“Spinal surgery for disc disease is usually a safe procedure, with a success rate of 90-95 per cent,” informed Dr Ehsan Bari, Assistant Professor and Consultant Neurosurgeon, Aga Khan University Hospital, Karachi (AKUH,K). He was speaking on the topic “Sciatica and Lower Back Pain' at the ‘Signs, Symptoms and Care' programme organised by the University Hospital in Quetta.
He said that surgery may be an option in cases where sciatica pain may indicate a more serious process, for example if the pain is accompanied by fever, loss of bladder or bowel control or progressive weakness in the limbs. Sciatica, is a medical condition in which pain along the large sciatic nerve runs from the lower back down the back of each leg. This is usually caused by pressure on the sciatic nerve from a ruptured vertebral disc, also known as “pinched nerve.”
Dr Bari said that low back pain is an extremely prevalent condition, and that nearly everyone at some point in time has back pain that interferes with their work and routine daily activities. Most low back pain can however be treated without surgery and treatment includes exercise among others. It is advisable to consider surgery if the back pain is severe and has not improved after six to twelve weeks of medical therapy.
Speaking on ‘Advancements in Brain Surgery,' Dr Bari said that due to the unforgiving nature of the nervous system, there is only a little space, if any at all, for trial and error. Surgeons need to be careful and sure of their diagnosis when deciding for brain surgery. The recent boom in technology and computer science has led to phenomenal advancements in neurosurgery. Endoscopic neurological surgery and image guided surgery (neuronavigation) has been increasingly used to treat neurological disorders. Using this technique, surgeons are able to navigate through the fluid-filled chambers of the brain, the ventricles, by introducing small endoscopes via tiny "keyholes" in the skull.
Endoscopic technology can also be used in conjunction with image-guided surgical navigation techniques, which rely on computer reformatting of radiographic image data. Patients undergo magnetic resonance imaging (MRI)-scanning prior to surgery and this information is used continuously by the surgeon to help guide the operation.
It must be emphasised that image guided surgery cannot substitute for good knowledge of surgical anatomy and experience. These tools have become essential for doing any kind of complex brain surgery and their use has led to improved patient outcome; shorter hospital stays, minimised morbidity and mortality.
As part of its outreach programme and societal commitment of creating awareness of early diagnosis and timely treatment, AKUH organises health awareness programmes. The Hospital has organised over 230 ‘Signs, Symptoms and Care' programmes in Karachi, Hyderabad, Quetta and the UAE, benefiting more than 45,000 people. AKUH's Patient Welfare Programme reaches out to patients by providing assistance to those patients who are unable to afford the medical cost of their treatment. 73 per cent of all patients treated at the AKUH are from low- to middle-income areas. Since the inception of this welfare programme in 1986, over PKR 1.6 billion has been disbursed to more than 300,000 needy patients.
