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Disc Hernia Surgery (Endoscopic) Tips

Endoscopy Discectomy For Sciatica Slipped Disc!

Dr. Varun Singla 87% (33 ratings)
MD, PDCC, MBBS Bachelor of Medicine and Bachelor of Surgery, FPCI
Pain Management Specialist, Delhi
Endoscopy Discectomy For Sciatica Slipped Disc!

Herniated Disc

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.

Causes

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.

 

Symptoms

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 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!

4116 people found this helpful

Hernia Surgery - What To Know About It?

Dr. C.S. Ramachandran 86% (587 ratings)
FICS, FCCP (USA), DNB (General Surgery), MS - General Surgery, MBBS
General Surgeon, Delhi
Hernia Surgery - What To Know About It?

Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). The hernia may be Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. The hernia can also originate from an incision (Incisional Hernia). The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the bellybutton. This results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm. Of all the hernia types, the Inguinal Hernia is the most common. 

Severe strain and muscle tear or weakness can result in hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of hernia. In case of hernia, the affected area tends to protrude or bulge out. If left untreated; hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.  

The severity of the hernia depends upon its size. In case the hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be Open or Laparoscopic. In open surgery, hernia is identified through an incision. Once located, the hernia is removed from the adjacent tissues. In Laparoscopic Repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.  In such repair, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chances of a recurrence.

Certain factors needs to be well addressed before performing hernia operation:

  1. Hernia operations, Laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
  2. Laparoscopic hernia operation should be avoided in case a patient has adhesions from previous surgery.
  3. Extreme care should be taken while performing a hernia operation in infants and children.
  4. In some cases, hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men. If you wish to discuss about any specific problem, you can consult a General Surgeon.
1762 people found this helpful

Hernia Surgery: What Should You Expect?

Dr. Preetham Raj 92% (10 ratings)
MBBS, MS - General Surgery
General Surgeon, Bangalore
Hernia Surgery: What Should You Expect?

A Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). Hernia can be an Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. It can also originate from an incision (Incisional Hernia).

The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (Inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the belly button, which results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm, and of all the hernia types, the Inguinal Hernia is the most common.

Severe strain and muscle tear or weakness can result in Hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of Hernia. In case of Hernia, the affected area tends to protrude or bulge out. If left untreated; Hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.

The severity of the Hernia depends upon its size. In case the Hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be open or laparoscopic. In open surgery, Hernia is identified through an incision. Once located, the Hernia is removed from the adjacent tissues. In laparoscopic repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.

In such repairs, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chance of a recurrence.

Certain factors must be well addressed, before performing a Hernia operation:

  • Hernia operations, laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
  • Laparoscopic Hernia operation should be avoided in case a patient has adhesions from previous surgery.
  • Extreme care should be taken while performing a Hernia operation in infants and children.
  • In some cases, Hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3676 people found this helpful

What Should You Expect From Hernia Surgery?

Dr. Nimesh Shah 84% (11 ratings)
MBBS, MS - General Surgery
General Surgeon, Mumbai
What Should You Expect From Hernia Surgery?

A Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). Hernia can be an Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. It can also originate from an incision (Incisional Hernia).

The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (Inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the belly button, which results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm, and of all the hernia types, the Inguinal Hernia is the most common.

Severe strain and muscle tear or weakness can result in Hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of Hernia. In case of Hernia, the affected area tends to protrude or bulge out. If left untreated; Hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.

The severity of the Hernia depends upon its size. In case the Hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be open or laparoscopic. In open surgery, Hernia is identified through an incision. Once located, the Hernia is removed from the adjacent tissues. In laparoscopic repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.

In such repairs, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chance of a recurrence.

Certain factors must be well addressed, before performing a Hernia operation:

  • Hernia operations, laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
  • Laparoscopic Hernia operation should be avoided in case a patient has adhesions from previous surgery.
  • Extreme care should be taken while performing a Hernia operation in infants and children.
  • In some cases, Hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men. If you wish to discuss any specific problem, you can consult a general surgeon.
2898 people found this helpful

Hernia Surgery: What You Need to Know About It

Dr. Ashok Gupta 92% (5463 ratings)
MS - General Surgery, MBBS
General Surgeon, Delhi
Hernia Surgery: What You Need to Know About It

It is believed that about 27% of all males and 3% of females can have a hernia during their lifetime. Factors like obesity, pregnancy, smoking, chronic lung disease aggravate the severity of the hernia.

