Advantages of PELD(Percutaneous Endoscopic Lumbar Discectomy) - Advanced Minimal Invasive Technique

Percutaneous Endoscopic Lumbar Discectomy (PELD)

Percutaneous Endoscopic Lumbar Discectomy (PELD) is a unique approach which is quickly getting popular amongst patients and surgeons in the treatment of nonsequestrated disc herniation (disc prolapse) as it reduces the post operative hospitalization and recovery time.

An advanced minimal invasive technique, Percutaneous endoscopic lumbar discectomy (PELD) is performed for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. In addition to decompression surgery, the technique has been found effective in management of spinal tumors and structural deformities. This surgery is recommended in patients who fail to respond effectively to conservative treatment with pain killers like NSAIDs (Non Steroidal Anti inflammatory Drugs) or when the pain threshold is low. In this form of surgery, an instrument called endoscope is used and the whole surgery is done under local anesthesia with the patient fully awake during surgery.

Who may require PELD?

Individuals suffering from chronic low back pain and disability may benefit from a PELD procedure. It is often used to treat patients suffering from degenerated discs, bulging discs or herniated discs that compress upon the surrounding structures within the spinal canal causing nerve compression, sciatica and low back pain. It can also be used if the patient fails to respond to conventional management therapies including direct injection therapies for three months or more. The surgery is also found to be successful in resection of spinal tumors, fusion and structural deformities of the spinal cord.

Relevant Anatomy

The human spine is made up of 33 bony segments called vertebrae which are stacked one above the other. These vertebrae are separated by small, soft, cushion like structures called the intervertebral discs that act as shock absorbers. These discs undergo degeneration due to age related wear and tear, resulting in disc herniation or prolapse. They compress the surrounding soft tissues or nerves giving rise to severe pain. If the vertebral discs in the lower back or the Lumbar region are compressed, they result in pain and tingling in the legs and spasms in the back.

Procedure and types of PELD

Percutaneous endoscopic lumbar discectomy is the ultimate form of minimal invasive spine surgery. It is an endoscopic daycare surgical procedure which is conducted in about 60 minutes, under local anesthesia with mild sedation. Patient is made to lie on his front on the operation table and exact entry point is mapped on patient’s body using image intensifier x-ray system. A small incision is made about 8-10 centimeters from the midline on the posterior part of the body. Now there are two different ways in which the inter-vertebral disc material can be removed (i.e. manually or using laser).

• Manual procedure also known as automated percutaneous discectomy involves insertion of a long spinal needle from side of back, directly into the disc, by-passing other bone and ligaments. Through this needle, guide wire is passed and after taking 5mm incision, dilator and working cannula are passed, through which endoscope is inserted. Camera and monitor is attached to endoscope and prolapsed part of disc is removed under vision.
• The laser surgery is referred to as percutaneous laser discectomy (PLD), which uses an external imager called the fluoroscope to direct the probe. The probe delivers laser energy which vaporizes a part of the inter-vertebral disc material and decompresses the nerve root. The most frequently used laser for treatment is Holmium yttrium- aluminum-garnet (Ho:YAG) laser.

In either procedure, the wound is closed with single stitch. Patient gets immediate pain relief and he can go home in 24 hrs and can resume his work soon.

Advantages of PELD

• Surgery is done under local anesthesia with conscious sedation.
• No muscle, ligament or normal tissue damage and minimal blood loss.
• Patient can be discharged in 24 hrs. No prolonged bed rest required after surgery.
• Early return to work.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed.
• Very good technique for old and medically compromised patients.
  
  
  
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Minimally invasive Surgery (MIS) and spinal fusion (mending the spine bones together)

Using innovative technology, a minimally invasive surgery (MIS) spinal fusion (mending the

spine bones together) can now be accomplished using two small poke-hole incisions with

minimal tissue dissection resulting in a faster recovery. Using the MIS procedure, Posterior

lumbar fusions (PLF) and transforaminal lumbar interbody fusions (TLIF) can both be

performed in less time, with less tissue damage, and less pain than traditional open spinal

fusion surgery.

