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Has your spine surgeon recommended an incision from the front and the back for your fusion?

When lumbar spinal fusion surgery is performed, there are several different approaches that can be selected. One option is an incision in the front and an incision in the back. This is called an anterior lumbar interbody fusion or an ALIF.  Although this is one option to do a lumbar fusion surgery, better options exist.

A minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) can be performed through two incisions that are 1 inch each (shown in picture above).  This accomplishes the same surgical goal as an ALIF. It is much less invasive and can frequently be done on an outpatient basis.

Some surgeons will even suggest doing the front incision under one surgical setting and then bring the patient back for a second surgery to do the incision on the back. While there is nothing technically wrong with that approach, it is a tremendous amount of surgery, anesthesia, and muscle tissue trauma.

A minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) is a much better option for the same result. Although the fusion rate for an ALIF is slightly higher than that for an MIS TLIF, the small difference in fusion rates does not justify the extra morbidity and surgical trauma, hospital stay time, and increased pain from the surgery.

If your surgeon has suggested a lumbar fusion surgery with an incision in the front and the back, it would be a good idea to get a second opinion from Dr. Shibayama to see if you are a candidate for a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) potentially on an outpatient basis.

Telemedicine Appointments

Dr. Shibayama is now offering telemedicine consults for evaluation of spine disorders which may require surgery.  If your provider is not available or you just don’t want to travel to your spine surgeon’s office, Dr. Shibayama can see you virtually via telemedicine.

You can be safe at home and save travel time to and from the office.  No longer will you have to sit in the waiting room of his office for your appointment.  You can just relax at home with your mobile device or computer ready to receive your telemedicine visit with Dr. Shibayama.

Telemedicine consults are available to anyone, anywhere in the United States and even the world. Even if you are already established with another spine surgeon, Dr. Shibayama is available for a visit for any issues you may be having.

If surgery is recommended, the number of visits to the office and hospital can be reduced to the bare minimum to keep you as safe as possible at home while preparing and/or recovering from surgery.

If you have been told you need spine surgery, our office is happy to conduct a brief telemedicine visit with you to review your condition and any associated imaging, such as an MRI, to help reassure you that spine surgery is necessary and to provide you with any alternative options including minimally invasive surgical solutions.

Schedule a Virtual Visit

Scheduling a virtual visit is easy.

  1. Call to Schedule an Appointment 615 – 267 – 6600
  2. Explain your request for a virtual visit
  3. Dr. Shibayama and his staff will schedule a convenient date and time for your Virtual Visit


February 10, 2020 Juris Shibayama, MDNews

What is a Slipped Disc (Spondylolisthesis)?

A slipped disc, also known as spondylolisthesis, is a condition that occurs when a bone in the lower spine shifts out of position and is displaced forward over the vertebrae (bone) beneath it. The condition can develop from spondylolysis, which is a stress fracture in one of the stacked bones (also called vertebrae) that make up the spinal column. Spondylolisthesis occurs when spondylolysis weakens the bone to the point that it begins to shift out of position in the spinal column. In addition with arthritis, the facet joints may become worn out and are no longer able to stabilize the vertebra which causes degenerative spondylolisthesis. If the bone shifts out of position too far, it may begin to press on surrounding nerves causing irritation or nerve damage that can cause shooting pain down the legs.

What Are the Symptoms of a Slipped Disc?

In Short Words

Dr. Juris Shibayama is an orthopedic surgeon in Smyrna, Tennessee and is affiliated TriStar StoneCrest Medical Center. He received his medical degree from University of Illinois College of Medicine. He did his orthopedic residency training at the University of Miami/Jackson Memorial Hospital in Miami, FL. He then completed a one year fellowship dedicated exclusively to spine surgery at Rush University Medical Center in Chicago, IL. He has been in practice 13 years.

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