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Minimally Invasive Spine Surgery
Gurvinder Deol, MD, discusses minimally invasive spine surgery techniques and the benefits of using these approaches (reduced hospital stays, less pain, quicker return to work and normal daily activities).
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Learn more about Gurvinder Deol, MD
Gurvinder Deol, MD
Dr. Gurvinder S. Deol is a board certified (FAAOS), fellowship-trained Orthopedic Spine Surgeon. He has a well-known reputation for excellent outcomes and cutting-edge procedures, and has extensive experience in the field of minimally invasive spine surgery. He frequently teaches techniques to neurosurgeons and spinal surgeons from around the world, and has recently developed new minimally invasive spinal technology that allows for more rapid recovery and minimizes postoperative pain typically associated with spinal surgery.Learn more about Gurvinder Deol, MD
Transcription:
Minimally Invasive Spine Surgery
Bill Klaproth: Back pain, which can often be connected to the spine is one of the most widespread health problems affecting four out of five Americans in their lifetime and nonsurgical, minimally invasive surgery may be the answer to eliminate chronic back and leg pain. Here to talk with us about minimally invasive spine surgery is Dr. Gurvinder Deol, spine surgeon with Wake Orthopedics. This is Wake Med Voices. A podcast from Wake Med Health and Hospital. I'm Bill Klaproth. Dr. Deol, thanks for your time. So for someone with chronic back and leg pain, who was a good candidate for minimally invasive spine surgery?
Dr. Deol: Basically someone who was had pain for anywhere from six weeks to three months who was failed extensive, not operative treatment, including physical therapy, various medications, maybe some injections that they continue to have pain either in their back or their leg. And an MRI has shown that they have either a pinched nerve or a compressive disc in their spine. Those people are good candidates for minimally invasive spine surgery.
Host: And then what are the different procedures you perform?
Dr. Deol: What we do is take the pressure off the nerves, the nerves go out of the back and into the legs. And so whether it's a discectomy or what we call a decompression, where we shave away bone spur to free up the nerve that's called a decompression or a discectomy. Then if the spine has some instability where one of the bones is move forwards on the other bone, then we sometimes also do a fusion. On both of those, whether it be a discectomy, or the fusion could both be done minimally invasively.
Host: So then what are the main benefits of minimally invasive surgery? It seems as if this is going to provide quicker recovery, less operating time, those types of things. So really that is the main benefit over traditional open surgery?
Dr. Deol: Yes, that's a great question. So I've been doing spine surgery, you know, for almost 20 years. And when I first started we would do big incisions, we would have more blood loss, people would stay in the hospital for two or three days. And now what we've been able to do over the last, probably five to 10 years, we've really evolved the ability to do the same surgery, do smaller incisions with less blood loss and essentially less muscle disruption under the skin. So we we're less ablative with the surrounding tissues were less ablated with the muscles. And so that way when we do smaller incisions, we have less blood loss and people a lot of times can either go home the same day or just spend one night in the hospital and go home the next day. But then their recovery is quicker. They typically have less pain and also they can hopefully get back to work or back to the activities they like quicker than with typical open surgery.
Host: So this does give you the ability to do outpatient spine surgery?
Dr. Deol: It does. And because we do it through smaller incisions and we lose less blood, and we can do surgery through these tubes and we use microscopes that way because of the things I mentioned people can go home the same day. So we can do spine surgery. In the outpatient setting, very much like sports medicine and hips and knees and shoulders have gone outpatient for many, many years. We now can do spine surgery outpatient because of essentially less blood, smaller incisions and less disruption to the surrounding muscles.
Host: So quicker recovery, less pain, and then a faster return to work and activities.
Dr. Deol: Yes. That's essentially, if you look at our data in regards to minimally invasive surgery, that's kind of panned out and people do well, and again don't have to have lengthy hospital stays.
Host: And then what about the long term prognosis after minimally invasive spine surgery? Do we know of the efficacy of this compared to traditional open surgery?
