Doctors at BLK Max Super Speciality Hospital provided a new lease of life to a 70-year-old patient who was suffering from severe back pain that radiated to his legs and affected his daily chores. A delicate keyhole surgery was performed in the spinal column to decompress the nerve roots that caused the pain. The patient had been suffering from severe pain in the back and lower limbs that affected his daily activities of life. He was not even able to walk for 50 metres and the pain would aggravate instantly upon standing for some time.
Despite trying to seek for a permanent solution at various centres, with all hopes lost, he presented to us as a last resort option. Detailed investigations revealed bilateral nerve compression at the L4-5 region (lower back), which required immediate surgical intervention. Pertaining to his age and other associated co-morbidities like diabetes and hypertension, the case was seemingly challenging. Since he had worsening claudication due to the severe canal stenosis, the team decided to perform minimally invasive Unilateral Laminotomy and Bilateral Decompression (ULBD) procedure, where decompression of the nerve roots and dura were performed through a keyhole incision bilaterally, and ensuring that the midline structure of the back is preserved. The entire procedure was done under the guidance of a microscope.
The minimally invasive procedure, medically known as Unilateral Laminotomy and Bilateral Decompression (ULBD) is claimed to be the gold standard treatment for treating patients with neurogenic claudication. In the procedure, a small keyhole incision on the skin is made to enroute the serial dilators to dock the interlaminar space in the spinal column. The minimally invasive nature ensures minimal blood loss, shorter hospital stay, quicker recovery and negligible post op complications like risk of infection etc.
It was a day care procedure, the surgery took less than an hour, but with excellent outcomes in such elderly morbid patients, as well. The patient has recovered very well and is able to sit and walk properly since the day of the surgery. He was discharged within a few hours post-surgery and his symptoms of leg pain improved immediately. He started uninterrupted walking for more than 30 minutes comfortably within a week.
In recent times, with the advent of latest technology, not only the procedures to treat spine related ailments have become minimally invasive but also the recovery time has come down, due to precise and painless treatment modalities.
(The Author is Senior Director & Head-Orthopedics Spine Surgery- BLK Max Super Speciality Hospital, New Delhi)
