Advantages Endoscopic Micro Discectomy - Spine Surgery Hospital in India

Micro Endoscopic Discectomy (MED) Surgery in India

The Microendoscopic Discectomy (MED) is a minimally invasive surgical technique used to remove a herniated nucleus pulposus (disc). Most people will have back pain sometime during life. And 90% of these people will get better, without treatment or with conservative therapy. Only 5% remain disabled longer than three months and for those, surgery may offer relief.

Procedure

A disc ruptures when there is a tear in the outer lining (annulus) of the disc . When a tear in the annulus occurs, a fragment of disc material may protrude and pinch surrounding nerves. When a nerve is compressed it can cause symptoms such as extremity pain, numbness, weakness, electrical sensations, and bowel and bladder incontinence. If symptoms are not relieved with conservative treatments, a patient may be a candidate for surgical removal of the herniated disc fragment.

Microendoscopic Discectomy differs from the open microdiscectomy. The incision using the microendoscopic technique is smaller (approximately 1cm), causing less trauma to the surrounding tissue. A smaller incision allows for decreased post-operative pain and a faster recovery. A patient is considered a potential candidate for a microendoscopic discectomy if he or she has a large herniated disc fragment extruded to the side of the spinal canal.

Microendoscopic Discectomy is performed by making a small incision in the patient's back and inserting a small endoscopic probe between the vertebrae and into the herniated disc space. A small camera is placed through the probe enabling the surgeon to view the operation on a TV screen in the operating room. Small surgical devices are placed through the probe to remove bone and herniated disc fragments.

The procedure usually takes about one hour; the patient is often able to return home on the same day. It is normal for a patient to experience postoperative pain, such as back pain, spasms, and lower extremity symptoms. These symptoms will usually improve as the nerve heals and inflammation of the nerve decreases. Patients are given pain medications during the healing process.

Who can benefit from Endoscopic Micro Discectomy (MED)?

This procedure is indicated for all those patients who are suffering from severe acute or chronic backache and/or radiating pain in the leg as a result of lumbar disc prolapse/slipped disc/herniated disc.

Quick Recovery – Great Advantage of Endoscopic Micro Discectomy (MED)

Since there is minimal damage to surrounding muscle tissue, the magnitude of post operative surgical pain is much less as compared to conventional open discectomy. The patients can get up and walk around on the post operative day itself making the hospital stay very short.

World Class Technical Expertise for Endoscopic Micro Discectomy

MyMedOpinion affiliated world Best hospitals in India are a benchmark in comprehensive spine care for such complex and sensitive surgeries. The procedure is performed by a highly qualified neurosurgeons who have trained for decades at world’s best spine hospitals and have an excellent track record of successful outcomes.

What are the advantages Endoscopic Micro Discectomy?

• Surgery done under local anesthesia with conscious sedation
• 5 mm skin incision
• Endoscope used for surgery
• No muscle, ligament or normal tissue damage
• Targeted fragmentectomy. (directly prolapsed disc tissue removed.)
• Minimal blood loss
• Patient can be discharged in 24 Hrs.
• No prolonged bed rest required after surgery. Can resume work sooner.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed. Very good technique for old and medically compromised patients.

Most Advanced Slip Disc Treatment in India | Best Spine Hospital India

Slip Disc Treatment in India

The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus. 

The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body. 

Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine. (The muscles and ligaments are not shown in the diagram below for clarity.) 

At what age can a slipped disc occur? 
A slipped disc in the lower back is most often seen between the ages of 30 and 50. In the cervical vertebrae around the neck, slipped discs are most often seen between the ages of 40 and 60. 

Who Gets A Slipped Disc? 
  

What Are The Symptoms Of A Slipped Disc? 

Back pain

The pain is often severe, and usually comes on suddenly. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze. 

Nerve root pain (usually 'sciatica')

Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on ('trapped') by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Nerve root pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc, the sciatic nerve is the most commonly affected nerve. (The term 'sciatica' means nerve root pain of the sciatic nerve.) The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg. There is a sciatic nerve for each leg. 

Lumbar Spine Surgery in India

Lumbago, or what is more commonly known to people as lower back pain , is one of the most widespread and prevalent spinal problems. The reason for such persistent back pain is any kind of pathological problem in the lumbar region of the spine, which is made up of the last five vertebrae.

Lumbar spine problems are most often caused by herniated inter-vertebral discs, anomalous developments on the vertebral bodies (osteophytes), which apply pressure on the spinal nerves that leads to narrowing of the spinal column around the spinal cord. The most important procedures followed in a lumbar Spine Surgery are decompression and fusion.

