What is Discectomy?
Discectomy refers to a surgical procedure that involves the removal of a damaged part of a herniated disk (also known as ruptured, slipped, bulging disk or disk prolapse) in the spine. A herniated disk is a condition where a portion of the soft material present in the disk pushes out from a crack in the tough exterior. The herniated disk may cause irritation or compression of the nerves located nearby, resulting in numbness, weakness and pain. These symptoms may affect the neck or the back and even radiate down to the arms and legs.
A doctor generally suggests discectomy to a patient if the symptoms have gradually worsened or the non-surgical treatments have not been effective. Though there are several ways for performing a discectomy, surgeons prefer minimally invasive discectomy, where small incisions are made and a small video camera is used for viewing purpose.
A patient may be recommended to undergo discectomy in the following circumstances:
What Procedure is followed :
It is important to follow the following pre-procedure instructions before undergoing a discectomy:
The surgery is performed by administering the patient with general anaesthesia. It can be done by one of the following methods or a combination of both:
After the surgery has been successfully completed, you will be shifted to a general bed where the doctors will monitor you and look for any complications related to the surgery or anaesthesia. You can go home the same day, or you may to stay in the hospital for a few days if you had a pre-existing health condition.
You can get back to work in 4-6 weeks after the surgery. In case your profession involves lifting heavy objects or operating heavy machinery, you may have to wait for 8 weeks before you resume working. Limit activities that involve bending, lifting or stooping for 3-4 weeks after the surgery. Also, avoid sitting down for long hours during this time.
Ensure to take your medications in time. A physical therapist will be able to teach you exercise for improving the flexibility and strength of your muscles around the spine.
Risk & Complication
Discectomy is generally considered to be a safe procedure. However, as with every surgery, there may be some risks that are associated with it. These complications also depend on your age, your general health condition, and how your body reacts to the surgery and the medications. Some of the complications that may occur are:
A discectomy reduces the symptoms of a herniated disc, but it does not cure the reason why the disc was actually herniated. To avoid injuring your spine once again, your doctor may recommend losing weight, go for low-impact exercises, and limit activities that involve repetitive or extensive twisting, bending or lifting. You can assume your normal diet, from the time you get back home. Fruits, vegetables and extra fluids must be added to avoid constipation.
Attending follow-up session with your doctor is important after undergoing a discectomy. You may also have to undergo an x-ray so that your doctor can analyse your progress.
The cost of discectomy would be approximately Rs. 2,25,000 – Rs. 2,75,000.
Ozone local anaesthesia with strict real time radiological control, which ensures the proper placement of Ozone in the center of the disc making it shrink.
Low Sciatica and PIVD
Among working-age people, as many as 20 percent experience back symptoms at least every year. facet arthropathy, sciatica, muscle strain, sacroilitis, bulging or herniated discs and degenerative disc disease. Prolapsed intervertebral discs (PIVD) are the most common cause of low back pain associated with a defined structural Abnormality.
Patients who are not helped by weeks of conservative therapy are often referred for pain that has persisted beyond a four-week period should be referred to a multidisciplinary pain center.
Different Non Surgical Interventions Employed Successfully:
Epidural Steroid Inj.
Epidurogram & Epidurolysis.
Nerve root sleeve/ transforaminal Inj.
Intra-discal steroid inj.
Nucleoplasty- Thermal & Mechanical
Conventional treatment methods for back pain comprise lamminectomy/ discectomy microsurgery, endoscopic disectomy and percutaneous arthoscopic disectomy, among others. These are invasive methods and their goal is to remove or contain the protruding disc. However, these methods have occasionally demonstrated a discrete incidence of failure and/or recurrence. Outcome studies of lumber disc surgeries ranging from 4% to 15%, have been noted. "In case of surgery, the chance of recurrence of pain is nearly 15 percent as against less than three percent in Ozone treatment.</p> <p><strong>Reasons for the failures</strong> of conventional surgeries are:</p> <ol> <li> <p>Dural fibrosis</p> </li> <li> <p>Arachnoidal adhesions</p> </li> <li> <p>Muscels and fascial fibrosis</p> </li> <li> <p>Mechanical instability resulting from the partial removal of boney & ligamentous structures required for surgical exposure & decompression</p> </li> <li> <p>Presence of Neuropathy.</p> </li> <li> <p>Multifactorial etiologies of back & <a href=">leg pain, some left unaddressed surgically.
Understanding the need for Nano-Technology
The use of ozone revolution for treating disc diseases
Muto suggested an intradiscal injection of Ozone for a disc Ozone injection into the intervertebral disc. After that successful outcome has been reported from various European centers. It is very important to note from those reports that complications are remarkably few. Not a serious single life-threatening complication was found even after 120,000 cases of Ozone nucleolysis, which stresses the safety of these procedures.
The most critical portion of performing any of the minimally invasive procedures is the accuracy and safe positioning of the needle (or terminal device) in the centre of the disc space. The risk in ozonucleolysis is particularly minimised, with the use of a very thin 22/25-gauge needle. It may take anywhere from 5 to 30 minutes to position a needle in the centre of the disc space under radiological guidance. Once the needle is safely placed in position, ozonucleolysis is completed in only another 2 to 3 minutes.
