Minimally invasive technique makes same-day spinal surgery a reality for NHSGGC patients
A spinal surgery technique that improves outcomes for patients, and has the potential to bring down waiting lists, has been introduced at NHS Greater Glasgow and Clyde’s Institute of Neurological Sciences (INS).
The INS is currently the only centre in Scotland performing the minimally invasive surgery, which helps people suffering lumbar disc prolapse, and since it was introduced at the beginning of November it has already shown huge potential.
The procedure, called endoscopic lumbar discectomy, involves a surgeon making a tiny incision in a patient’s back – as little as 8mm wide – and then using an endoscope to see inside the patient and remove a prolapsed disc or free up spinal nerves.
And while it’s still a significant operation, the fact the incision is so small, and that the disturbance to surrounding bone, ligaments and muscle is significantly reduced, if not eradicated completely, the post-operative recovery is much better than traditional techniques.
Mohamed Abdelsadg, Consultant Neurosurgeon and Complex Spine Surgeon within the INS, said: “This minimally invasive procedure could offer a quick fix for acute disc prolapse unresponsive to analgesia and physiotherapy.
“After the operation we have seen much earlier mobilisation, and patients are generally treated and discharged within 24 hours – sometimes on the same day. There is also a much lower risk of infection.”
The development was made possible by a major investment of more than £200,000 from the Scottish Government.
Four consultant neurosurgeons at the INS – Mr Mohamed Abdelsadg, Mr Calan Mathieson, Mr Likhith Alakandy and Mr Chris Barrett – have already completed the appropriate trainings and are currently offering the procedure to patients from across the West of Scotland.
While it’s early days and patients are being carefully selected as the new technique beds in, staff are expecting that to change relatively quickly.
Mr Abdelsadg continued: “This is a new technique so we’re not offering the procedure for everyone at the moment and we are being quite careful about the cases we’re selecting.
“However, we’re on a steep learning curve. We’ve been auditing the results of the surgery, reviewing and sharing our data, and we’re seeing a pattern of improvement across the team.
“As our experience grows, we’ll be able to expand considerably the number and type of patients we’re able to treat.”
The minimally invasive technique is a significant departure from the more traditional procedure, called micro discectomy. That involves an incision of 5-8cm in the middle of the back, with the surgeon stripping away muscle and ligaments, often removing bone to create a ‘window’ to work in, and then removing the prolapsed disc or freeing up the nerves.
Because of the amount of tissue affected, this technique can be a more painful process with a raised risk of infection.
In the main, patients are often discharged within 48-72 hours, but they may suffer continuing back discomfort, and in some cases they need to stay in hospital for up to seven days because of the wound pain.
Susan Groom, Director of Regional Services at NHSGGC, welcomed this latest development. She said: “The INS has been in operation for more than 50 years now, and over that time it has earned an international reputation for pushing boundaries and innovation.
“The fact the Scottish Government supported the development of this new service here is testament to that reputation, and I would like to thank all those involved in bringing it to the INS.
“Traditionally, surgery to treat a prolapsed disc can be a painful procedure, so this new approach at the INS will help to reduce the suffering of patients more quickly, with quicker recovery times and with a much lower chance of infection.
“NHS services throughout the UK are under considerable pressure at the moment, and the fact this new minimally invasive technique will help reduce waiting times on top of other benefits is a significant added bonus.”
The INS team plan to continue collating their early results and then present them at the Society of British Neurological Surgeons conference in Belfast in March.
PICTURES
TOP – The INS team involved in the new technique – from left: Janie Smart, William Davidson, Nicola Ferguson , Carla O’Neill , Savitha Meleveedu, Likhith Alakandy, Mohamed Abdelsadg, Marios Theologu, Adam Ross. Kneeling: Johanna Armstrong.
BOTTOM – From left: Marios Theologu, Chris Barrett, Calan Mathieson.