History:
A 50-year-old woman presented with complaints of lower back pain and bilateral lower limb pain persisting for 20 years, which worsened over the last 3 months. These symptoms started after the birth of her children. She sought treatment
at various hospitals but did not find relief. Although painkillers provided temporary relief, the pain would return once she stopped taking them. Consequently, she had to stop working completely for the past 5 to 6 months.
Despite trying various Ayurvedic treatments, none were successful. She also experienced neuroclaudication, where after 10 minutes of activity, she would
feel severe pain and restlessness in her legs, prompting her to rest. We
attempted different non-surgical treatments, but none alleviated her pain. She described her pain as unstable, worsening when transitioning from sitting to standing and vice versa. Her family and friends discouraged surgery, leading
her to delay it until her pain became unbearable. Ultimately, due to the severity
of her pain and lack of alternatives, she and her medical team decided to proceed with surgical intervention.
MRI:
The MRI findings suggest degenerative changes in the spine, including osteophytes, ligament thickening, disc herniation, nerve root compression, and a minor vertebral displacement. These findings can contribute to symptoms such as back pain, leg pain, and neurological issues.
Operation:
On August 1, 2023, a surgical procedure was performed under general anesthesia by Spine Specialist near Pune Dr. Sangram Rajale involving fusion at the L3-L4 level and transforaminal lumbar interbody fusion (TLIF) at L4-L5 using Jayon implants.
TLIF, or Transforaminal Lumbar Interbody Fusion, is a surgical technique used to treat conditions such as degenerative disc disease, spinal instability, and disc herniation in the lumbar spine (lower back). During TLIF, the surgeon accesses the spine through a small incision from the side of the back (transforaminal approach), allowing them to remove the damaged disc between two vertebrae (such as L4 and L5) and insert a bone graft or cage device into the disc space. This promotes fusion between the vertebrae, stabilizing the spine and relieving pressure on nerves. Screws and rods are often used to further support and stabilize the spine during the fusion process
Condition On Discharge:
She experienced immense satisfaction with the surgery; previously unable to walk 20 feet, she now climbed 10-15 steps at once. It felt like a rebirth to her, being virtually pain-free. She could sit and rise from the floor effortlessly, and her husband noted a remarkable 110% relief from pain, adding to their joy.