Spine surgery has evolved through the years with new technologies emerging by the day. Sutureless spine surgery in Chennai is an endoscopic spine surgery or minimally invasive spine surgery which has revolutionized back and neck ailments.
There has been a colossal development in technology, equipment, instrumentation and procedures involved in spine surgery.
Sutureless spine surgery in Chennai involves minute tubes inserted through millimeter sized skin cuts, along with cameras to reach the infected part precisely without disturbing surroundings. These surgeries have better outcomes such as mitigated pain and speedy recovery as compared to traditional surgeries.
Owing to the technology development, the surgery is performed in day care basis with local anesthesia. Lasers and drills are employed to make cut the tissue, through incisions of few millimeters.
Focusing camera at the compression level of nerve allows the surgeon to access the pathology in more comprehensive way.
Endoscopic Spine Surgery (ESS) helps restore motion after operation. The procedure also suffices regional anesthesia and does not require general anesthesia. It also mitigates risks in senior patients or those with other health complications.
ESS cannot be confused with either minimally invasive or laser surgeries. A skilled ESS surgeon takes care to ensure that the tubular retractors minimize aspects such as need to cut tissues, blood loss, post-operative pain and assure fast recovery.
Sutureless spine surgery in Chennai cures herniated discs, spinal stenosis, facet arthritis, degenerative disc disease, spondylolisthesis and sciatica.
However ESS has drawbacks in its requirements where scoliosis, spinal instability, trauma, cancer discourage the procedure where traditional methods or minimally invasive spine surgery is recommended.
ESS is not suitable for revision surgery, spondylolisthesis and cancer. The specialized skill which is still in its early stage is practiced by few surgeons with regular records of proficiency.
Sutureless spine surgery in Chennai has a steep learning curve which needs extra training and careful candidature of patients whose anatomy is studied in detail.
Radiation exposure to patient and doctor, during sutureless surgery draws deep concern. Earlier experiences in sutureless surgery might include dural damage, dysesthesia, nerve injury to name a few.
Patient is administered with local anesthesia after which 1 inch incision is made and tubular trocar with approximately width of a pencil is inserted.
The spine is accessed either through intralaminar (back of spine between laminae) or transforaminal (back or side of nerve passage). A minute camera is inserted in trocar to the targeted operative field of the spine to the surgeon’s direct view. Such a view directs and guides the surgeon throughout the surgery.
Once the surgery is performed the trocar and camera are removed, incison is closed with small dressing.
Spinal cord has three tissue layers collectively known as meninges, which comprises dura mater, arachnoid mater and pia mater. Meninges is membrane enveloping the brain and spinal cord.
Arachnoid is sandwiched between pia (closest to central nervous system) and dura (outermost layer). Meninges has blood vessels which cover the cerebrospinal fluid.
Dura is susceptible to injury and tear while going through spinal surgery, as a result of which cerebrospinal fluid (CSF) leakage which surrounds the brain and spinal cord. This in turn causes CSF fistula formation, pseudomeningocele, meningitis, arachnoiditis and epidural abcess.
CSF leakage is indicated by positional headaches, nausea, vomiting and neck pain or stiffness. When a dural tear occurs it has postoperative management for 2 or 3 days and follow up of two to eight years.
Posterior approach is preferred over invasive anterior and lateral routes, given that the spinal cord is not subjected to hostile manipulation. Sutureless technique through laminoplasty repairs ventral CSF leaks.
In one instance, dural tear was repaired with non-penetrating titanium vascular anastomosis clips with no CSF leak reported in postoperative magnetic resonance images.
While endoscopic spine surgery is performed to treat prolapsed disc, minimally invasive spine surgery is performed for bones of spine.
Endoscopic surgery offers a two dimensional view of the three dimensional operative field resulting in a suboptimal visualization whereas microscopic surgery provides three dimensional view with little disruption to tissue.
In discectomy, endoscopic techniques have higher complications compared to microscopic techniques where the latter is preferred for disc removal.
Sutureless spine surgery in Chennai is considered as future of pain management as it cures the spine pain and does not just manage the same. The technique that was initiated in lumbar spine, is now employed in cervical, thoracic and thoracolumbar junction areas.
With developments in instrumentation and robotic technology, positive hopes bloom for motion preserving scoliosis surgeries and tumour resections. It would thus provide a cost effective, patient oriented health care.
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