A 40-year-old ordnance factory worker, Ashok, who had a radiating pain in the right leg for two months was successfully operated in a city hospital using the next generation bi-portal endoscopy procedure.Walking or sitting crosslegged was extremely difficult for the patient. It was found in subsequent investigations that he had spinal nerve compression at the L-5 and S-1 vertebrae -medically termed lateral recess stenosis.
It is one of the most common spinal degenerative conditions, in which open spaces within the spine become narrowed, leading to pressure on the spinal cord and nerves in the spine.
To take the pressure off his spinal nerves, a team of doctors carried out the next generation bi-portal endoscopy procedure that provided him immediate relief.Following a successful operation, Ashok was discharged in three days.
The next generation endoscopic spine surgery attempts to expand the strength of traditional endoscopy procedure and reduce the co-morbidities associated with conventional open spine surgery .
The traditional posterior (back side) spine surgery approach includes detaching the strong support muscles from the spine in order to stabilize it and decompress the nerve. The posterior minimally invasive spine technique uses a smaller incision.
However, the next generation minimally invasive biportal endoscopic spine surgery uses a similar small incision, but leave the supporting muscles attached. The procedure is completed in the same session by working “between the muscle fibres“.“I am completely relieved of the radiating pain, which had severely hampered my daily routine. Post-surgery , I resumed my work within a week,“ Ashok said.
Orthopaedic spine surgeon Ketan Deshapande along with spine surgeon Pradyumna Pai Raiturka carried out the complicated surgery at Saishree Hospital on Sunday .
“The bare minimal muscle disruption in this approach leads to better outcomes and lesser need for reoperation. This is the first time that the bi-portal endoscopic spinal decompression surgery has been performed in Maharashtra,“ Deshpande said.
Deshpande is exclusively trained in endoscopic and minimally invasive spine surgeries.
“This is a revolutionary procedure in terms of technical advancement and is more acceptable than traditional endoscopy . This is because the surgical view is comparable with that of open surgical approach and is cost-effective as well,“ Raiturkar said.
In surgeries on the spine, the objective is to decrease the pain and weakness by stabilizing the spine (artificial disc or fusion) or taking pressure off the nerve (decompression or discectomy).
“In order to get to the spine, the surgeon must navigate through the skin, muscles and ligaments in a way that these structures are minimally affected and continue to support the spine when the surgery is complete. This objective is best achieved in this bi-portal endoscopic approach,“ Deshpande said.
So, should a patient with any spine issue seek this minimally invasive procedure?
“No, this surgical approach is not for all spinal complaints. It is best suited for selected patients only ,“ said Deshpande, who has trained with South Korean neuro-spine expert Eum Jin Wha -the inventor of the technique.Click here to read more