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FACT :- Not all Surgeons are alike, Innovations in Surgical Technology have enabled a handful of uniquely trained Surgeons to perform minimally disruptive surgery, resulting in less discomfort and faster recovery for the patient.
Dr Vangani has specialized in minimally invasive surgery for Herniated Cervical and Lumbar Discs. These unique out patient procedures frequently allows patient to feel relief immediately after the surgery is complete. The surgery usually last only 30 minutes.
After the surgery, majority of the Herniated Cervical disc patient relieved of their neck and arm pain and Lumbar Herniated disc patients are relieved of their back and leg pain. Using an operating microscope Dr Vangani also performs more traditional spinal operations such as anterior cervical discectomy for Cervical Spine Spondylosis and Lumbar Laminectomy for spinal stenosis.
Many of our patients are physically active and are involved in various sports activity. Dr Vangani is keenly aware of their need to return to their previous performance level and tries very hard to achieve it. Also because of Dr Vangani's reputation, many of his patients come from various fields of medicine i.e. physician, nurses, gynecologist, psychologist as well as policeman, fireman, bank employees etc.
Dr Vangani frequently presents lecture and live demonstration of procedure of Cervical and Lumbar disc at many places in India.
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Anatomy & Causes
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The spinal column consists of 24 separate bones, called vertebrae, plus the fused bones of the sacrum and the coccyx. Your spinal column is the central support for the upper body, carrying most of the weight of your head, chest, and arms. Together with the muscles and ligaments of your back, your spinal column enables you to walk upright.
The Cervical region has seven vertebrae (C1 through C7), the Thoracic region has 12 vertebrae (T1 through T12) and the Lumbar region has five vertebrae (L1 through L5). The Sacral region consists of five vertebrae, all fused together to form one continuous bone mass known as the sacrum. The Coccygeal region consists of four vertebrae, all fused together to form the coccyx or tailbone.
Spine Parts & Its ImportanceThe Cervical VertebraeThe vertebrae in the cervical (or upper back) portion of your spine carry the weight of your head. The pressure from this weight along with the "wear and tear" associated with the constant turning and bending of your head and neck is what usually leads to problems associated with the cervical vertebrae.
The Lumbar VertebraeThe vertebrae in the lumbar (or lower back) portion of your spine are under constant pressure from the weight of your upper body, even when you are simply sitting in a chair. The "wear and tear" of this pressure is what usually leads to problems associated with the lower back.
The Intervertebral VertebraeThe intervertebral discs are composed of a fiber-like outer lining (the annulus) and a gelatin-like inner core (the nucleus). These discs act as the spine's "shock absorbers," preventing vertebra from rubbing against one another and providing much of the flexibility found in your spine. Because they are under constant pressure, it is the intervertebral discs which first show signs of the "wear and tear" associated with the aging process.
The Spinal NervesRunning through the center of the spinal column is the spinal cord, which ends in the lumbar spine in a bundle of nerves called the cauda equina. At each disc level, a pair of spinal nerve roots branch off from the spinal cord or cauda equina and pass through an opening called the foramen.
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Laser Discectomy
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Innovation and technology allow laser assisted surgeries to be utilized on a variety of medical conditions—safely and effectively. People suffering from pain caused by a herniated or "slipped" disc in the spine, now may find relief through minimally invasive laser surgery.
Initial treatment for a herniated disc is usually conservative such as physical therapy or anti-inflammatory medication to relieve pain and restore function. If symptoms persist, treatment may lead to a surgery called a discectomy. You and your doctor will discuss the best treatment based on your diagnosis. Laser discectomy replaces conventional spine surgery in 10-12 percent of disc cases requiring surgery.
In treatment of Lumbar Disc disease, it is useful and advantageous. Laser discectomy is an out patient procedure with one-step insertion of a needle into the disc space. Disc material is not removed, instead nucleus pulposus is burned by the Laser. In comparison to other discectomy procedures, Laser Discectomy is least invasive.
The aim of Pacutaneous Laser Disc Decompression (PLDD) is to vaporise a small portion of nucleus pulposus of an offending disc, thereby reducing the volume of a diseased disc and pressure within it, which is believed to exert an effect on noncontiguous portion of nucleus that is protuding through the annulus fibrosus and abutting on exiting nerve root.
A small change in disc nucleus volume can exert disproportionately large change in the intradiscal pressure.
Outcomes of a Laser Discectomy
Our initial results and those in the U.S.A. suggest that, in properly selected patients, Laser Discectomy using the Holmium/Diode Surgical Laser System is a safe and effective alternative to open operative discectomy. Our early studies suggest that 95% of patients with primary compressive nerve root symptoms are satisfied with the results of laser discectomy one year after surgery and 92% are satisfied by the end of the second year and 90% at the end of year 3.
The advantages of the Laser Discectomy over conventional surgery include:
- Performed as an out patient procedure.
- Do not preclude alternative surgical options.
- Reduced risk of complications.
- Usually provide immediate relief of symptoms.
- Reduced soft tissue injury.
- No bone is sacrificed.
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Endoscopic Discectomy
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Endoscopic Discectomy is an OPD surgical procedure to remove herniated disc material. Using local anesthesia with the help of XRay fluoroscopy and magnified video for guidance, a small specially designed endoscopic probe is inserted between the Vertebra and into Herniated disc space through skin of the back. Tiny Surgical attachments are then sent down the hollow center of the probe to remove a portion of the offending disc. Sometimes, the microsurgical attachments can be used to push the bulging disc back into place and be used for the removal of disc fragments and small burn spurs.
On average, the procedure takes about an hour. XRay exposure is minimal. You normally will feel little, if any pain or discomfort. Upon completion, the probe is removed and a small Band-Aid is placed over the incision. The amount of nucleus tissue removed varies and the supporting structure of the disc is not affected by surgery.
An Endoscopic Discectomy is different from an open disc surgery, because there is no traumatic muscle dissection, no bone removal and no large skin incision. The risk of complications from scarring, blood loss, infection and anesthesia that may occur with conventional surgery are drastically reduced and eliminated with this procedure. Endoscopic Discectomy was invented to be an effective treatment for herniated disc while avoiding these risks. Endoscopic discectomy is truely a minimally invasive procedure.
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