Decompression : Lumbar Decompression spine surgery in India is performed to assuage pain caused by pinched nerves. The surgery is generally recommended in cases of spinal stenosis caused by thickened joints, loosened ligaments, bony growths, or disc herniation.

The various procedures used for Decompressing Lumbar spine are:•  Discectomy•  Laminotomy or Laminectomy•  Port Hole Decompression•  Foraminotomy or Foraminectomy•  Osteophyte removal•  Corpectomy

Fusion : Lumbar fusion surgeryin India has two individual approaches. The most common process used is the posterior approach, where the surgery is done from the back. The three main Posterior fusion techniques are:

•  Postero lateral gutter fusion surgery•  Posterior lumbar interbody fusion (PLIF) surgery•  Transforaminal lumbar interbody fusion (TLIF) surgeryThe anterior approach involves placing the bone directly into the section between the vertebrae where the shock-absorption disc had been situated.

Candidates

Lumbarspine surgery in India is indicated for people who have pain that extends (radiates) from the back to the buttocks or back of thigh, pain that interferes with daily activities, weakness of legs or feet, numbness of legs, feet, or toes, loss of bowel of bladder control, had physiotherapeutic & medication input, but that hasn't helped.

Expected ResultsMost patients can expect a dramatic and lasting improvement in their back and leg pain after the lumbar spinal surgery . Though the success rates are excellent in Lumbar surgery , it can be lower in patients who smoke, are overweight, have diabetes or other significant medical illnesses, have osteoporosis, or who have had radiation treatments that included the lower back. Good nutrition and slowly increasing activity (as recommended by your physician) in the recovery period can help achieve success.

RecoveryYou are likely to experience pain and discomfort after the surgery which will be controlled with pain killers prescribed by your surgeon. You would be advised to walk the same day or the next after the surgery to prevent any clot formation. You would also be advised to do breathing exercises after the lumbar surgery for better circulation of blood and decrease the risk of any lung problem. You would need to stay at the hospital for about 5-6 days after the surgery and can go back home with specific instructions to follow. Many people return to work in 3-4 weeks after the surgery. But you may or may not be allowed to do heavy work depending upon your specific condition.

Lower Back Pain Treatment and Surgery in India - Best Spine Hospital India

Pain or discomfort in the lower portion of our back and the spinal column is a common phenomenon and can be largely attributed to our changing lifestyles.

Wrong posture or inadequate exercise is most often the cause of the pain in the lower spinal column. The treatment of such a pain can vary from a simple over the counter medicine to surgery depending on the severity and the cause.

The pain is generally felt in the lumbar and the sacral region and can also affect other areas. A sprain in the muscles or the ligaments constituting the lower portion of the spine can be the most common cause of backache. Some of the other problems that involve pain in the lower back are disc degeneration due to arthritis or ageing, spondylitis, infections and tumors.

In most of the cases the pain is localized in the lower back and vanishes after some time. However, it may even extend to the buttock or the leg on the affected side. In cases wherein the pain is persistent and increases with time or results in weakness in the foot or loss of bladder control- proper medical check up becomes essential.

In some cases stiffness or persistent pain around the spine can disturb your sleep resulting in further problems like tiredness. Such problems can be rectified by the used of pillows designed to maintain our body posture and thus ensure proper sleep. The use of the wrong type of mattresses can also affect the body posture and result in back pain.

Lower back pain is one of the commonest problems afflicting people around the world at some point of time in their life.

In the initial stages of pain, stretching exercises work effectively as Lower Back Pain Treatment.

The lower back supports the upper body and allows the body to turn, twist, bend, lift and walk. It plays a very important role in mobility. The lower back takes a lot punishment, as we tend to overuse or misuse it.

There are many options available for Lower Back Pain Treatment, depending upon the problem.

Surgery is usually the last resort in the treatment of back pain. It is usually only recommended if all other treatment options have been tried or in an emergency situation. The main procedures used in back pain surgery are discectomies, spinal fusions, laminectomies, removal of tumors and Vertebroplasty.

There are different types of surgical procedures that are used in treating various conditions causing back pain. Nerve decompression, fusion of body segments and deformity correction surgeries are examples. The first type of surgery is primarily performed in older patients who suffer from conditions causing nerve irritation or nerve damage. Fusion of bony segments is also referred to as a spinal fusion and it is a procedure used to fuse together two or more bony fragments with the help of metalwork. The latter type of surgery is normally performed to correct congenital deformities or those that were caused by a traumatic fracture. In some cases, correction of deformities involves removing bony fragments or providing stability provision for the spine. A time-tested procedure to repair common intervertebral disc lesions which offers rapid recovery (just a few days) involves the simple removal of the fibrous nucleus of the affected intervertebral disc.