Posterior Lumbar Fusion (PLF) is the general term used to describe the technique of

surgically mending two (or more) lumbar spine bones together along the sides of the bone.

Bone graft is placed along side the spine bones (not in between the disc spaces, which is

called an interbody fusion), and ultimately fuses together. Minimally invasive PLF is

generally always performed in conjunction with instrumentation (use of metal screws/rods)

so as to impart immediate stability while the bone mends and to increase the fusion rate

(percentage of patients where the bone successfully mends together). MIS TLIF includes the

PLF described above, as well as performing an interbody fusion, which means the

intervertebral disc is removed and replaced with a bone spacer (metal or plastic may also be

used). A MIS TLIF involves placing only one bone graft spacer in the middle of the interbody

space, without retraction of the spinal nerves.

The MIS PLF technique is often favored as the 2nd staged procedure when a multiple level

ALIF is performed, and a laminectomy is not necessary. A MIS TLIF is commonly performed

when one or two spinal levels are being fused in conjunction with a partial posterior

decompression (facetectomy and laminectomy), and interbody fusion is indicated.

MIS PLF and MIS TLIF are commonly performed for a variety of spinal conditions, such as

spondylolisthesis and degenerative disc disease, among others.

Surgical Technique

The surgery is performed utilizing general anesthesia. A breathing tube (endotracheal tube)

is placed and the patient breathes using a ventilator during the surgery. Preoperative

intravenous antibiotics are given. Patients are positioned in the prone (lying on the

stomach) position, generally using a special operating table/bed with special padding and

supports. The surgical region (low back area) is cleansed with a special cleaning solution.

Sterile drapes are placed, and the surgical team wears sterile surgical attire such as gowns

and gloves to maintain a bacteria-free environment.

A 1 inch (depending on the number of levels) poke-hole incision is made on each side of the

low back, directly over the involved spinal levels. The fascia and muscle is gently divided

using special cannulated retractors and sleeves. The pedicle screws and rods are implanted

and the facet joints are fused through the two tiny incisions under x-ray guidance. If a TLIF

is to be performed, a partial laminectomy (removal of lamina portion of bone) and complete

facetectomy is performed to allow visualization and removal of the intervertebral disc. The

intervertebral disc is then removed using special biting and grasping instruments (such as a

pituitary rongeur, kerrison rongeur, and curettes), an operating microscope, and x-ray

guidance. Special distractor instruments are used to restore the normal height of the disc, as

well as to determine the appropriate size spacer to be placed. A bone spacer (metal or plastic

spacers may also be used) is then carefully placed in the disc space.

The wound areas are usually washed out with sterile water containing antibiotics. The deep

fascial layer and subcutaneous layers are closed with one or two sutures. The skin can

usually be closed using special surgical glue, leaving a minimal scar and requiring no

bandage.The total surgery time is approximately 2 to 3 hours, depending on the number of

spinal levels involved.

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Most Advanced Laser therapy for spine Treatment in India

Laser therapy for spine Treatment in India Laser therapy is the use of monochromatic light emission from a low intensity laser diode (250 milliwatts or less) or an array of high intensity super luminous diodes (providing total optical power in the 1000-2000 milliwatt range). Conditions treated include musculoskeletal injuries, chronic and degenerative conditions and wounds. The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This also enhances the body's natural healing processes. The following chart outlines some of the specific effects of Low Intensity Laser Therapy.  

The underlying science behind cold laser therapy is sound. Studies have shown that light of certain wavelengths can reduce pain and inflammation. Lasers can offer very focused beams of light which can be used to target specific areas, which means that in theoretical use, a low intensity laser calibrated to emit light of a specific wavele ngth could potentially be used very effectively to treat areas of inflammation on the body. However, like all medical devices, cold lasers need to be carefully evaluated for safety and efficacy.

