back pain -stitchless technique[slip disc]
Twentyfive-year-old Narendra Kumar had been suffering from severe pain on his right side in his thigh and leg for more than three months. It hindered his busy schedule as an businessman.
A recent MRI of his spine showed a prolapse at L4-5& L5-S1 vertebrae and a recurrent disc herniation (disc bulge) and nerve root compression in the L4-5 vertebrae.
When he heard that the nerve compression could be fixed without a major surgery, he was relieved. Using a relatively newer technique ,called percutaneous endoscopic lumbar discectomy (PELD) or *stitchless spine surgery, the nerve roots at both levels were decompressed. “There was no incision and muscle cutting, it was like a small procedure ,pin hole-which relieved me of my severe pain,” said Narendra.
Doctors in JPRC spine and joint careJaipur are conducting difficult spine surgeries without cutting through muscles and bones. Patients suffering from slipped disc, low back pain due to nerve compression, sciatica are being relived of pain using stitchless spine surgery medically known as PELD. A patient is discharged within 24 hours.
Narendra Kumar was lifting some heavy objects when he felt severe pain in his lower back and buttocks. followed by severe leg pain and numbness. An MRI scan clearly showed he was suffering from a slipped disc. Doctors told him, the disc can be removed without any skin incision, Kumar said. He was up and about a day after surgery
“This surgery is a modern technique useful for patients with lower back pain, sciatica and a slipped disc. Not all spine surgeries can be done using PELD. Only certain patients will benefit from the technique,” said dr Sanjay Sharma intervention spine pain physician and dr Lalit Bhardwaj renowned neurosurgeon
has performed sixty surgeries using PELD in the last six months. “Stitchless spine surgery can help in the early phases of pain when the spine discs have not hardened with time and pain has not become chronic, secondarily affecting the surrounding muscles,” he said.
The technique has matured in the last two to three years and there are many papers establishing its efficacy and advantages. It incorporates principles of miniature endoscopy, radiofrequency waves and laser technique. “It is relatively new in India. There are very few hospitals offering such techniques,” dr Sanjay Sharma said.
said there are very few neurosurgeons in India who conduct PELD. “It is a relatively new technique, but effective in treating certain spinal problems.” Dr Sanjay also conducts PELD.
Dr sharma said the surgery can be best performed under simple local anaesthesia. “We leave it to patients to choose the type of anaesthesia one is most comfortable with. There is no need of general anesthesia in this surgery,” he said.only under sedation and local anaesthesia only.
Patients suffer the pain and see doctors only when the condition is in advanced stages. “When there is intervertebral disc prolapse (slipped disc), a certain percentage of the slipped discs shrivel-up in a few weeks and do not need surgery. However, it is equally clear that a significant number of these discs become hard due to calcification, progressively lodging them in a narrow crevice of the spine, severely compressing the nerves. This causes chronic backache, sciatica and neurogenic claudication, not to mention irreversible nerve damage,” said dr Lalit Bhardwaj neurosurgeon and dr Sanjay Sharma interventional spine pain physician at JPRC.
The first line of treatment should be non-surgical, but if the symptoms do not regress fast, one should take out the compressive elements,” dr sanjay Sharma said.
Low back, thigh and leg pain due to foraminal stenosis (or disc prolapse) can be treated most effectively only with this technique. “This is because the standard posterior open or other approach is unable to decompress this area easily and effectively as it is covered by a facet joint. So, the patients who used to be either told that ‘nothing much can be done for this condition,’ can now be most definitely and efficiently treated by using PELD,” dr Sharma from JPRC spine and joint care Jaipur.