The Problem
“I was in pain for the last 20 years and after surgery, it feels like that pain was a nightmare,” said the patient.
A 66-year – old lady from Bangalore visited our centre with complaints of sever low back pain which was radiating into legs. Pain was associated with numbness in left leg. Patient has been progressively losing height also.
During Diagnosis
On detailed assessment she was diagnosed as a case of degenerative lumbar scoliosis which was gradually progressing. Degenerative lumbar scoliosis causes back pain radicular leg pain due to stretching of nerves or compression over nerves and causes severe pain at the site where rib cage starts touching the pelvis.
Detailed discussion was done with patient and family and all non-operative treatments were discussed. Patient came back to us for surgery after failing 4 months of conservative treatment.
Before Surgery
Considering her age, she was planned for advanced minimally invasive surgery for degenerative scoliosis. Surgery was done in 2 stages at an interval of 1 week.
In Stage 1: We did approach the spine from side of abdomen and changed 3 discs L1-L2, L2-L3 and L3-L4 with OLIF cages. OLIF (Oblique Lumbar Interbody Fusion) allows us to put large lordotic cages through the side of abdomen in minimally invasive manner, leading to very fast recovery and 3-dimensional correction of scoliosis.
After Surgery
In stage 2: Posterior Spinal Fusion was done from D10 to Sacrum. L4-L5, L5-S1 disc were removed and replaced with TLIF cages. She is now happy, pain free enjoying her life.
Conclusion
Advanced minimally invasive techniques have allowed us to achieve good results in this highly complex disorder of degenerative scoliosis. But surgery should be done only where patient’s disability is severe and all non-operative treatment option are exhausted.