Doctors generally recommend cold laser therapy as part of an overall pain management program. For people dealing with chronic pain, cold laser therapy is an option which could be used to reduce the pain, while people with persistent inflammations may also benefit. However, this therapy should not be undertaken without medical supervision, and it is generally not recommended as a replacement for other forms of medical treatment, such as the use of physical therapy to manage chronic pain.

Some practitioners of acupuncture have suggested that cold laser therapy could be used much like acupuncture and acupressure, with the beams of the laser targeting specific points on the body. These practitioners of alternative medicine rely on their training and experience to support their beliefs about the use of cold laser therapy. Stimulation of pressure points can be used to treat a number of conditions treatable with acupuncture. 

A number of terms are used to refer to cold laser therapy, including low power laser therapy (LPLT), low level laser therapy (LLLT), biostimulation, soft laser, and laser acupuncture. In all cases, the technique involves exposing the skin to targeted laser beams for set periods of time and at set intervals. The light in the laser is supposed to stimulate damaged cells to promote healing and a reduction in inflammation and pain. The "cold" refers not the temperature of the laser, but to the fact that the laser is of low intensity, rather than high intensity lasers, which can burn the skin. 

Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. 

Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our world best hospitals in India. Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.

Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest technology and infrastructure to offer the most advanced spine surgery at low cost.

Salient features of these hospitals are:

Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.

Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.

Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.

Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.

Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.

For more information visit:          http://www.medworldindia.com    https://www.facebook.com/medworld.indiaPlease scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.
Call Us : +91-9811058159Mail Us : care@medworldindia.com

Discectomy and Microdiscectomy : Advantaages of Minimally Invasive Spine Surgery

 Minimally Invasive Spine Surgery 

The trend in spine surgery has moved toward minimally invasive procedures. More than 20 years ago a similar trend started with knee surgery. At that time if a patient had torn knee cartilage the surgical procedure required opening the knee. It took several weeks or months for the patient to recover. Now many knee surgeries are performed through small keyhole incisions using an arthroscopic tube. Similar advances continue to be made in spinal procedures. Devices are now available that use microscopic fiber optics that transmit anatomical images to a monitor similar to a television. The equipment is made with built-in magnification that enables the surgeon to view tiny structures through a portal. 

Open Surgery versus Minimally Invasive 
Spine surgical procedures are often referred to as an open procedure or minimally invasive. Open procedures require larger incisions, muscle stripping, more anesthesia, operating time, hospitalization and, the patient usually needs more time to recuperate. Minimally invasive surgical techniques utilize portals or tiny incisions made in the skin (percutaneous) through which small, specialized instruments are inserted. For example, an endoscope allows the surgeon to see an illuminated and magnified view of the operating field through a tiny incision.

Today many different types of spine surgery can be performed utilizing minimally invasive techniques. Some types of minimally invasive spine surgery use laser technology. Lasers may be used to separate or eliminate tissue. New instruments for use in minimally invasive spine surgery have been developed and continue to be refined.

Discectomy and Microdiscectomy are terms that mean the surgical removal of part or an entire intervertebral disc. The difference between these terms is that microdiscectomy uses microscopic magnification. These procedures are performed to remove a herniated or ruptured disc. The advantage to microdiscectomy is that the procedure is minimally invasive. The incision and instruments are small, which enables the patient to recover quickly.

Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. 

Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our World's Best hospitals in India. Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.

Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at 
affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest 
technology and infrastructure to offer the most advanced spine surgery at low cost.

Salient features of these hospitals are:

• »
• Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.
• »
• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• »
• Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• »
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
• »
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.
  
