ALIF, the damaged disc is removed and replaced with an implant. This can help restore disc height, improve spine alignment, and help the vertebrae fuse together.

​ALIF can be helpful in some revision cases because it uses a different path than earlier back surgeries. This lets Dr. Swiatek treat the disc space without having to go through scar tissue from the first surgery.

A lumbar pedicle subtraction osteotomy (PSO) is a complex surgery used to fix major spine alignment problems.

In a PSO, Dr. Swiatek removes a wedge-shaped piece of bone from a vertebra. The spine is then realigned and stabilized with hardware.

Because PSO is major surgery, it is usually done only for serious spine deformities or alignment problems that cannot be fixed with simpler procedures.

If you have had several spine surgeries and now have major deformity or imbalance, a PSO may be considered if other surgeries are not enough.

A Ponte osteotomy is a type of back surgery that helps make the spine more flexible and corrects some alignment or deformity issues.

This surgery removes parts of bone from the back of the spine so the vertebrae can be moved into a better position. Sometimes, more than one osteotomy is done for bigger corrections.

In revision spine surgery, Ponte osteotomies may be used if you have spine deformity, stiffness, or alignment problems that started or continued after earlier surgery.

A lumbar corpectomy is a surgery where a significant portion of the vertebra and nearby disc are removed to relieve pressure on the spinal canal and rebuild that part of the spine.

​This is a bigger surgery, usually done when there is major pressure, damage, deformity, or other problems that cannot be fixed with a smaller operation.

​After removing the damaged parts, the spine needs to be rebuilt and stabilized. The exact method depends on your condition and how much bone and disc were taken out.