4. Ambulatory Spine Surgery
Include those surgical procedures more
complex than office-based procedures but
less complex than major procedures
requiring less than 24 hours admission for
post anesthetic and patient monitoring.
5. Ambulatory Spine Surgery
• progress in diagnosis with MRI
• progress with surgical tools:
Better Endoscopic tools with minimal fiber optics diameter , a large
working channel , a flow integrated system keeping the surgical field
clear
• progress with anaesthesiology pain
prevention, patient comfort and security
• more people requirement against pain
6. Ambulatory Spine Surgery
• Advances in surgical technique and
technology have a profound effect on
shifting many surgical procedures
previously require long-term in-patient
hospitalization are now routinely
performed on an out-patient basis.
7. Day Spine Surgery procedures
at
Nova Medical Centers
Ambulatory
spine
surgery
Percutaneous
Endoscopic
Lumbar
Disectomy
(PELD)
Percutaneous
Endoscopic
Lumbar
Foraminoplasty
Fully
Endoscopic
Lumbar
Disectomy
Percutaneous
Transforaminal
Lumbar
Interbody
fusion
(Pe-TLIF)
Nucleoplasty
Kyphoplasty
9. Different Surgical Options For
Treatment of Slipped Disc
• Laminectomy : A traditional treatment
procedure
• Microdisectomy: This is referred to as
Gold standard
• PELD: Latest advancement
18. Photograph taken during the First International Symposium held at the Graduate Hospital in Philadelphia
in 1983. From left to right: Dr. Hijikata, Professor Adam Schreiber,Dr. Parviz Kambin.
20. Various types of lumbar disc herniation
treated by PELD
Far lateral type
Para central type
Inferior Migration
Central type Foraminal type
Superior Migration
21.
22.
23.
24.
25.
26.
27. Extended use of PELD
PELD is also suitable for
• elderly patients,
• patients with cardiovascular problems,
• patients who are afraid of surgery and
general anesthesia.
28. Advantages of PELD
• Immediate pain-relieve in 95 % of the cases
• Eliminating the possibility of resection of bone and
ligament
• Performing selective Disectomy
• No need for general anesthesia
• Outpatient treatment
• Faster rehabilitation
• Earlier return to work or sports
• Higher patient satisfaction
29. Nucleoplasty
• Contained herniated disc.
• Safe and controlled
method of removing the
bulged tissue.
• Performed on outpatient
basis.
• Rapid recovery of patients
30.
31.
32. Kyphoplasty (Balloon Kyphoplasty)
• Kyphoplasty is a used to
repair osteoporotic
fracture vertebrae.
• Restores the vertebral
body height.
• Reduces or eliminates the
back pain.
• Performed as an
outpatient basis.
• Allows in performing daily
activities
38. SUMMARY
• Percutaneous Endoscopic Lumbar Disectomy (PELD) is
a safe and sparing excision of herniated disc material for
disc prolapse.
• Nucleoplasty is a safe procedure for Contained Disc
Herniation.
• Kyphoplasty is a safe procedure for Osteoporotic
Vertebral Compression fractures.
• Pe-TLIF (Percutaneous Endoscopic Transforaminal
Lumbar Interbody Fusion) is the advanced technique in
Lumbar Interbody Fusion for severe Degenerative
Lumbar Disc Disease.
39. Take Home Message
Ambulatory Spine Surgery
or
Day Care Spine Surgery
Safe method
for all types of
Lumbar Disc Prolapse
Osteoporotic Vertebral Fractures
Lumbar Degenerative Disc Disease
40. MOVE A HEAD WITH TECHNOLOGY
Avicenna’s (980–1037 AD)
principal method of
treating spinal disorders
Modern Operative Room
41. Thank You
Day care Spine Surgery
Day Care surgeries. 24 hours.
No more. Maybe less.