Expert Spine Care by Dr. Rajesh Bindal
Lumbar spinal fusion is a surgical procedure used to stabilize and strengthen the lower spine. It is commonly recommended for patients with persistent back pain, spinal instability, or degenerative conditions that do not improve with conservative treatment. At Texas Spine & Neurosurgery in Sugar Land, Dr. Rajesh Bindal, a board-certified neurosurgeon, specializes in minimally invasive lumbar fusion surgery—a technique that reduces tissue trauma, speeds recovery, and improves surgical precision.
Conditions Treated with Lumbar Fusion
Minimally invasive lumbar fusion may be used to treat a variety of spinal conditions, including:
- Lumbar instability
- Spondylolisthesis
- Degenerative disc disease
- Recurrent disc herniation
- Spinal fractures
- Spinal tumors
- Failed back surgery syndrome
The most commonly treated levels for lumbar fusion are L4-L5 and L5-S1. Fusion is often combined with microlumbar discectomy or lumbar laminectomy to decompress pinched nerves due to disc herniation or spinal stenosis.
What Happens During Minimally Invasive Lumbar Fusion?
Minimally invasive lumbar fusion surgery involves the following steps:
- A small skin incision is made off-center from the spine.
- Fluoroscopy (real-time X-ray) is used to confirm the surgical level.
- Sequential tubular dilators are inserted to gently split the back muscles, minimizing tissue damage.
- A retractor is placed over the dilators to create a working channel.
- A surgical microscope is used to enhance visibility, improving accuracy and safety during decompression and fusion.
- Spinal tumors
- Failed back surgery syndrome
L4-L5 & L5-S1 Spinal Fusion Technique
Dr. Bindal performs spinal fusion using a combination of:
- Transforaminal Lumbar Interbody Fusion (TLIF)
- Posterolateral Fusion (PLF)
In TLIF, a laminectomy and facetectomy are performed to access and decompress the disc space. The damaged disc is removed, and the vertebral endplates are prepared to receive a bone graft, which fuses the vertebrae together over time.
Pedicle Screw and Rod Placement
- Titanium screws are inserted above and below the fusion site.
- Connecting rods are added and secured to stabilize the spine.
- Intraoperative X-ray and neuromonitoring are used to ensure precise screw placement and maximize safety.
Dr. Bindal is a pioneer in the use of intraoperative neuromonitoring for pedicle screw accuracy, a technique that minimizes radiation exposure and enhances surgical outcomes.
L4-L5 & L5-S1 Spinal Fusion Technique
Dr. Bindal performs spinal fusion using a combination of:
- Transforaminal Lumbar Interbody Fusion (TLIF)
- Posterolateral Fusion (PLF)
In TLIF, a laminectomy and facetectomy are performed to access and decompress the disc space. The damaged disc is removed, and the vertebral endplates are prepared to receive a bone graft, which fuses the vertebrae together over time.
Pedicle Screw and Rod Placement
- Titanium screws are inserted above and below the fusion site.
- Connecting rods are added and secured to stabilize the spine.
- Intraoperative X-ray and neuromonitoring are used to ensure precise screw placement and maximize safety.
Dr. Bindal is a pioneer in the use of intraoperative neuromonitoring for pedicle screw accuracy, a technique that minimizes radiation exposure and enhances surgical outcomes.
Bone Graft Options
- Autograft (from the patient’s iliac crest)
- Cadaveric bone (allograft)
- Bone Morphogenic Protein (BMP)—a synthetic option often covered by insurance that avoids the need for bone harvesting
Dr. Bindal will discuss the most appropriate bone graft option based on your medical history and surgical goals.
Who Is a Candidate for Minimally Invasive Lumbar Fusion?
Not all patients are candidates for minimally invasive lumbar fusion. It may not be appropriate for those who have:
- Previously undergone open lumbar fusion
- Significant spinal deformities
- Severe obesity
- Conditions better treated with anterior lumbar interbody fusion (ALIF)
Dr. Bindal performs a comprehensive consultation, including review of imaging, medical history, and functional limitations, to determine if minimally invasive fusion is right for you.
Recovery and Outcomes
- Most patients are up and walking the day after surgery
- Reduced pain medication use is typical by the second post-op week
- Return to light daily activities often begins within a few weeks
- Full fusion may take several months to occur, with regular follow-up to monitor healing
Minimally invasive fusion techniques often result in faster recovery, less blood loss, and lower complication rates compared to traditional open surgery.
Schedule Your Consultation with Dr. Rajesh Bindal in Sugar Land, TX
If you’ve been diagnosed with lumbar instability, spondylolisthesis, or a degenerative spinal condition, Dr. Rajesh Bindal can help you explore your treatment options. With a focus on minimally invasive techniques, Dr. Bindal offers patients the latest in surgical innovation with a commitment to personalized care.
Call 281-313-0031 today to schedule your consultation at Texas Spine & Neurosurgery in Sugar Land, TX.