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6 Treatment Techniques That Doctors Must Expertise In for "Spinal Diseases"
Therefore, expertise means that a physician can apply their knowledge to treat various spinal diseases through a variety of techniques. Of the six current treatment techniques that are noteworthy, if a physician can master all of them, it will benefit patients by allowing them to choose the most appropriate treatment method.
The following techniques will vary in complexity depending on the tools used.
1. Treatment with "laser".
This is one of the modern techniques in the treatment of herniated discs. It requires high skill and precision from the physician. The use of fluoroscopy and MRI allows doctors to visualize the disc's location in real-time, enabling accurate needle insertion and device placement, minimizing nerve damage.
Lasers are a technology that requires meticulous understanding and control. The physician must adjust the energy level appropriately to generate enough heat to contract the intervertebral disc without damaging nearby tissues. Every movement of the needle must be steady and precise, much like creating a work of art demanding the utmost precision.
2. Percutaneous Stenoscopic Lumbar Decompression (PSLD) surgery.
This is the most commonly used method by doctors for treating spinal conditions. It requires specialized knowledge and skills in several areas, beginning with the use of fluoroscopy to pinpoint the location and guide the insertion of the endoscope to accurately target the treatment area.
The doctor will then perform the treatment using a monitor that displays magnified images of the inside of the spinal canal in detail. This allows them to safely use special instruments to grasp and cut away tissue that is compressing a herniated disc or compressing it from bones, joints, and ligaments. The use of cameras and equipment is difficult and requires extensive training from the doctor to achieve proficiency.
Furthermore, skills in managing complications and post-operative care are required to ensure rapid patient recovery. Therefore, lower spine surgery has unique structural characteristics that differ from cervical spine surgery. Studying more about the anatomy of the lower spine and managing dense fascia to reduce surgical risks is crucial.
3. PSCD (Percutaneous Stenoscopic Cervical Decompression) or EPCF (Endoscopic Posterior Cervical Foraminotomy)
Cervical spine surgery is a minimally invasive technique requiring specialized skills because the neck is close to the spinal cord and vital structures such as nerves and blood vessels. Therefore, physicians need a thorough understanding of the anatomy of the cervical spine. Before treatment, fluoroscopy is used to guide the precise insertion of an endoscope. The procedure is then performed while monitoring magnified images of the spinal canal, allowing the physician to use specialized instruments to safely grasp and remove tissue compressing the nerves without damaging the spinal cord.
4. Full Endo TLIF (Full Endoscopic Transforaminal Lumbar Interbody Fusion)
Full Endo TLIF is a specialized surgical technique requiring a high level of knowledge and expertise. Treatment with Full Endo TLIF demands advanced skills, particularly expertise in selecting and installing joint fusion devices such as interbody cages and bone grafts, which must be appropriately fitted to the patient's spinal structure. The placement of these devices requires high precision and controlled movement within confined spaces, utilizing an endoscopic camera providing magnified images along with fluoroscopy for guidance to ensure safe positioning. The surgeon must also be skilled in controlling percutaneous screws to stabilize the bone without damaging nerves and vital tissues, thus ensuring efficient surgery and minimizing complications.
Surgeons who are skilled in endoscopic surgery may have the necessary experience for performing Full Endoscopic TLIF, but further training and education are still required, particularly in areas such as interbody cage placement and the use of fusion instruments.
5. Endoscopic ACDF (Endoscopic Anterior Cervical Discectomy and Fusion) surgery.
Cervical spine surgery is a complex procedure because it involves accessing the front of the neck, a region teeming with vital structures. It requires in-depth knowledge of cervical spine anatomy, particularly the delicate structures such as nerves, blood vessels, and other crucial organs. Physicians must be skilled in operating an endoscope to accurately visualize and access confined spaces, and use fluoroscopy to guide the placement of fusion devices such as interbody cages and bone grafts. These devices must be securely positioned to avoid damaging tissues or nerves. The surgeon must be proficient in selecting the right equipment and managing complications such as hemorrhage and nerve injury to ensure a successful surgery and safe patient recovery.
6. Bone Cement Injection
This is a treatment method for patients with spinal fractures, cracks, or collapses who do not want surgery. This method requires a high level of specialized expertise and experience from the physician, as the treatment procedure requires precise and clear planning. The cement injection must be completed in a single session and cannot be reversed in an operating room. Therefore, specialized skills are necessary to ensure patient safety.
The procedure begins with the use of fluoroscopy to precisely track the needle's position as it is guided into the fractured bone. Doctors must practice controlling the needle insertion in confined spaces to ensure it reaches the desired point without damaging nerves and surrounding tissues.
Controlling the amount and distribution of the injected cement is also crucial. It must be the right amount to strengthen the bone without leakage. Finally, the physician must be skilled in managing complications, such as cement leakage to nerves or blood vessels, to ensure the most effective and safe treatment possible.
Therefore, with the rapid advancements in medical technology, at S Hospital we prioritize treating the root cause, emphasizing expertise in a variety of technologies, including PSLD (Percutaneous Stenoscopic Lumbar Decompression), PSCD (Percutaneous Stenoscopic Cervical Decompression), and laser treatment. We are the first hospital in Thailand to utilize these techniques to treat patients.
But the most important thing is for doctors to assess and choose the most appropriate treatment method for the patient's benefit, so that they can return to their normal life. "Because your smile is our reward."
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