Prime’s spine surgery program is the most technologically advanced initiative of its kind in the Country. The program focuses on endoscopic surgical management of degenerative diseases of the spine. Common surgeries offered under this program include the repair of herniated, protruded, extruded, or degenerated discs that are the principal cause of back and leg pain. Fixation and fusion of discs are also performed routinely using minimal access techniques to reduce overall surgical morbidity. Prime’s spine group has over 50 years of combined experience and has done pioneering work in advancing the diagnosis of spine related ailments and spine surgery technology internationally.
The adoption of laser assisted endoscopy for surgical intervention of the spine has revolutionized the diagnosis and treatment of spine related diseases in a variety of ways:
1. Endoscopic approach utilizes local anesthesia
The most significant advance in endoscopic spine surgery is that a local anesthetic is used for the procedure. Local anesthesia ensures a pain free procedure while allowing a patient to be awake and responsive. This allows the surgeon to target the pain generator precisely while avoiding other critical areas of the spine that do not contribute to the source of pain. This focused approach is not possible in traditional surgical methods as the patient is unconscious under general anesthesia.
Also, surgery under local anesthesia is significant as it eliminates any risk associated with administering general anesthesia to patients with other medical complications. Patients with co morbidities such as diabetes, hypertension, cardiac conditions or respiratory problems are considered high risk for surgery under general anesthesia. Such patients with spine related diseases can now seek pain relief with the endoscopic approach in a safe manner.
Separately, it has been found that in approximately 30% of patients, MRI imaging that is used for the diagnosis of the disease does not directly co relate with the underlying source of pain. The exact source of pain and its post surgical persistence is not completely answered by MRI scans alone. Several years of endoscopic spine surgery on awake and responsive patients has given our team vast amounts of information relating to spine disease pathology. This has significantly improved the diagnosis, precise targeting of intervention and management of spine related back and leg pain.
2. Endoscopic approach preserves the natural structure and stability of the spine
Often times, the source of pain in degenerative diseases of the spine is limited to a tiny fragment that causes compression or irritation of a nerve in an area that is difficult to access surgically. The difficulty in access is due to the anatomy of the spine. Non endoscopic traditional techniques of management of such diseases require some muscles of the back and the bone structure be surgically cut to gain access to the pain causing area. This approach leaves an unstable spine, which requires further surgery such as fixation or fusion to provide additional mechanical support. The highly invasive nature of traditional surgery results in extended pain management and recovery time.
In the endoscopic approach, a highly skilled surgeon targets the pain causing area from the side without disturbing the bone structure of the spine. Utilizing high precision lasers and specially designed instruments, the pain causing fragments can then be removed causing no damage to the underlying muscles or bone. This results in instant pain relief and depending on the pre-operative fitness levels of the patient, a quick return to normal life.
3. Endoscopic approach allows for staged intervention to reduce overall surgical morbidity and enhanced outcomes.
The endoscopic approach is a superior alternative to traditional methods of surgery for patients requiring multiple level intervention of the spine. Traditional methods of relying completely on MRI imaging for the diagnosis of spine related pain may result in excess surgical morbidity for the patient.
The endoscopic approach allows a surgeon to stage surgery and evaluate the results of each stage. While it may seem that multiple stages are required to provide a patient pain relief, this approach allows a surgeon to cause no more surgical trauma than required, resulting in better outcomes.
4. Endoscopic approach does not require a surgical incision
The lateral insertion of the endoscope to gain access to the surgical site requires a small incision (7-8 mm) with no post operative sutures. Also, the patient experiences almost no blood loss during surgery. The non-endoscopic or open surgery requires a large posterior midline incision resulting in additional post surgical trauma and recovery time.
5. Endoscopic approach is safe
The endoscope and the use of laser for spine surgery is US FDA approved.
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Dr. Sunil Nadkarni
Qualifications: MBBS, MS (Orth), FRCS (Ed), MCh (Liverpool) Dr. Sunil Nadkarni’s expere..Read more
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