  
  
  For more information visit:          http://www.medworldindia.com    
                      https://www.facebook.com/medworld.india
  Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.
  Call Us : +91-9811058159
  Mail Us : care@medworldindia.com

Most Advanced Laser Spine Treatment and Surgery in India

Laser therapy is the use of monochromatic light emission from a low intensity laser diode (250 milliwatts or less) or an array of high intensity super luminous diodes (providing total optical power in the 1000-2000 milliwatt range). Conditions treated include musculoskeletal injuries, chronic and degenerative conditions and wounds. The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This also enhances the body's natural healing processes. The following chart outlines some of the specific effects of Low Intensity Laser Therapy. 

The underlying science behind cold laser therapy is sound. Studies have shown that light of certain wavelengths can reduce pain and inflammation. Lasers can offer very focused beams of light which can be used to target specific areas, which means that in theoretical use, a low intensity laser calibrated to emit light of a specific wave length could potentially be used very effectively to treat areas of inflammation on the body. However, like all medical devices, cold lasers need to be carefully evaluated for safety and efficacy.

Doctors generally recommend cold laser therapy as part of an overall pain management program. For people dealing with chronic pain, cold laser therapy is an option which could be used to reduce the pain, while people with persistent inflammations may also benefit. However, this therapy should not be undertaken without medical supervision, and it is generally not recommended as a replacement for other forms of medical treatment, such as the use of physical therapy to manage chronic pain.

Some practitioners of acupuncture have suggested that cold laser therapy could be used much like acupuncture and acupressure, with the beams of the laser targeting specific points on the body. These practitioners of alternative medicine rely on their training and experience to support their beliefs about the use of cold laser therapy. Stimulation of pressure points can be used to treat a number of conditions treatable with acupuncture.

A number of terms are used to refer to cold laser therapy, including low power laser therapy (LPLT), low level laser therapy (LLLT), biostimulation, soft laser, and laser acupuncture. In all cases, the technique involves exposing the skin to targeted laser beams for set periods of time and at set intervals. The light in the laser is supposed to stimulate damaged cells to promote healing and a reduction in inflammation and pain. The "cold" refers not the temperature of the laser, but to the fact that the laser is of low intensity, rather than high intensity lasers, which can burn the skin.

Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our world best hospitals in India. Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.

Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest technology and infrastructure to offer the most advanced spine surgery at low cost.

Salient features of these hospitals are:

• Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.

• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.

• Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.

• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.

• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.

For more information visit:          http://www.medworldindia.com       
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com

FAQ About Minimally Invasive Spine Surgery : Best Spine Surgery Hospital in India

When should Iconsider surgery?
Surgery should always be the last resort when it comes to treating spinal conditions in the neck and back. However, if various non-operative treatments have been attempted without improvement or worsening over a 6-12 month period, then surgical treatment seems reasonable for certain specific conditions such as spinal stenosis, sciatica, spondylolisthesis or degenerative scoliosis. The decision for surgery should be individualized to the patient and the patient’s symptoms, along with their level of function.


Am I a candidate for minimally invasive spine surgery?
The field of minimally invasive spine surgery continues to grow. Most surgeries today can be treated with some aspect of minimally invasive surgery. However, there are certain conditions that require standard open treatment, such as high-degree scoliosis, tumors and some infections.

The best options should be individualized to the patient’s diagnosis and overall patient condition. At UCSD we perform both minimally invasive spine surgery, as well as open-surgery, and choose the type of treatment that is best suited for the individual patient. 


Why do I need to get an MRI, CAT Scan and an XRay before I have surgery?
The integration of our newest technolgies that assist in MISS surgery often require that radiologic procedures be tailored to fit each operation and will often require a new scan.


How long willI be in the hospital?
I general, minimally invasive spine surgery decreases the hospital stay by one-half. In a typical endoscopic discectomy, the surgeries are performed in the same day, and the patients go home shortly after surgery on the same day.

For various types of lumbar fusion surgery, the patient typically goes home in 2-3 days, where previously they stayed in the hospital 5-7 days. Furthermore, the immediate post-operative period is marked by much less pain when using minimally invasive techniques.