Dr. Deol: In the long run you achieve the same result, which is either to take the pressure off the nerve or to do a fusion. So now the good news is that we can do it less invasively, and essentially get the same outcome as an open operation.
Host: Right. So I know you kind of told us at the beginning who is a good candidate, someone listening to this may think, Hey, I'm a good candidate for this. I want that. Are there people that aren't good candidates for a minimally invasive spine surgery?
Dr. Deol: People who have had surgery before, they tend to have more scar tissue, so that can be a little more challenging to do surgery to small tubes or to small what we call key hole incision. And then more complex what we call deformity, where we're doing bigger reconstructive surgery. Those are typically not candidates for less invasive surgery at this point, but other than that there's really, we have a lot of minimally invasive spine surgery options both in the low back and the neck. And so most people believe it or not, tend to be quite good candidates. And obviously we tailor everything to the individual patient. But most of the time we do have good options to do less invasive surgery for most people.
Host: And is there anything else we should know about minimally invasive spine surgery?
Dr. Deol: I think it's come a long way in the last five years and I think spine surgery historically, obviously when you tell any patient that they need spine surgery or they're looking at spine surgery, can be quite intimidating. It can be very nerve wracking for someone to go through that kind of surgery. And so I think what we're able to do is take something that historically was very intimidating, middle, a little more anxiety provoking and say, look, we can do the same operation we do through small incisions and we can even do this in an outpatient center where you could even go home the next day. And people are quite amazed when we tell them that because their perception of, I think spine sugary is often the former, what we talked about. And so when we kind of educate them in regards to what can be done, that's the most compelling. And then just seeing these people go home either the same day or the next day and then they get back to work. They get back to their activities such as well, it's a point where their children or whatever they like to do. That's the most compelling thing about what we do and returning people to the activities they like to do.
Host: Well, the benefits of this are easy to see, easier procedure, less pain, quicker return to work in activity. So minimally invasive spine surgery really is a game changer for a lot of people. Dr. Deol, thank you so much for your time. This has really been fascinating.
Dr. Deol: Yeah, absolutely.
Bill Klaproth: That's Dr. Gurvinder Deol, a spine surgeon with Wake Orthopedics. I am Bill Klaproth with Wake Med Voices brought to you by Wake Med Health and Hospitals in Raleigh, North Carolina. To learn more about orthopedic services at Wake Med, please visit wakemed.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Wake Med Voices, a podcast from Wake Med Health and Hospitals. I'm Bill Klaproth. Thanks for listening.
Minimally Invasive Spine Surgery
Bill Klaproth: Back pain, which can often be connected to the spine is one of the most widespread health problems affecting four out of five Americans in their lifetime and nonsurgical, minimally invasive surgery may be the answer to eliminate chronic back and leg pain. Here to talk with us about minimally invasive spine surgery is Dr. Gurvinder Deol, spine surgeon with Wake Orthopedics. This is Wake Med Voices. A podcast from Wake Med Health and Hospital. I'm Bill Klaproth. Dr. Deol, thanks for your time. So for someone with chronic back and leg pain, who was a good candidate for minimally invasive spine surgery?
Dr. Deol: Basically someone who was had pain for anywhere from six weeks to three months who was failed extensive, not operative treatment, including physical therapy, various medications, maybe some injections that they continue to have pain either in their back or their leg. And an MRI has shown that they have either a pinched nerve or a compressive disc in their spine. Those people are good candidates for minimally invasive spine surgery.
Host: And then what are the different procedures you perform?
Dr. Deol: What we do is take the pressure off the nerves, the nerves go out of the back and into the legs. And so whether it's a discectomy or what we call a decompression, where we shave away bone spur to free up the nerve that's called a decompression or a discectomy. Then if the spine has some instability where one of the bones is move forwards on the other bone, then we sometimes also do a fusion. On both of those, whether it be a discectomy, or the fusion could both be done minimally invasively.
Host: So then what are the main benefits of minimally invasive surgery? It seems as if this is going to provide quicker recovery, less operating time, those types of things. So really that is the main benefit over traditional open surgery?
