Procedure of Percutaneous Endoscopic Lumbar Discectomy (PELD) in India

Percutaneous endoscopic lumbar discectomy is the ultimate form of minimal invasive spine surgery. It is an endoscopic daycare surgical procedure which is conducted in about 60 minutes, under local anesthesia with mild sedation. Patient is made to lie on his front on the operation table and exact entry point is mapped on patient’s body using image intensifier x-ray system. A small incision is made about 8-10 centimeters from the midline on the posterior part of the body. Now there are two different ways in which the inter-vertebral disc material can be removed (i.e. manually or using laser).

Manual procedure also known as automated percutaneous discectomy involves insertion of a long spinal needle from side of back, directly into the disc, by-passing other bone and ligaments. Through this needle, guide wire is passed and after taking 5mm incision, dilator and working cannula are passed, through which endoscope is inserted. Camera and monitor is attached to endoscope and prolapsed part of disc is removed under vision.

The laser surgery is referred to as percutaneous laser discectomy (PLD), which uses an external imager called the fluoroscope to direct the probe. The probe delivers laser energy which vaporizes a part of the inter-vertebral disc material and decompresses the nerve root. The most frequently used laser for treatment is Holmium yttrium- aluminum-garnet (Ho:YAG) laser.

In either procedure, the wound is closed with single stitch. Patient gets immediate pain relief and he can go home in 24 hrs and can resume his work soon.

Who may require Percutaneous Endoscopic Lumbar Discectomy

Individuals suffering from chronic low back pain and disability may benefit from a PELD procedure. It is often used to treat patients suffering from degenerated discs, bulging discs or herniated discs that compress upon the surrounding structures within the spinal canal causing nerve compression, sciatica and low back pain.

It can also be used if the patient fails to respond to conventional management therapies including direct injection therapies for three months or more. The surgery is also found to be successful in resection of spinal tumors, fusion and structural deformities of the spinal cord.

Relevant Anatomy

The human spine is made up of 33 bony segments called vertebrae which are stacked one above the other. These vertebrae are separated by small, soft, cushion like structures called the intervertebral discs that act as shock absorbers. These discs undergo degeneration due to age related wear and tear, resulting in disc herniation or prolapse. They compress the surrounding soft tissues or nerves giving rise to severe pain. If the vertebral discs in the lower back or the Lumbar region are compressed, they result in pain and tingling in the legs and spasms in the back.

Comprehensive Spine Surgery and Treatment at World Class Neurosurgery Hospitals in India:

• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral XT scanning , MRI and Electrophysiology unit all under one roof.
• Use of most advanced Surgical techniques for treatment of spinal ailments with focus on Minimal Access Micro Endoscopic spine surgeries, Functional spine preservation techniques and Spinal Arthroplasty for all( disc diseases) as well as instrumentation. Minimally Invasive Surgery ensures quicker recovery and return to active life. 
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.

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