When can I go back to work after minimally invasive back surgery?
The decision to return to work should be individualized to the patient, as well as the patient’s occupation. For patients with sedentary jobs, such as office work, a minimally invasive discectomy would allow that patient to begin part-time work within 1-2 weeks. For a larger surgery such as a fusion, this may take 4-6 weeks. Again, return to work is much faster using minimally invasive surgery vs. standard open surgery but this decision is individualized to special needs of each patient. 


How long is the recovery?
Recovery from each surgery is different. Some patients return to full activity in 6 weeks while other patients require more time. We encourage all patients to participate in a physical therapy program to safely begin the process of returning to all normal activities. 


After surgery, how long will my pain last?
On average, patients who have had minimally invasive spine surgery are discharged in half the time of traditional surgery and the pain usually follows this rule. Each procedure will have a differnent rate of recovery. 


Will I have totake pain medication after my surgery? Will I become dependent?

There is no evidence that post-operation pain treatment leads to addiction. 


Do I have to wear a brace?
Although most patients are provided a brace, this is for comfort only. The use of minimally invasive techniques that preserve muscle function, along with specialized implants that act as an internal brace, allows one to avoid having to wear a brace. Most patients find that the brace improves their pain for about 1-2 weeks, and thereafter it is only worn occasionally.


Will I need physical therapy after I get minially invasive spine surgery?
Physical therapy is an important component of a rapid recovery. This is individualized to the patient, but in most cases, physical therapy started 2-6 weeks after surgery, depending on the surgery performed and the patient’s overall condition. 


Do you use lasers for minimally invasive back surgery?
Minimally invasive spine surgery utilizes a wide variety of advanced techniques, including lasers, endoscopes, operating microscopes, as well as computer-assisted navigation systems, so that procedures typically done with a large, open decision can be done through small openings.

By necessity, advanced technologies are needed to accomplish the same task that we would otherwise do with an open procedure using more basic equipment. The decision to use one or other types of advanced technologies depends on the individual condition and the surgery performed.

Most commonly, laminectomy is performed to treat spinal stenosis - Best Spine Surgery Hospital in India

Laminectomy or Laminotomy (a partial laminectomy) is sometimes called a decompression procedure and is a spinal procedure to remove a portion of the vertebral bone called the lamina. The lamina is a posterior arch of the vertebral bone lying between the spinous process, which juts out in the midline and the more lateral of each vertebra. The pair of lamina, along with the spinous process, make up the posterior wall of the bony spinal canal.  Although the procedure indicates excision of the lamina, the operation called conventional laminectomy, removes the lamina, spinous process and overlying connective tissues and ligaments, cutting through the muscles that overlie these structures. Minimal surgery laminectomy is a tissue preserving surgery that leaves the muscles intact, spares the spinal process and takes only one or both lamina. Laminotomy is removal of a mid-portion of one lamina and may be done either with a conventional open technique, or in a minimal fashion with the use of tubular retractors and endoscopes.