What causes it?

When an organ residing in a cavity such as the abdomen tries to push through the muscular layer it resides in, it is called as hernia. Though said to be genetic, hernias can be caused by things such as improper heavy lifting, incorrect posture, or chronic constipation and as a result of surgical complication or injury.

Types of Hernia

Hernia can be an Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. It can also originate from an incision (Incisional Hernia).The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (Inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the belly button, which results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm, and of all the hernia types, the Inguinal Hernia is the most common.

Treatment of Hernia

In case of Hernia, the affected area tends to protrude or bulge out. If left untreated; Hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment.

Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.The severity of the Hernia depends upon its size. In case the Hernia is rapidly increasing in size, a surgery is needed for the repair.

The surgery performed can be open or laparoscopic. In open surgery, Hernia is identified through an incision. Once located, the Hernia is removed from the adjacent tissues. In laparoscopic repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.In such repairs, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chance of a recurrence.

4232 people found this helpful

Hernia

Dr. Ashok Gupta 92% (5463 ratings)
MS - General Surgery, MBBS
General Surgeon, Delhi
Hernia

HERNIA

Description:

A hernia is a weakness or defect in the lining of the abdominal (belly) or pelvic (groin) wall. It can be present at birth or develop over the years.

Signs and Symptoms:
You may see or feel a lump under the skin or in males a bulge in the scrotum (this is usually intestine). This may present with straining while lifting heavy objects, during a bowel movement or urination. Coughing and sneezing may also produce a bulge. The lump may disappear when laying down or even with gentle pressure. A hernia can be present without an obvious lump. It can be painful or cause a burning sensation. Sometimes it may be present for years without any symptoms.

Treatment:
What should you do if you suspect that you have a hernia? There is no acceptable nonsurgical medical treatment for a hernia. The use of a truss (hernia belt) can help keep the hernia from bulging but eventually will fail. The truss also causes the formation of scar tissue around the hernia making the repair more difficult. Have your doctor perform an examination, because if the repair is delayed it can result in incarceration (intestine is stuck and cannot get back inside) or strangulation (intestine is stuck and develops gangrene). The latter is an emergency.

The hernia will not go away, it will only get bigger. The bigger the defect the bigger the operation required to fix it.

Under certain circumstances the hernia may be watched and followed closely by a physician. These situations are unique to those individuals who are high operative risks, ie, severe heart or lung disease, or bleeding problems. Of course, even in the high risk person, if the symptoms become severe or if strangulation occurs, then an operation must be performed.

Surgical Options:
What type of operation is best for you? There are two main options for hernia repair:

1) Open Repair: The traditional, open repair has been the gold standard for over 100 years. There are 5-10 different approaches and can be performed routinely with local and intravenous sedation. Open repair is generally painful with a relatively long recovery period.


2) Laparoscopic Repair: Laparoscopic repair has been developed over the last 10 years. It is usually performed under general anesthesia but spinal anesthesia is an option. Local anesthesia can be used under special circumstances. Benefits of Laparoscopic (laparoscopic) repair compared to the open repair are: shorter operative time, less pain, and shorter recovery period.

Laparoscopic Hernia Surgery:
For Laparoscopic hernia surgery a telescope attached to a camera is placed through a small opening under the belly button. Two other small cuts are made (each no larger than the diameter of an eraser on the end of a pencil) in the lower abdomen. The defect is covered with a mesh (synthetic material made from the same material that stitches are made from) and secured in position with other stitches/staples/titanium tacks or tissue glue.

Risks to Laparoscopic Hernia Surgery:
As with the open operation, bleeding and infection can occur. The risk of nerve injury appears to be less than in open repair, as does the potential for recurrences of a hernia.

After the Operation:
Usually you can be discharged home a few hours after the completion of the Laparoscopic hernia operation. Take it easy the first few days. Walking stairs is allowed, and walking outside (weather permitting) is encouraged. Taking a bath or shower 48 hours after the operation is permitted. Avoid driving for at least 3 days and any time while taking pain medication.

