Lumbar Spine

Lumbar spine disease encompasses a range of medical conditions that affect the lumbar spine, which is the lower portion of the spine located in the lower back.

The lumbar spine consists of five vertebrae (L1 to L5) and plays a crucial role in supporting the upper body, facilitating movement, and protecting the spinal cord. These conditions can be caused by factors such as aging, trauma, degeneration, herniation, or congenital issues.

Overview of Conditions

Overview of common surgical procedures and anatomical approaches Dr Parkinson often employs:

  • Causes: Age-related wear and tear causing discs to degenerate (lose hydration, resilience, and reduced height) and potential instability.
  • Symptoms: Chronic lower back pain, pain that occasionally eradiates and intensifies with certain activities or positions.
  • Treatment: Conservative measures such as physical therapy, lifestyle modifications, pain management such as NSAIDs, muscle relaxants, epidural steroid injections, and in advanced cases, surgical interventions like spinal fusion.
  • Cause: A herniated or bulging disc in the lumbar spine, often due to injury, degeneration, or repetitive strain.
  • Symptoms: Lower back pain, leg pain (sciatica) radiating down one leg, numbness, tingling, and muscle weakness.
  • Treatment: Conservative measures like rest, physical therapy, pain medications, and epidural steroid injections. Surgery may be necessary for severe or refractory cases.
  • Cause: Narrowing of the spinal canal in the lumbar region, typically due to age-related changes, herniated discs, or arthritis.
  • Symptoms: Lower back pain, leg pain, and numbness. Walking or standing may worsen symptoms.
  • Treatment: Physical therapy, pain management, and lifestyle modifications. Surgical intervention may be required for advanced cases to decompress the spinal cord.
  • Causes: Compression or irritation of the nerve roots, often due to herniated disc or spinal stenosis.
  • Symptoms: Sciatica, sharp pain in the lower back that radiates down the leg, numbness, tingling.
  • Treatment: Pain relief medications, physical therapy, epidural steroid injections, and potential surgical intervention.
  • Cause: One vertebra slips forward over the one below it, often due to degeneration, injury, or congenital factors.
  • Symptoms: Lower back pain, radiating leg pain, and muscle weakness. The severity of symptoms varies depending on the degree of slippage.
  • Treatment: Conservative methods, including physical therapy and bracing, for mild cases. Severe cases may require surgery to stabilize the spine.
  • Cause: Compression or irritation of the sciatic nerve, often due to lumbar disc herniation or spinal stenosis.
  • Symptoms: Shooting pain, numbness, tingling, or weakness that radiates from the lower back down the back of one or both legs.
  • Treatment: Conservative approaches such as rest, physical therapy, pain management, and epidural injections. Surgery is considered for severe or intractable cases.
  • Cause: Typically caused by trauma, osteoporosis, or tumours in the spine.
  • Symptoms: Severe lower back pain, loss of height, and possible deformity of the spine.
  • Treatment: Conservative management may include pain medications, bracing, and physical therapy. Surgical procedures like vertebroplasty or kyphoplasty may be necessary for severe fractures.
  • Causes: Degeneration of the facet joints in the lumbar spine.
  • Symptoms: Chronic lower back pain, tenderness, stiffness, and pain that worsens with movement.
  • Treatment: Physical therapy, pain relief medications, facet joint injections, and in some cases, radiofrequency ablation.
  • Causes: Overstretching or tearing of the muscles or ligaments in the lumbar region, often due to physical activity or trauma.
  • Symptoms: Acute lower back pain, muscle spasms, limited mobility.
  • Treatment: Rest, cold or hot compresses, NSAIDs, muscle relaxants, and physical therapy.
  • Causes: Injury or degeneration of the sacroiliac joint where the spine meets the pelvis.
  • Symptoms: Pain in the lower back or buttocks, sometimes radiating to the leg.
  • Treatment: Physical therapy, SI joint injections, pain medications, and in refractory cases, SI joint fusion.

Dr Richard Parkinson practices the latest minimally-invasive surgical techniques when performing lumbar spine surgery, such as tubular microdiscectomy (keyhole retractor surgery using a powerful operative microscope) as well as the ultra-minimally-invasive percutaneous discectomy (keyhole endoscopic surgery).

Lumbar spine conditions can be a significant source of morbidity, often leading to pain, functional limitations and reduced quality of life. It is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan if you suspect you have a lumbar spine condition as some conditions can cause permanent nerve and spinal cord injury if left untreated, which can result in long-term disability and permanently impaired movement. Treatment options vary depending on the specific condition, its severity, and the patient’s overall health.

Overview of Surgical Procedures

Overview of common surgical procedures and anatomical approaches Dr Parkinson often employs:

  • Percutaneous Endoscopic Lumbar Surgery (Ultra-Minimally-Invasive)
  • Lumbar Spine Decompression Surgery (Anterior or Posterior)
  • Lumbar Microdiscectomy (Microdecompression)
  • Lumbar Artificial Disc Arthroplasty (Replacement)
  • Lumbar Corpectomy
  • Lumbar Fusion (Anterior or Posterior)
  • Lumbar Laminectomy / Laminotomy
  • Lumbar Foraminotomy
  • Lumbar Laminoplasty
  • Lumbar Nerve Root Decompression
  • Lumbar Spinal Fracture Fixation
  • Lumbar Spinal Deformity Correction Surgery (Scoliosis or Kyphosis)
  • Tumour Resection
  • Revision Surgery

A/Prof Richard Parkinson

MBBS, BMedSci, FRACS

Neurosurgeon & Spine Surgeon with 25+ Years Experience

A/Prof Richard Parkinson performs surgery at Sydney’s leading private hospitals.

He consults and operates from Sydney’s most advanced neurosurgical and spinal surgery hospitals, including St Vincent’s Private Hospital, Prince of Wales Private Hospital and The Mater Hospital.

These hospitals offer the latest neurosurgical facilities, including cutting-edge imaging equipment and surgical navigation systems, dedicated and well-trained theatre clinical staff, as well as post-surgical rehabilitation specialists.

A/Prof Parkinson’s areas of expertise include surgery of the entire spinal column, scoliosis surgery, peripheral nerve surgery, as well as physical rehabilitation of athletes that have suffered a brain or spine injury.

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