BRIEF ABOUT THE PROCEDURE

There are many variations of laminectomy, in the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut and the parts of the vertebra adjacent to the lamina are left intact. After an incision is made in the midline of the neck or back, the muscle is moved away to expose the lamina, which are the bony shingles that overlay the neural (nerve) elements. The lamina can be removed in whole or in part to expose a single nerve root or more of the neural elements as needed. In the case of a lumbar disc herniation, a laminotomy, or partial removal of the lamina is usually sufficient to gain access to the affected nerve root.  The nerve root will usually be visible just beneath the lamina, with a disc herniation underneath it. The nerve root is gently held out of the way with a retractor and the disc herniation can be accessed. The traditional form of laminectomy (conventional laminectomy) excises much more than just the lamina, the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure and weeks to months with conventional open surgery. A lamina is removal is done to break the continuity of the rigid ring of the spinal canal to allow the soft tissues within the canal to expand or as one step in changing the contour of the vertebral column, or in order to allow the surgeon access to deeper tissues inside the spinal canal. Conventional open laminectomy often involves excision of the posterior spinal ligament and some or all of the spinous process and facet joint. Removal of these structures, in the open technique, requires cutting the many muscles of the back which attach to them. Laminectomy performed as a minimal spinal surgery procedure, however, allows the bellies of muscles to be pushed aside instead of transected and generally involves less bone removal than the open procedure. The recovery period after laminectomy depends on the specific operative technique; minimally invasive procedures having a significantly shorter recovery period than open surgery. Removal of substantial amounts of bone and tissue may require additional procedures to stabilize the spine, such as fusion procedures and spinal fusion generally requires a much longer recovery period than simple laminectomy. Most commonly, laminectomy is performed to treat spinal stenosis. Laminectomy for Spinal Stenosis Spinal stenosis is the single most common diagnosis leading to any type of spine surgery and laminectomy is a basic part of its surgical treatment. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. Surgical treatment that includes laminectomy is the most effective remedy for   severe spinal stenosis, however most cases of spinal stenosis are not severe and do not require surgery. When the disabling symptoms of spinal stenosis are primarily neurogenic claudication and the laminectomy is done without spinal fusion, there is generally a very rapid recovery with excellent long term relief. However, if the spinal column is unstable and fusion is required, there is a recovery period of months to more than a year and relief of symptoms is less likely.

Most Advanced Minimally Invasive Lumbar Fusion Surgery in India

Lumbar spinal fusion is a common technique to help patients with back pain, who have failed non-operative treatment. Once you and your physician have decided that you need fusion of your lumbar spine, you should realize that there are many different ways this procedure can be done. The choice of which technique is best for you is dependent on what is wrong with your spine. Your surgeon may have more experience with fusion techniques from the front of the spine (anterior), the back of the spine (posterior), or some of the newer, less invasive approaches. These newer techniques are often called Minimally Invasive Spinal (MIS) surgery. The goals of all these techniques remain the same, to achieve a lumbar fusion, and lessen the patient's pain.

The most common method of spinal fusion involves the posterior approach, with an incision along the back of the patient's spine. Often, this procedure is used if bone spurs, thickened ligaments, or disc ruptures need to be removed to alleviate pressure on the nerves. The fusion procedure then involves placement of metal screws, rods and bone graft. Anterior spinal fusions require an incision through the abdomen. After removal of the degenerated disc, a metal cage with bone graft is usually placed between the spinal bones (vertebral bodies). Some patients will require both front and back procedures.

There are many new surgical techniques that are being developed to improve the results of lumbar fusions. Minimally invasive spine surgery for lumbar fusion is one of these newer techniques. MIS procedures have smaller incisions, cause less trauma to the surrounding normal tissues, and hopefully results in a faster recovery for the patient. One of these MIS techniques is a procedure known as extreme-lateral lumbar interbody fusion (XLIF). During the XLIF procedure the lumbar spine is approached from the side through a small skin incision. The surgery is performed through a muscle that lies next to the lumbar spine known as the psoas muscle.

With the XLIF procedure, approximately 2/3 of the disc can be safely removed. After the disc is removed, an artificial graft is placed in between the vertebrae, to allow the bones to fuse together. For a single level XLIF procedure, the surgery can be usually be performed in about an hour. Most patients stay in the hospital for 24 hours following the procedure, and do not require a brace. Occasionally, weakness may be noticed while lifting your leg after surgery. This psoas muscle weakness should return to normal fairly soon after surgery.

Not everyone is a candidate for this surgery, once conservative (non-operative) treatments have failed, you should consult a surgeon to see if you are an appropriate candidate.

The major advantage of all of these  minimally invasive techniques is that there is less damage caused to the surrounding tissues. Unfortunately, in traditional spinal surgery it is necessary to cut through muscles and move them out of the way in order to reach the spine. This can cause a large amount of pain following surgery, and it can lengthen the recovery time. Instead of cutting and moving muscles, the minimally invasive techniques can more gently spread through the muscles to allow access to the spine. This is much less painful for the patient, and it does not require as long of a recovery period for the muscle to heal.