Remember to make a follow-up appointment with your surgeon 1-2 weeks following the operation. Seek medical attention sooner if you develop fever, bleeding, severe belly pain, excessive swelling or nausea and vomiting.

7 people found this helpful

Hiatal Hernia - How You Can Treat It With Surgery?

Dr. Yogendra Kumar 88% (56 ratings)
MBBS, MS - General Surgery
General Surgeon, Ghaziabad
Hiatal Hernia - How You Can Treat It With Surgery?

Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small Hiatal hernia doesn't cause problems and you may never know you have a Hiatal hernia unless your doctor discovers it when checking for another condition.

But a large Hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large Hiatal hernia sometimes requires surgery.

Causes

Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughingvomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting Hiatal hernia is more.

The two common types of Hiatal hernia are:

  1. Sliding Hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of Hiatal hernia is less intense and has no symptoms.
  2. Fixed Hiatal hernia or Paraoesophageal Hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.

Symptoms

Usually, no symptoms are experienced during Hiatal Hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:

  1. Heartburns which become worse when a person lies down
  2. Chest pain, better called epigastric pain
  3. Problem in swallowing food
  4. Belching

Tests for Diagnosis

Several tests can be carried out for the diagnosis of Hiatal hernia. They include:

  1. Barium X-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, Hiatal hernia is signified.
  2. Endoscopy is another test for detection of Hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.

Treatment

Medicines, which are used to cure a Hiatal hernia may include antacids for neutralizing stomach acid, H2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of Hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:

  1. Exercise regularly and maintain a healthy weight
  2. Avoid lifting heavy objects and ask for help
  3. Avoid any kind of strain on the abdominal muscles

Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of Hiatal hernia.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2006 people found this helpful

All About Hiatal Hernia

Dr. Gaurav Bansal 91% (2207 ratings)
MBBS, MS-General Surgery , FMAS, FIAGES
General Surgeon, Gurgaon
All About Hiatal Hernia

Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small Hiatal hernia doesn't cause problems and you may never know you have a Hiatal hernia unless your doctor discovers it when checking for another condition.

But a large Hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large Hiatal hernia sometimes requires surgery.

Causes

Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughing, vomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting Hiatal hernia is more.

The two common types of Hiatal hernia are:

  1. Sliding Hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of Hiatal hernia is less intense and has no symptoms.
  2. Fixed Hiatal hernia or Paraoesophageal Hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.

Symptoms

Usually, no symptoms are experienced during Hiatal Hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:

  1. Heartburns which become worse when a person lies down
  2. Chest pain, better called epigastric pain
  3. Problem in swallowing food
  4. Belching

Tests for Diagnosis

Several tests can be carried out for the diagnosis of Hiatal hernia. They include:

  1. Barium X-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, Hiatal hernia is signified.
  2. Endoscopy is another test for detection of Hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.

Treatment

Medicines, which are used to cure a Hiatal hernia may include antacids for neutralizing stomach acid, H2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of Hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:

  1. Exercise regularly and maintain a healthy weight
  2. Avoid lifting heavy objects and ask for help
  3. Avoid any kind of strain on the abdominal muscles

Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of Hiatal hernia.

3175 people found this helpful

Ozone Discectomy For Disc Prolapse!

Dr. Neeraj Jain 85% (19 ratings)
MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Ozone Discectomy For Disc Prolapse!

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

  • Ozone Discolysis

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 

  1. The various treatment options have confused clinicians and investigators due to high failure rate and complications associated with different kinds of surgeries and interventions. There has been a surge of interest in the search for a safer alternative method of decompressing the nerve roots maintaining the structural stability.
  2. Another safe least invasive alternative therapy that has been receiving exposure in Europe is the use of medical Ozone (02/03 mixture) in the treatment of PIVD. Epidural steroid injection, transforaminal epidural decompressions has a high success rate (up to 85%), but chances of recurrences are there specially if these interventions are done at later stage. anaphylaxis following intradiscal chymopapain injection. Injection of Ozone for discogenic radiculopathy (low back pain with radiation to legs) has developed as a revolutionary alternative to chemonucleolysis and disc surgery .

