Wockhardt Hospitals Kalyan successfully performs a revolutionary minimally invasive spine surgery - Percutaneous Endoscopic Lumbar Discectomy (PELD) on a 49-year-old man suffering from severe backache.
Truly a minimally invasive spinal surgery, the procedure known as PELD was performed with a single 0.6 cm incision using a technically evolved Yeung endoscopic spine system (YESS) method under local anaesthesia. The PELD Technique is known to be an innovative spine procedure that can help appropriately screened patients recover faster without scars or stitches and more importantly, helps patients walk immediately after the procedure without any pain.
The patient, Sunil Ghag, was suffering from acute back pain as a result of prolapsed inter-vertebral disc, more commonly known as slipped disc. With the severity of the pain only increasing with time, conservative treatment with non-steroidal anti-inflammatory drugs (NSAID) and intermittent pelvic tractions was of little help, forcing him to seek surgical intervention.
An MRI confirmed the prolapsed disc, revealing disc degeneration. "The patient had two options," recalls Dr Vikas Gupte, consultant spine surgeon, Wockhardt Hospitals. "He could either opt for the conventional open discectomy, or the minimally invasive PELD under local anaesthesia." The patient was convinced about going for it as the chances of root injuries were minimal with PELD, promising immediate normalcy and discharge from the hospital.
As Dr Gupte explains, "In the PELD procedure, the patient is made to lie prone on a special operation table and the exact entry point is mapped on the patient's body using image intensifier x-ray system. A long spinal needle is then passed from the side of the back which goes into the disc directly by-passing other bone and ligaments. Through this needle, a guide wire is passed and after making a 6mm incision under local anaesthesia, a dilator and working cannula are passed through the incision. The camera and the monitor are attached to an endoscope that is passed through the incision and the prolapsed part of disc is removed under vision. Advanced instruments like radio-frequency and laser machine are used for such surgery. The surgery lasted for 40 minutes and the wound was closed with a single stitch."
Dr Deepu Banerjee, Neurosurgeon, Wockhardt Hospitals points out that the instrumentation using YESS technique consists of a 6 mm scope that facilitates direct view of the disc fragments in the spine thus minimizing muscle, ligament and tissue damage, while alleviating chances of nerve root injury. "Even the nerve roots are clearly visible through the powerful camera of the Yeung endoscope," he added.
Post-op, the patient was able to walk without any pain and was discharged after 24 hours. According to experts, PELD with YESS technique is the ultimate form of minimal invasive spine surgery in appropriately screened patients.