How does water contained within the domain of proteoglycans. The water binding capacity of the proteoglycan molecule is partially a property of its size and physical shape, but the main force that holds water to the molecule stems from the ionic, carboxyl (COOH) and sulphate (SO4) radicals of the glycosaminoglycan chains. The ozone can have a direct effect on these carboxyl and sulphate groups, breaking down some of these glycosaminoglycan chains which make up the proteoglycans. The destruction of these cross-linked structures reduces their ability to hold water therefore diminishing the size of the herniation by collagen fibers and signs of regression (vacuole formation and fragmentation)- a sort of disk “<strong>mummification</strong>.”</p> soluble receptors able to neutralize proinflammatory cytokines like interleukin (IL)-1, IL-2, IL-8, IL-12, IL-15, <a href=">interferon, and tumor necrosis factor. Therefore, by reducing the inflammatory components there is a corresponding reduction in pain.
By stimulating fibroblasts & immunosuppressor cytokines
In fact, over 120,000 patients have been treated successfully worldwide using the injection of medical ozone with a success rate of 80-90% and with a near nil rate of procedure-related complications. “The procedure is a safe and effective alternative to open surgical procedure. Patients get the advantage of going home after a short recovery on the same day. They generally go to work within a week and are spared prolonged absence from work and disability,” The treatment relieves pain substantially and, after two sittings, people "can go back to work under medical guidance".
Comparison: 1. More hospital stay One day/day care 2. Complications of prolonged surgery& spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular in European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post-operative discomfort or morbidity and low cost.
We all know that spine is one of the crucial parts of our body. The spine forming bones or vertebrae are protected by spongy and small discs. In healthy condition, these discs play the roles of shock absorbers for our spine and help to retain its flexibility. However, while a disc gets damaged, it might break open or bulge. This particular condition is known as ‘herniated disc’. This condition is also called ruptured or slipped disc. An individual can be suffering from the issue of the herniated disc in any of the part of his/her spine. However, most of the herniated discs influence the lumbar spine or lower back. Sometimes, it happens in cervical spine or neck and rarely this condition is seen in the thoracic spine or upper back.
A herniated disc might be sourced from the disc erosion. With age, the discs start drying out and they become unable to retain their flexibility. Another reason for which this problem can generate is spine injury. It might result in minute cracks or tears in the disc’s hard outer coating. While it occurs, the thick gel (from the internal part of the disc) might be forced out via the cracks or tears in the disc’s outer layer. As a result, the disc can become break open or bulge.
Whenever a herniated disc starts pressing the nerve roots, the affected person can feel pain, weakness, and numbness in the nerve traveling area of his/her body. When the herniated disc issue affects one’s lower back portion, it can generate numbness and pain in his/her buttock, as well as, down his/her leg and this condition is known as sciatica. It is the most prominent sign regarding a low back herniated disc. If a herniated disc does not provide pressure to the nerve, then the affected person might be suffering from a backache. Sometimes, there is no pain absolutely. Generally, a herniated disc heals automatically with the passage of time. The affected person should take patience and strictly follow the treatment plan provided by the doctor. In case, there is no change in the symptoms within the pre-specified period, then that person should consult the doctor about the appropriate surgery.
Endoscopic techniques for the purpose of diagnosis have been started since the late 1970s. Experts initiated the utilization of the popular techniques of endoscopic surgery in the 1990s, however, the particular technique is now used for the spine conditions’ treatment. In this procedure, pain and spine specialist make use of specialized instrumentation, as well as, video cameras and perform it through minute incisions. For alleviating interruption to one’s tissue and muscles, the surgeon receives access to the respective vertebrae through the placement of collections of tubes in the endoscopic spine surgery. The Endoscopic spine processes are usually executed in either 23-hour stay or an outpatient setting. The particular minimally invasive spine surgery is utilized for relieving pain sourced from pressing of herniated discs on nerve roots. In case you have a concern or query you can always consult an expert & get answers to your questions!
Also called as slipdisc pain or sciatica may affect your lumbar or cervical or throracic spine. But most common is l4 5and l5-s1 level or c5-6 level.
Most of painful condition of pertaining to your spine due to bulge, prolapse (protrusion), extrusion, sequestration. In with all condition nucleus pulposus come out from it originally site. Causing pressure over traversing or exiting nerve roots. Most of time patient getting treatment for of slipdisc or sciatica etc without any radiological evidence.
What causes pivd?
*unwanted prolonged exposure to sitting posture
*acute forward flexion
*unwanted weight lifting
*trauma or accident
*keep on exercise for chronic pain condition
What is symptoms?
Paresthesia, numbness, tingling sensation, burning sensation, spasms in thigh's and calf muscles, radiating pain upto knee or foot. Unable to sitting or standing for long hours, bowl or bladder incontinence, motor power affected
What are basic investigation?
X-rays only show alignment and fracture and displacement of vertebrae,
Mri scan shows all soft and hard structure of spine-all disc, nerve, ligaments, joint, vessel and muscles etc can be seen in perfect way
Emg, ncv, neurometry etc
There's two types of options for your spine pain, one is conservative treatment with bed rest, exercises and medicine. But upto certain duration 6week to 6month you can try with. If no red flag sign like loss of motor power. Or bowl bladder involvement should take opinion from surgeon.
Post procedure- follow up-
Regular physiotherapy and rehabilitation services is mandatory for strengthening of your spine.
Prognosis-success of procedure is 95%with all precautions and safety measures.
Lumbar disc prolapse is common
The mri images and symptoms of the patient need not necessarily match.
Here comes the role of pain management specialist
He examines the patient thoroughly and offers treatment options like root injections or endoscopic discectomy under local anesthesia
What is Discectomy?
What Procedure is followed :
Risk & Complication