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>

<p> </p> <p><strong>By Inhibiting inflammatory Nociceptors</strong></p> <ul> <li> <p>Synthesis of Prostaglandins & Secretion of Proteinases</p> </li> <li> <p>Liberation of Bradykinin and Pain Inducing Products</p> </li> <li> <p>Several studies suggest disc inflammation as a mechanism of sciatica due to disc herniation. Ozone has been shown to have an effect on the inflammatory cascade by inhibiting synthesis of proinflammatory prostaglandins or release of bradykinin or release of algogenic compounds; increased release of antagonists or 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 

  • Local production of Antioxidant Enzymes
  • Another action which may prove to be one of the most important is the stimulation of
  • Release of immunosuppressor cytokines like transforming growth factor, and IL-10 fibroblastic activity by ozone. Fibroblasts initiate the repair process by stimulating the deposition of collagen. Although yet to be validated, this mode of action could explain the resolution of PIVD on CT scans and the small percentage of patients who have relapses after the completion of treatment plan.
  • Ozone may have a reflex therapy effect called ‘chemical acupuncture’, breaking the chain of infection which is healed with antibiotics.

     

    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.

4671 people found this helpful

Surgery In Case Of Hernia - Factors That Needs To Be Addressed Before It!

Dr. Ashish Ganatra 90% (109 ratings)
M.S
General Surgeon, Rajkot
Surgery In Case Of Hernia - Factors That Needs To Be Addressed Before It!

Hernia may be defined as the protrusion of an organ into an adjacent connective tissue or muscle. The protrusion usually occurs through a tear or a weakened area in the muscle (Fascia). The hernia may be Inguinal Hernia, Umbilical Hernia, Hiatal Hernia or Femoral Hernia. The hernia can also originate from an incision (Incisional Hernia). The Inguinal Hernia is commonly observed in males. Here, the intestine squeezes through a tear in the abdominal wall into the groin (inguinal canal). At times, the small intestine bulges through the abdominal wall (weak spot) near the bellybutton. This results in Umbilical Hernia. In Hiatal Hernia, the upper part of the stomach passes into the chest through the diaphragm. Of all the hernia types, the Inguinal Hernia is the most common. 

Hernia during surgery is repaired & not removed. The hole or defect is closed either by non absorbable strong stitches or by mesh. Meshes are now available in various types and a treating surgeon may guide which one is best on case to case.

Severe strain and muscle tear or weakness can result in hernia. Obesity, chronic constipation, chronic coughing and sneezing, ageing, damage caused by injury, medical conditions like Cystic Fibrosis, contribute to increased incidences of hernia. In case of hernia, the affected area tends to protrude or bulge out. If left untreated; hernia can prove to be detrimental. One needs to consult a physician for proper diagnosis and treatment. Physical examination can help in the diagnosis of Inguinal Hernia. An ultrasound is needed to diagnose Umbilical Hernia. A Barium X -ray or endoscopy can be of great help in the diagnosis of Hiatal Hernia.  

The severity of the hernia depends upon its size. In case the hernia is rapidly increasing in size, a surgery is needed for the repair. The surgery performed can be Open or Laparoscopic. In open surgery, hernia is identified through an incision. Once located, the hernia is removed from the adjacent tissues. In Laparoscopic Repair, small incisions are made in the affected region. Through these incisions, specialized instruments are inserted. It is through these instruments that the surgeon visualizes and performs the surgery.  In such repair, a mesh, held in place by sutures is used as a scaffold. This facilitates the growth of new tissues in the affected person. This technique significantly lowers the chances of a recurrence.

Certain factors needs to be well addressed before performing hernia operation

  • Hernia operations, Laparoscopic in particular, should be performed by experienced surgeons. Inexperienced surgeons will do you more harm than good.
  • Laparoscopic hernia operation should be avoided in case a patient has adhesions from previous surgery.
  • Extreme care should be taken while performing a hernia operation in infants and children.

In some cases, hernia surgery might affect or injure the vas deferens in men. This in turn can affect fertility in men. In case you have a concern or query you can always consult an expert & get answers to your questions!

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