Nephrology and Urology



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Overview

 


Percutaneous Endoscopic Lumbar Discectomy (PELD):




Percutaneous endoscopic lumbardiscectomy (PELD) is a new technique for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach.



Posterior Cervical Fusion is done through the back (posterior) of the neck. The surgery joins two or more neck vertebrae into one solid section of bone. The medical term for fusion is arthrodesis. Posterior cervical fusion is most commonly used to treat neck fractures and dislocations and to fix deformities in the curve of the neck. Surgeons sometimes attach metal hardware to the neck bones during posterior fusion surgery. This hardware is called instrumentation.


How Is The Surgery Done ?

An incision is made at the back of the neck, and the muscles pulled to one side. The lamina (the "roof" of the spine) may be removed in order to decompress the spinal cord, or only the part of the lamina may be removed that is over the foramen where the nerve roots are being trapped. A foraminotomy, making more room for the nerve root, or a discectomy, removing protruding part of the disc or disc fragments, may be done to relieve pressure on a nerve. The muscles are released and the incision is closed.

The cervical spine begins at the base of the skull and supports the weight of the head. The spinal cord runs from the brain down through the cervical spine, controlling the function of the body's organs and limbs. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shock-absorbers and allow for bending and movement of the head. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus.



Risks


There is a 90% satisfaction outcome from cervical laminectomies and discectomies. Complications are rare, but you need to be advised that they can occur.

Some Possible Complications Are:


  1. Pain, numbness, and clumsiness could occur even if the surgery is correctly done.
  2. There could be impaired muscle function or paralysis which is temporary or permanent.
  3. Incontinence or impotence could occur. This refers to loss of bowel, bladder or sexual function.
  4. Unstable spine is a possibility. Sometimes, in order to resolve the problem, so much bone is removed that the spine is left with weakness or instability. If there is not enough bone left to provide the appropriate amount of stability, it might be necessary in the future to contemplate having a spinal fusion which is a more extensive surgical procedure to reconstruct the weakness in the bones.

































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