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A new technique of discectomy based on pathophysiology of disc
International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Seyed M Rezaian
California Orthopaedic Medical Clinic, USA
Scientific Tracks Abstracts : Case Rep Surg Invasive Proced
Abstract:
Joseph Barr Professor of Harvard University in 1967, in a critical speech in San Diego said, “We must find another technique than laminectomy to avoid post-operative iatrogenic complications. The research for that goal has been continued since all over the world. The recent literature confirms that the sino-vertebral nerve, a tiny branch of a sensory, radicular nerve, after exiting inter-vertebral forename, in lumbar spine, turn back and re-enter into the spinal canal, innervates only one third of the posterior part of the disc and posterior longitudinal ligament. To observe this anatomical fact, we think the pain from herniated disc could be successfully treated by abolition of small part of disc without disturbing the stability of spine. The senior author has designed, a new technique called Universal Endoscopic Discectomy (UED), accordingly, just a small part of posterior part of disc under local anesthesia is removed or with the laser evaporate; like one surgery for treatment of all herniated discs, at any level and any ages as outpatient procedure. After complete evaluation of the patient, a dynamic disco gram is taken to pinpoint the site of problem. Then under fluoroscopic control and local anesthetist, 10 ml normal Salinas with epinephrine from poster-lateral was injected into the foremen (in lumbar spine and between carotid sheet and trachea-esophageal, in cervical spine). In this way, we created a column of water for safe passage of the guide wire dilating tubs, microscope and perpetuity forceps and laser beam. We removed protruded disc manually by pituitary forceps in younger and evaporated with Holmium laser in elderly. Since 1984 -2014, we have operated 1050 patients, ages range from 13-96 years. 1 to 20 years of follow up revealed that 92% were good or excellent, 2% poor, 5% fair, 3% lost in follow up complication, permanent nuro-vascular injury nail. Infection one drop foot in one temporary para paresis in 23, others nail. It is time that, we consider minimal invasive surgery as treatment for herniated disc under local anesthesia as outpatient procedure (acute or chronic).
Biography:
S M Rezaian is the Medical Director of the California Orthopedic Medical Clinic, Inc. He has completed his Orthopedic Surgery Residency training in London, England, under world-renowned orthopedic authorities. He has been a Member of the Royal College of Physicians and the Royal College of Surgeons in London, England, since 1969. He is an Active Member and Fellow of the British Orthopedic Surgeons. He is a Fellow of the International Society of Orthopedics and Traumatology (United States Section), a Diplomat and Fellow in Orthopedic and Spine Surgery of the International College of Surgeons (United States Section), and many other societies. He is licensed to practice in the State of California, Iran, and England, UK, where he completed his training and residency in Orthopedic Surgery. He is Board Certified by the American Academy of Neurological and Orthopedic Surgeons, 1984, Board Certified in Spine Surgery by the American Board of Spine Surgery, 1987. His clinical specialties include: orthopedic and spine surgery, management of back pain and back injury, treatment of failed back surgery and correcting complex musculoskeletal inquiries. He is a Former University Professor of Orthopedic Surgery with over 20 years’ experience in the practice of orthopedic medicine and surgery. He has over 100 published papers in the scientific literature, and he has made over 200 presentations of scientific papers at both the national and international level. He is an active member of more than 20 scientific societies, which includes the North American Spine Society, California Orthopaedic Association, Los Angeles Medical Association, California Medical Society, American Medical Association, American Back Society, and fellow of the International Society of Traumatic and Orthopedic Surgery. He has been Chairman of over 20 national and international scientific meetings. He is an Associate Professor of Orthopedic Surgery at the Western University of Health Sciences.
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