Dr. Deol: Yes, that's a great question. So I've been doing spine surgery, you know, for almost 20 years. And when I first started we would do big incisions, we would have more blood loss, people would stay in the hospital for two or three days. And now what we've been able to do over the last, probably five to 10 years, we've really evolved the ability to do the same surgery, do smaller incisions with less blood loss and essentially less muscle disruption under the skin. So we we're less ablative with the surrounding tissues were less ablated with the muscles. And so that way when we do smaller incisions, we have less blood loss and people a lot of times can either go home the same day or just spend one night in the hospital and go home the next day. But then their recovery is quicker. They typically have less pain and also they can hopefully get back to work or back to the activities they like quicker than with typical open surgery.
Host: So this does give you the ability to do outpatient spine surgery?
Dr. Deol: It does. And because we do it through smaller incisions and we lose less blood, and we can do surgery through these tubes and we use microscopes that way because of the things I mentioned people can go home the same day. So we can do spine surgery. In the outpatient setting, very much like sports medicine and hips and knees and shoulders have gone outpatient for many, many years. We now can do spine surgery outpatient because of essentially less blood, smaller incisions and less disruption to the surrounding muscles.
Host: So quicker recovery, less pain, and then a faster return to work and activities.
Dr. Deol: Yes. That's essentially, if you look at our data in regards to minimally invasive surgery, that's kind of panned out and people do well, and again don't have to have lengthy hospital stays.
Host: And then what about the long term prognosis after minimally invasive spine surgery? Do we know of the efficacy of this compared to traditional open surgery?
Dr. Deol: In the long run you achieve the same result, which is either to take the pressure off the nerve or to do a fusion. So now the good news is that we can do it less invasively, and essentially get the same outcome as an open operation.
Host: Right. So I know you kind of told us at the beginning who is a good candidate, someone listening to this may think, Hey, I'm a good candidate for this. I want that. Are there people that aren't good candidates for a minimally invasive spine surgery?
Dr. Deol: People who have had surgery before, they tend to have more scar tissue, so that can be a little more challenging to do surgery to small tubes or to small what we call key hole incision. And then more complex what we call deformity, where we're doing bigger reconstructive surgery. Those are typically not candidates for less invasive surgery at this point, but other than that there's really, we have a lot of minimally invasive spine surgery options both in the low back and the neck. And so most people believe it or not, tend to be quite good candidates. And obviously we tailor everything to the individual patient. But most of the time we do have good options to do less invasive surgery for most people.
Host: And is there anything else we should know about minimally invasive spine surgery?
Dr. Deol: I think it's come a long way in the last five years and I think spine surgery historically, obviously when you tell any patient that they need spine surgery or they're looking at spine surgery, can be quite intimidating. It can be very nerve wracking for someone to go through that kind of surgery. And so I think what we're able to do is take something that historically was very intimidating, middle, a little more anxiety provoking and say, look, we can do the same operation we do through small incisions and we can even do this in an outpatient center where you could even go home the next day. And people are quite amazed when we tell them that because their perception of, I think spine sugary is often the former, what we talked about. And so when we kind of educate them in regards to what can be done, that's the most compelling. And then just seeing these people go home either the same day or the next day and then they get back to work. They get back to their activities such as well, it's a point where their children or whatever they like to do. That's the most compelling thing about what we do and returning people to the activities they like to do.
Host: Well, the benefits of this are easy to see, easier procedure, less pain, quicker return to work in activity. So minimally invasive spine surgery really is a game changer for a lot of people. Dr. Deol, thank you so much for your time. This has really been fascinating.
Dr. Deol: Yeah, absolutely.
Bill Klaproth: That's Dr. Gurvinder Deol, a spine surgeon with Wake Orthopedics. I am Bill Klaproth with Wake Med Voices brought to you by Wake Med Health and Hospitals in Raleigh, North Carolina. To learn more about orthopedic services at Wake Med, please visit wakemed.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Wake Med Voices, a podcast from Wake Med Health and Hospitals. I'm Bill Klaproth. Thanks for listening.