Presented by: Dr Paul Licina — Spine surgeon Event: Challenges in the Ageing Spine - 2014

1. Spectrum of surgery for
degenerative conditions
in the elderly
Dr Paul Licina – Spine Surgeon

3. STABILITY
RESTABILISATION
INSTABILITY
DESSICATION
OSTEOPHYTES

4. STABILITY
RESTABILISATION
INSTABILITY
DESSICATION
OSTEOPHYTES
DISC
HERNIATION
LOW BACK
PAIN

5. STABILITY
RESTABILISATION
INSTABILITY
DESSICATION
OSTEOPHYTES
STENOSIS
DEFORMITY

6. SPINAL STENOSIS
narrowing of the spinal canal
with nerve compressionWhat is it ?
leg pain and
neurogenic claudication
What does
it cause ?

7. SPINAL STENOSIS
when symptoms severeWhen do we
operate ?
SURGERY IN THE FORM OF DECOMPRESSION
nonoperative treatment
unsuccessful
Why do we
operate ?

10. SPINAL STENOSIS
stenosis with instability
• degenerative spondylolisthesis
• degenerative scoliosis
When do we
add fusion ?
SPONDYLOLISTHESIS SCOLIOSIS

11. Aetiology
• due to degeneration of
facet joint
• facet joint stability fails
and L4 slips forward on L5
• leads to spinal stenosis
DEGENERATIVE SPONDYLOLISTHESIS

15. DEGENERATIVE SCOLIOSIS
Aetiology
• due to asymmetric
degeneration of disc and
facet joint
• vertebral tilt leads to
spinal deformity and
accelerated degeneration
• associated spinal stenosis

20. Thank you