Endoscopic Spine Surgery

A Stitchless Spine Surgery under Local Anaesthesia for Back Pain or Sciatica

Back pain and Sciatica is a very common problem. It is estimated that nearly 70% population worldwide will suffer from debilitating lower back pain and Sciatica (pain radiating down the leg) at least once in their life. In most patients, this pain is short-lived and can be managed by medication and short periods of rest, but in some it is excruciating and debilitating. In severe cases, the spinal nerves are swollen and inflamed and may get compressed giving rise to numbness and weakness in the legs. This can affect mobility and disrupt daily routines.

Our spinal column is made of series of spinal bones and forms the protective tube for the passage of the spinal cord and nerves. These spinal bones are separated by intervertebral discs, which act like cushions or shock absorbing pads. When these discs get ruptured the jelly like nucleus escapes from them and touches the spinal nerves, giving rise to excruciating pain in the back and radiating in the legs along the nerve. This pain may be associated with numbness or weakness in the legs.
After detailed evaluation and MRI scans, the treatment is planned. In milder cases, it is treated with medication, rest and exercises. Nerve injections or spinal injections are given for moderate pain. Very few patients, not responding to conservative treatment or with structural change need stitch-less endoscopic procedure under local anaesthesia. The patient always retains the right of exercising his choice of surgical/non-surgical treatment.

Endoscopic spine surgery is a revolutionary minimally invasive procedure that effectively treats back and spine conditions. Using only local anaesthesia, this minimally invasive procedure leads to faster recovery when compared to standard open surgery. It is now a day-care procedure. It is done from the side by passing the endoscope into the affected disc by dilating the muscles and tissues. This approach preserves the natural structure and stability of the spine, as cutting of muscles and bone structure is totally avoided. This is a stitch-less procedure with the skin incision so small (7 to 8 mm) that it closes naturally and there is almost no blood loss.

1. The endoscope provides excellent visualization making it possible to remove the extruded, prolapsed or herniated part of the disc selectively
2. Lasers and Radio-frequency devices are used to ablate or shrink the hard tissue and bony overgrowth compressing the nerves allowing the surgeon to reach otherwise inaccessible areas without cutting the bones, as is done in conventional surgeries
3. The use of local anaesthesia is the biggest advantage of this procedure. The awake patient can give valuable feedback about the pain, making it a very safe procedure. The procedure is extremely safe for elderly patients with medical conditions such as diabetes, hypertension, cardiac or respiratory problems and for overweight patients, who are otherwise considered at slight risk for surgery or general anaesthesia
4. As it is stitch-less and done under local anaesthesia, the pain relief is significant and rapid and it is possible for many patients to walk home the same day, depending on their level of fitness. This avoids ICU monitoring and long hospital stays, no urinary catheters, no long term injections of higher antibiotics. It does not even require follow up dressings and all this makes it cost effective and affordable

• Back pain or pain radiating down your leg.
• Pain in the thighs, pain in the knees.
• Difficulty sitting crossed legged or when required to straighten the legs.
• Heel pain and difficulty getting out of bed in the morning.
• Leg or calf pain that disturbs the sleep or cramps in the legs.
• Very uncomfortable with cold temperature or sleeping under the fan.
• Disturbed sleep due to back pain on changing sides.
• Cramping and pain in the legs on standing or walking.
• Numbness or tingling sensation, burning of the soles.
• Weakness in the legs or foot and toes, footwear slipping off the foot.
• Urinary and bowel problems.
• If you have done an MRI or have taken spinal or epidural injection
• If you have already been told that you require a spinal surgery
• If you have disc prolapse.
• The stitch-less endoscopic procedure can be done for all types of disc degenerations, herniations, bulges, protrusions, extrusions or foraminal-stenosis.
• If you have answered yes to any of the above, you should have an evaluation to reach a precise diagnosis and treatment before you have major damage
• It can also be done in patients who have already undergone spinal surgery but have no relief.