Percutaneous Endoscopic Lumbar Discectomy (PELD)
Surgery in India Percutaneous Endoscopic Lumbar Discectomy (PELD) is quite a unique approach which is quickly getting popular amongst patients and surgeons in the treatment of nonsequestrated disc herniation (disc prolapse) as it reduces the post operative hospitalization and recovery time.
PELD or Percutaneous Endoscopic Lumbar Discectomy is an advanced minimally invasive spine surgery done for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. PELD is also a good treatment option in management of spinal tumors and structural deformities also in patients whose pain threshold is low or who are not responding well to conservative treatments like pain killers, anti inflammatory drugs and rehabilitation.
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.
Percutaneous Endoscopic Lumbar Discectomy is a minimally invasive day care procedure which is performed under local anaesthesia and mild sedation. The patient is made to lie on his front on the operation table and through an image intensifier X-ray system the entry point on patient’s body is mapped. There are two ways by which inter-vertebral disc is removed which could be manual or using laser.
A manual procedure, also known as automated percutaneous discectomy, entails inserting a long spinal needle from side of back directly into the disc bypassing other bone and ligament structures. A guide wire is made to pass through the spinal needle and after making an incision of 5 mm an endoscope is inserted. To the endoscope is attached a camera and monitor which provide visual help in removing the prolapsed part of disc.
The laser surgery or percutaneous laser discectomy uses an external imager or fluoroscope to direct the probe. Through this probe laser energy is passed which vaporizes a part of inter-vertebral disc material which helps in decompression of the nerve root. Holmium yttrium- aluminum-garnet (Ho:YAG) laser is the most frequently used laser for this treatment. Following the procedure, the wound is closed and single stitched. With this procedure the pain relief is immediate and the patient can soon resume work.
• Surgery done under local anesthesia with conscious sedation
• Very good technique for old and medically compromised patients.
• No muscle, ligament or normal tissue damage
• It saves the time and the costs. 75% of the patients discharged on the same.
• Due to rapid recovery, comparing to open surgeries, it is recommendable for the workers or students with the desire of early return-to-work.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed.
• Very good technique for old and medically compromised patients.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed.
Our world class spine hospitals in India are fully equipped with state of art diagnostic centres with advanced Digital X-ray, MRI and CT scan facilities and fully-equipped operating room with specialized equipment like endoscope and laser, to undertake such specialized procedures. The surgery is performed by experienced orthopedicians or neurosurgeons, who have specialized in spine surgeries and who have undergone specialized training in the world’s best spine surgery hospitals in USA, UK and Australia. Our hospitals also provide excellent patient care at extremely affordable costs which is just around 20-30% of the surgery cost in countries like US.
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