Healthcare

Biography

Biography: Sandeep Sherlekar

Abstract

From 2004 FDA approved percutaneous nerve root decompression. In 1995, Dr. Said Osman, presently with the American Spine Center, had published one of the earliest studies on the safety of this approach. From early 2013, the American Spine ambulatory spine surgery center has been leading the way for this procedure in Maryland, USA Methods: 150 cases who underwent endoscopic lumbar spine surgery from March 2013 ( 139 single level endoscopic discectomies, 41 two level endoscopic discectomies) were reviewed. The percutaneous transformational approach was used after determining the side from MRI evaluation. 4% patients underwent bilateral discectomies. Lidocaine was used to infiltrate the incision site and the area of surgical approach. Totally intravenous anesthesia ( TIVA) with Barbiturates, Propofol and Ketamine were the drugs used for all cases. All cases were operated with intraoperative neuromonitoring using free running EMG of the lower extemities. L5-S1 was the commonest level operated ( 49 patients). All patients went home the same day. 1 patient complained of severe radicular pain of a VAS level higher than pre-operatively. 2 patients developed a collection at the incision site due to infection, and required post-operative drainage at 2 weeks. The Median ODI score was 65% before surgery and 48% at 6 months. There was an average 3 point reduction in VAS at 6 months after surgery. Conclusion: Ambulatory Percutaneous Disc Surgery is an alternative to open surgery with the benefits of low post-operative morbidity and early mobility. Patient reported scores have shown satisfaction with the procedure.