Nashik resident Shobha Rathi (52) was suffering from excruciating lower back pain for the last three months. She was unable to sit on the floor for her daily prayers and found it difficult to walk or take the bus to get to the rural primary health centre where she works as a nurse.
But life changed after a unique surgery at Lilavati Hospital in Bandra. “I do not experience pain while walking now. I will be able to sit on the floor also soon,” she said.
Tests revealed that Rathi’s back pain was due to a condition called spinal instability, where a segment in the lumbar (lower) region of her spine became loose or unstable due to daily wear and tear. This causes the spinal canal to become narrow leading to pressure on the spinal cord and nerve roots (See graphic).
Rathi came to Mumbai for treatment.
On February 23, senior neuro and spinal surgeon Dr P.S. Ramani implanted a new high-tech device between two of Rathi’s spinous processes (protruding bones in spine) using a minimally invasive procedure.
The device, which is called In-Space percutaneous interspinous distraction device, keeps the processes apart and eases the pressure on the spinal cord.
It also allows the spine to bend in all directions.
“Devices that reproduce the function of the region have been available for a few years but they were about three-cm long. We had to make a fairly big cut to implant them,” said Dr Ramani.
“The new device is just 12 to 16-mm in diameter and can be implanted without any incision.”
The surgeon pointed out that the device is cheaper — it costs Rs 40,000 — compared to older devices that cost Rs 70,000. “The patient is also mobile immediately after the surgery and can be discharged on the same day,” he said.
Though the incidence of instability in the spine is not known and it is ten times less common than slipped disc, it is still a fairly common cause of backache.
“It is more common among people from the lower middle class and lower class because they do more physical work,” said Dr Ramani.
He added that the new device could be used only if the instability has not caused too much damage and when the upper vertebra is likely to move backward (retrolisthesis).