Background: The female had severe back pain and bilateral leg pain. She was 150 kg in weight and mostly confined to the bed because of pain. She had multiple medical problems like Obstructive Sleep Apnoea. She could not lie down comfortably due to pain. The patient could hardly walk due to pain and weakness. Crippling back pain and leg pain throughout the day and more in the night made her life miserable. Patient used to spend several nights without sleep.
Diagnosis: X-ray showed Spondylolisthesis at L5-S1 i.e. slippage of vertebrae over each other. MRI showed Lumbar Spinal Stenosis i.e. severe narrowing of spinal canal. It was clear that she needed surgery to treat the problem. Doing open spinal surgery would be associated with huge risk due to medical problems. It would also increase the risk of infection and blood loss.
Due to disability from crippling back pain and leg pain, minimally-invasive fusion was planned. Doing minimally-access surgery in such morbidly obese patient was a difficult task. Special long instruments for the surgery were made ready and the surgery was planned.
Minimally-Access Surgery: Guide wires were placed under fluoroscopy control. Position of guide wires was confirmed on X-ray. With tubular retractors decompression was done and interbody fusion was done. Minimally-invasive PLIF was done successfully by Dr Abhijit Pawar. The procedure was complete in 2.5 hrs with almost no blood loss.
Recovery: On post operative day 2, patient was relieved of her back pain and leg pain. She started walking without support. On post operative day 5, the patient was discharged. Now she walks for longer duration and also sleeps well. Family is glad that she underwent this advanced procedure and her quality of life has dramatically improved.
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