Gleneagles Global Health City (GGHC), a leading quaternary care multi-specialty centre in Chennai, becomes the first hospital in the country to use real-time ultrasound guidance to remove a prolapsed disc through an endoscopic spine procedure on a 13 week pregnant woman.
Ms. Mohana from Salem had been experiencing severe back pain radiating to the leg and was unable to walk, stand or lie down in one single position. She was diagnosed to have a disc prolapse. As the pain progressed quickly, she had consulted many orthopedic surgeons, spine surgeons and gynecologists to assist her with the right solution for her acute pain without harming her unborn baby since it was her naturally conceived second baby, after her IVF conceived first baby 4 years ago.
She was told by other hospitals that she could either go ahead with the pregnancy and live with pain or to terminate her pregnancy before her spine surgery as X-ray radiation used during the endoscopic spine surgery is harmful to the fetus.
Following her online consultation with Dr Karunakaran she travelled to Chennai for the Endoscopic Spine procedure. After initial evaluations, the Interventional Radiologist Dr Mohnish and his team opted for an Ultrasound guidance (without X-ray radiation) for her spine procedure.
While all spine surgeries are performed using x-ray guidance and under general anesthesia, the team of medical experts a GGHC had to work in cohesion with each other to tailor-make the medical procedure based on the need of the hour. An Endoscopic discectomy, a minimum invasive surgical procedure, was performed for removing the prolapsed disc through an 8mm incision, using an ultrasonic mapping of the affected level (L4-L5) without causing any radiation hazard to the fetus under epidural anesthesia, thereby not causing any placental exchange of hazardous general anesthesia drugs.
The patient witnessed excellent pain relief post the procedure and was discharged on the same day.
Dr Karunakaran, Director – Institute of Spine Sciences, Gleneagles Global Health City, Chennai said, “I feel, doctoring is all about alleviating pain and saving lives. As a team, we were able to achieve complete pain relief without causing any harm to both the mother and fetus with absolutely zero x-ray radiation risk. While all her previously consulted doctors informed her that terminating her pregnancy is the only way to relieve her off her pain, here at the Advanced Endoscopic Spine Centre @ GGHC, we were able to both relieve her pain & continue with her pregnancy.
Dr Mohnish, Lead Interventional Radiologist, Gleneagles Health City, Chennai, added, “Interventional Radiology procedures are minimally invasive procedures where we choose the right modality like ultrasound or fluoroscopic x rays to do a procedure. In this case, we had to replace X-rays with ultrasound and support our spine department.
This new technique will help many pregnant mothers to undergo the procedure without causing any harm to the fetus. This is the first time in history, ultrasound has been used to identify the disc level in an adult patient without X-ray radiation. Interventional Radiology uses high end, cutting edge technologies for treatment and soon many people will be able to avail the benefits of Interventional radiology among health care providers.”
Dr Madhurima S, Senior consultant, Gleneagles Health City, Chennai, added, “Anesthesia during pregnancy has to be tailored to provide pain free surgery to the mother as well as minimize risks to both baby and mother. We chose an epidural anesthetic technique over general anesthesia to avoid drug exposure to the growing baby. Epidural anesthesia involves giving drugs near the spinal cord which temporarily numb the nerves at the surgical site, making surgery painless. The advantage of this technique is that no drugs are injected in blood or inhaled by the mother and exposure of drugs to the baby is avoided. As the surgery is performed in the prone position, we took care to position her without any compression of her abdomen. Close cooperation between spine surgeons, anesthetists, radiologists and obstetricians resulted in this success”
While commenting on this achievement, Dr Alok Khullar, CEO – Gleneagles Global Health City, Chennai, said, “Maternity brings great happiness and fulfilment to the family as a unit and I am thrilled that our Doctors were able to safely relieve the intense pain for Ms Mohana without any possible risk to the baby.”