CHENNAI: Gleneagles Global Health City (GGHC), Chennai, becomes the first hospital in the country to use real-time ultrasound guidance to remove a prolapsed disc through an endoscopic spine procedure on a 13-week pregnant woman.
Mohana from Salem had been experiencing severe back pain and was diagnosed with disc prolapse. She had consulted many orthopedic surgeons, spine surgeons and gynecologists. She was told that she could either go ahead with the pregnancy and live with pain or to terminate her pregnancy before her spine surgery as X-ray radiation used during the endoscopic spine surgery is harmful to the foetus. Following her online consultation with Dr Karunakaran she came to Chennai for the endoscopic spine procedure. After initial evaluations, interventional radiologist Dr Mohnish and his team opted for an ultrasound guidance (without X-ray radiation) for her spine procedure.
While all spine surgeries are performed using X-ray guidance and under general anaesthesia, the team of medical experts at GGHC had to work in tandem to tailor-make the medical procedure based on the need of the hour. An endoscopic discectomy, a minimally invasive surgical procedure, was performed for removing the prolapsed disc, using an ultrasonic mapping of the affected level (L4-L5) without causing any radiation hazard to the foetus under epidural anaesthesia, thereby not causing any placental exchange of hazardous general anaesthesia drugs. The patient was discharged on the same day.
Dr Karunakaran, director, Institute of Spine Sciences, GGHC, said, “As a team, we were able to achieve complete pain relief without causing any harm to the mother or foetus with absolutely zero x-ray radiation risk. While all her previously consulted doctors informed her that terminating her pregnancy is the only way to relieve her off her pain, here at the Advanced Endoscopic Spine Centre at GGHC, we were able to both relieve her pain and continue her pregnancy.”
Dr Mohnish, added, “Interventional radiology procedures are minimally invasive where we choose the right modality like ultrasound or fluoroscopic X-rays to do a procedure. In this case, we had to replace X-rays with ultrasound and support our spine department. This new technique will help many pregnant mothers to undergo the procedure without causing any harm to the foetus.”
The surgery
An endoscopic discectomy was performed for removing the prolapsed disc, using an ultrasonic mapping of the affected level