Another benefit of less muscle damage is less blood loss and thus a reduced need for blood transfusions using the minimally invasive techniques. There is often less need for narcotic pain medications following this form of surgery, and a shorter hospital stay.

 

Spinal Disc Protrusions do not require open spine surgery : Best Spine Surgery Hospital in India

Percutaneous Disc Nucleoplasty is minimally invasive surgery to reduce the volume of a bulging or herniated disc. In both cases the spinal disc puts pressure on a nerve root or the spinal cord and causes back pain or sciatic pain.

Spinal Disc Protrusions do not require open spine surgery

Many patients with back pain show no clear indication of a herniated disc. However with MRI investigation protrusion of the intervertebral discs can be diagnosed. This protrusion can put pressure on nerves or the spinal cord and can cause persistent, or stress-related chronic back pain. Normally this kind of back pain (lumbar or cervical), responds well to conservative treatment options.

When will your neurosurgeon consider Nucleoplasty?

If after six weeks, conservative treatment has not been successful, your spine specialist should consider an intradiscal procedure: The disc protrusion can be reduced by treating the liquid core of the spine simply by using an injection needle. This needle (cannula) allows a radiofrequency instrument to enter the core of the disc, thereby avoiding all the surgical risks associated with open back surgery. This is essentially the principle of the Nucleoplasty.

Nucleoplasty, as a minimally invasive treatment, covers only smaller disc herniations or disc bulges that have not yet broken through the solid fibre ring of the disc and are therefore are not accessible via an open surgical procedure (surgical removal of the disc material).

Endoscopic Nucleoplasty is safe for patients and is a minimally invasive procedure, which produces very good outcomes, without the risks and postsurgical complications associated with open back surgery.

Disc Nucleoplasty is performed on an outpatient basis, with minimal anesthesia requirements. Fluoroscopic guidance is employed as an introducer needle is placed at the nucleus/annulus junction. A SpineWand is introduced through the passage way, and advanced into the disc nucleus. Using Coblation, tissue is then removed by either creating channels (lumbar spine) or spheres (cervical spine). After sufficient tissue is removed, a bandage is placed on the skin and the patient is discharged home. Patients are then usually placed on a routine rehabilitation program.

Nucleoplasty is recommended for patients who have not responded to rest, medical intervention (including steroid injection), and/or physical therapy.

There are many people across the world who suffers from slipped disc problem. In 90 per cent of these cases, the disc prolapsed is contained or limited to the disc space and are not suitable for the traditional discectomy surgery involving the complete removal of the diseased disc. The open surgery is an overkill leading to unsatisfied results, more complications and costly procedure.

In such clinical circumstances, percutaneous treatment also known as disc nucleoplasty has emerged as the best alternative. Moreover the cost of Disc Nucleoplasty at Medworldindia affiliated hospitals in India is minimal. Conventionally the disc prolapse is treated with bed rest and analgesics but with limited relief.

Many successful Nucleoplasty procedures have been performed in India. This minimally invasive approach to treating contained disc herniations has helped most of the International patients return to active and productive lives with effective cost savings. 

Expert Neuro and Spine Surgeons in India who have ample experience in performing this procedure said that, “Spinal Surgery is fast becoming a major sub-speciality in neurosurgery”. Disc nucleoplasty is an innovative percutaneous method of healing disc disease. Disc prolapse can occur in lumbar as well cervical region causing low back pain, radiating pain and neck pain respectively. Related symptoms are excruciating pain, numbness, tingling sensation in hands and legs, burning and weakness of the limbs. The patient will have restricted movement, walking, bending and doing normal day to day activities becomes very difficult. The severe pain results in incapacitation leading to loss of man hours.