Patient Name : Mrs. Revane
Age : 49 years
Introduction
A 49-year-old woman presented with 8–10 years of whole-spine pain, severe low back pain, bilateral leg radiation to the toes, neck pain, and upper limb numbness. MRI revealed L3-L4 & L4-L5 disc prolapse with lumbar canal stenosis. She underwent Unilateral Biportal Endoscopic Decompression, Fixation & Fusion and achieved complete recovery with full resolution of neurological symptoms.
Patient History & Presentation
- Low back pain + bilateral leg radiation
- Whole-spine pain for almost a decade
- Neck pain + bilateral upper limb numbness
- Claudication: 5 minutes
- Standing tolerance: 30 minutes
- Pain aggravated while sitting, getting up, turning in bed
- No bowel/bladder issues
Examination:
- Hyperlordotic gait
- L4-L5 tenderness
- Left slouch test positive
- Power: 5/5
- Reflexes: right knee brisk
- Sensations: normal
The symptoms clearly indicated multi-level nerve root compression.
Diagnosis & Radiological Findings
MRI (19/12/2024):
- Bilateral paramedian disc protrusion at L4-L5
- Compression of nerve roots
- Lumbar canal stenosis
Diagnosis:
L3-L4, L4-L5 Disc Prolapse + Lumbar Canal Stenosis
Surgical Procedure
Performed on 20/02/2024:
Unilateral Biportal Endoscopic L4-L5 Decompression
Precise minimally invasive nerve decompression.
Fixation & Fusion
To stabilize the affected segments.
Dural Tear Repair
A small intraoperative dural tear was closed with:
- 5-0 Prolene sutures
- Duragen patch reinforcement
Technique Advantages:
- Minimal tissue damage
- Faster healing
- Better visualization
- Lower postoperative pain
People Also Ask (SEO):
- Is endoscopic spine surgery safe? → Yes, especially for multi-level disc disease.
- Does a dural tear affect outcomes? → When repaired properly, patients recover normally.
Post-Operative Recovery
- Full weight-bearing walking
- Stair climbing
- Wound clean & dry
- No fever
- Sensations intact
- Distal pulses normal
Long-Term Outcome (3–6 Months)
- 100% relief from back pain
- Complete relief from bilateral leg radiation
- Neck pain reduced significantly
- Upper limb numbness resolved
- Standing > 1 hour
- Walking > 1 hour
- No neurological deficits
- Patient extremely satisfied
Why Surgery Was Necessary
- Years of unresolved spine pain
- Multilevel disc prolapse
- Progressive claudication
- Significant nerve root compression
Biportal endoscopic surgery offered the least invasive and most effective solution.
About Dr. Sangram Rajale
Dr. Sangram Rajale is a Pune-based Spine Surgeon specializing in:
- Endoscopic Spine Surgery
- Biportal Endoscopic Fusion
- Minimally Invasive Spine Fusion
- Sciatica & disc prolapse treatment
He consults at The Spine Doctor – Bavdhan, Pune.
FAQs
A minimally invasive two-portal technique for decompression and fusion.
Yes, with microsuturing and collagen patch reinforcement.
Most patients walk within 24 hours.
Because the disc compresses the nerve roots.
Only when instability or multi-level disease is present.