A discectomy is performed when the intervertebral disc have herniated or torn. It involves removing the protruding disc, either a portion of it or all of it by placing pressure on the nerve root. The disc material which is putting pressure on the nerve is removed through a small incision that is made over that particular disc. This is one of the most popular types of back surgeries and which also has a high rate of success. The recovery period after this procedure does not last longer than 6 weeks. The type of procedure in which the bony fragments are removed through an endoscope is called percutaneous disc removal.

Microdiscectomy may be performed as a variation of standard discectomies in which a magnifier is used to provide the advantage of a smaller incision, thus a shorter recovery process.

Spinal fusions are performed in cases in which the patient has had the entire disc removed or when another condition has caused the vertebrae to become unstable. The procedure consists in uniting two or more vertebrae by using bone grafts and metalwork to provide more strength for the healing bone. Recovery after spinal fusion may take up to one year, depending greatly on the age of the patient, the reason why surgery has been performed and how many bony segments needed to be fused.

In cases of spinal stenosis or disc herniation, laminectomies can be performed to relieve the pressure on the nerves. During such a procedure, the surgeon enlarges the spinal canal by removing or trimming away the lamina which will provide more space for the nerves. The severity of the condition as well as the general health status of the patient are key factors in establishing the recovery time, which may be range from 8 weeks to 6 months.

Back surgery can be performed to prevent the growth of benign and malignant tumors. In the first case, surgery has the goal of relieving the pressure from the nerves which is caused by a benign growth, whereas in the latter the procedure is aimed to prevent the spread of cancer to other areas of the body. Recovery depends on the type of tumor that is being removed, the health status of the patient and the size of the tumor.

Minimally Invasive Surgery (MIS) for Spine Treatment - World's Class Spine Hospitals in India

The term "Minimally Invasive" in most cases, when describing a surgical procedure, refers to a technique using small incisions to gain access to the particular area of the body needing treatment. By avoiding a larger incision, there can be less force from the retractors on the surrounding tissues, less tissue dissection, and usually better preservation of the surrounding blood supply to the tissues in the operated area. 

Ideally, these factors lead to quicker healing and a recovery with less pain, although these differences have not been proven conclusively. For an "open" procedure (non-MIS), the surgical wound is larger and more dissection is required. Retraction on the muscles, when kept in place during a long procedure, has been shown to cause damage to these muscles, with some of these effects possibly permanent.

The comparison between minimally invasive and open surgery can be made when describing a lumbar fusion. This procedure typically has the patient lying face down during the surgery, with the work done on the back side (posterior). With an open case, the incision is usually in the midline and the muscles are spread to the sides by retractors. Since the natural tendency of the muscles is to return to the midline, the force can be fairly high at the spot where the retractor is in contact with the muscles.

 If the surgeon tries to minimize the length of the incision with the open technique, he/she may have to use the retractors to spread harder to see the areas where the work needs to be done. These retractor-induced forces can be reduced somewhat by, paradoxically, making a longer incision. With a minimally invasive approach, usually a tubular retractor is used. 
After the appropriate level of the spine is identified with x-ray, first small, then sequentially larger tubes are placed, one over another, to dilate (expand) the opening. The force on the muscles is distributed more equally in a direction like spokes on a wheel, with less localized pressure and thus less potential for muscle damage.

While many patients will feel an attraction to the advantages of a minimally invasive approach, there still needs to be an understanding of all aspects of the surgical plan in order to make an informed decision. Patients need to know the rationale behind the proposed surgery, the chances of success and expected rehab course, and probably most importantly, the risks.

While minimally invasive spine surgery has many advantages, which are summarized below, anyone considering surgery on their spine should know that there are still potential risks, even with a small incision. An internet search of "minimally invasive spine surgery" will produce links to many websites STOCKED with shining 

testimonials of how much better the patients felt after the advertised procedure, but there is often little discussion of long term follow-up, rates of recurrence of symptoms, or risk of having no relief or being worse. Minimally invasive spine surgery is still spine surgery.

To summarize, the advantages  of minimally invasive spine surgery are:

Advantages:

• Smaller incisions, usually a few smaller scars instead of one larger scar
• Less tissue dissection
• Less damage to surrounding muscles
• Potential for less blood loss, quicker healing, shorter hospital stay, and less pain
• Quicker return to daily activities

For patients considering a minimally invasive approach, they should understand that each case is considered individually, and they should consult their doctor to see what might be appropriate treatment options after non-operative treatments have been exhausted.