Bloomington / Normal, IL

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Newest Technique for Relief of Back Pain


By Becky Weise

Minimally invasive surgery” has been a medical buzz term for the past few years, and for a very good reason. Most traditional surgeries have a minimally invasive option. These options offer improved patient outcomes with a quick recovery.

For example, most traditional spine surgery involves exposing the spine by cutting through healthy tissue to just reach the surgical area. This means disrupting muscles, vessels, and bony elements not associated with the actual area of concern. Larger and deeper incisions are necessary, which means the body has to work extra hard to heal all the affected tissue. Even though these tissues and muscle heal, they can remain stiff, less functional, and may never fully recover. Minimal approaches to the spine greatly reduce the amount of healing and enhance recovery by never damaging these healthy tissues to begin with.

Minimally invasive spine surgery also gives rise to procedures that can be performed in outpatient surgery centers. Quicker surgeries with fewer associated risks help patients return to normal activities soon after their procedure.

Dr. Nitin Kukkar, who treats patients at the Orthopedic and Sports Enhancement Center, adds that, “minimally invasive procedures on the back and spine do not typically involve cuts toward the center of the spine. Instead, small incisions (7mm) are made on the side of the back, far enough away from the spinal cord so nerve damage is not a potential risk.”

One of the latest techniques in minimally invasive procedures involves having the patient fully conscious during the operation. Dr. Kukkar also specializes in endoscopic spine surgery, which means back surgery while the patient is awake. This is also a tissue dilating process, which separates the muscle tissues instead of cutting. Dr. Kukkar inserts a 22mm tube (about the circumference of a quarter) through the dilated muscle, and while looking through the tube with the aid of a microscope, the necessary surgical corrections are made. The patient is awake and can converse with the doctor while nerve impulses are safely monitored with a computer. The tissues recover quickly and with the added benefit of patient communication, this type of procedure maximizes the potential for a favorable outcome.

All of this new minimally invasive and endoscopic technology takes extensive training — even more so than traditional procedures. The way to achieve good results and minimize or avoid future back problems for patients is largely a matter of training and experience, according to Dr. Kukkar. Even though less-invasive spine surgery requires extra training and mentoring with qualified surgeons, it still does not replace the hand skills acquired through experience. “There is a lot of ‘feel’ in spine surgery,” says Dr. Kukkar. “That is one reason why robotics are not an option for this kind of procedure at this point.” There is a visual aspect of course, and microscopes and cameras have improved dramatically over the past decade, but still, “feel” is important. Therefore, not only do the surgeon’s eyes and hands have to be well trained, but he or she must have a good “feel” for the delicate spinal tissues and the positional working relationship between the nerves and spine.
A positive outcome for the patient is the priority and goal of any procedure, and Dr. Kukkar feels it can only be developed by spending time with the patient during the diagnostic phase. “You have to know what the problems are so that you know best how to treat them,” he says. Each patient undergoes a thorough examination as well as a conversation regarding what kind of pain and where it is experienced. Then each patient receives an individualized treatment plan. “The first chance is the best chance to help someone,” Dr. Kukkar believes. The proper diagnosis followed with the proper procedure yields good outcomes.

With extensive training in endoscopic and minimally invasive procedures and the desire to help the patient with the best strategy, Dr. Kukkar is leading the way with advanced procedures, that years ago, were done as major surgery. Although there are situations when traditional “open” surgery is necessary, more and more the options for correcting problems associated with a patient’s back are being addressed through minimally invasive options — and sometimes while the patient is awake.

For more information about these procedures or to make an appointment, you may contact Dr. Kukkar at Orthopedic & Sports Enhancement Center, 309-663-9000 or OSEC is located at 2406 E. Empire Street in Bloomington.