Dr Petrus Stone completes 200 DLIF procedures
Posted on 27 February 2019
Direct Lateral Interbody Fusion, or DLIF, is a surgical procedure for treating the symptoms of degenerative disc disease. Having recently performed his 200th procedure, Dr Petrus Stone at Mediclinic Bloemfontein is regarded as the area’s leading expert in this minimally invasive surgery.
Located between vertebrae in the spine, spinal discs play a crucial role in absorbing shock as the back moves, bends and twists in the course of everyday life. Over time, these discs can dry out and crack, leading to degenerative disc disease. This debilitating condition can severely limit this necessary mobility by targeting the most mobile parts of the spinal column.
“When someone has a diseased segment of the spine, especially in the disc or joints, this can lead to pinched nerves,” says Dr Petrus Stone, a neurosurgeon and spinal surgeon at Mediclinic Bloemfontein. “This causes pain and weakness in the back and legs.”
The solution: fusion. “Usually, we look to surgically fuse the affected vertebrae, to join them together. We would typically perform a bone graft in order to pack fragments between the vertebrae, and supplement that with instrumentation, such as screws and rods, to help the vertebrae to unite and hold the segment in place.”
The traditional approach to spinal fusion involves an open discectomy, either anterior (from the front) or posterior (through the back). This is a major surgery that may require surgeons to cut through major muscle groups and can lead to extended recovery times as a result.
Dr Stone gives an example: “If I were to perform fusion surgery to treat two or three degenerated discs in the traditional way through the back, this would usually involve a midline incision of perhaps 15 or 20 cm. With the keyhole approach, we access the area from the side of the abdomen, and this involves much smaller cuts, of about 4 or 5 cm each.”
The direct, lateral approach allows doctors keyhole access to the area while minimising disruption of the surrounding soft tissues, nerves and blood vessels, which is why it has been gaining traction as the surgical option of choice in recent years.
The benefits of this minimally invasive approach to patients include less pain, less risk of haemorrhage and a much-reduced chance of infection. Patients who have undergone this surgery also spend less time in hospital, and recover quicker, once they are back at home, says Dr Stone.
“Remember, this is a degenerative disease, which means many of these patients are on the older side. They might not be good candidates for open surgery. So DLIF is also an option for those who are not great candidates for open surgery, and who previously had to suffer in silence.”
During surgery, a patient will lie on the side, as surgeons place retractor into an incision in your side and surgically tunnel to the spine. They will then remove the disc that is causing the pain, and insert an implant – holding bone graft – before placing small screws and rods through small incisions in the back, as required. These secondary implants help stabilise the spine while the bones fuse together.
Dr Stone was trained in this surgical procedure under the supervision of neurosurgeon Dr Kevin Foley and a team of other specialists in Memphis, in the United States.