R. ARIVANANTHAM
CHENNAI, JULY 14
In a remarkable demonstration of how cutting-edge medical technology is redefining the limits of modern surgery, orthopaedic specialists at SIMS Hospital have restored mobility to an 84-year-old patient who had been rendered virtually immobile by severe spinal nerve compression—using an incision no wider than a fingertip. The trailblazing procedure, performed through a single 8 mm opening, not only eliminated the need for extensive open spine surgery but also offered new hope to elderly and high-risk patients once considered unsuitable for minimally invasive treatment.
The patient, who suffered from multi-level spinal stenosis and degenerative scoliosis, experienced severe lumbar nerve compression that left him unable to walk beyond a few painful steps. Compounding the challenge, he had previously undergone Coronary Artery Bypass Graft (CABG) surgery and was living with a permanent cardiac pacemaker, making conventional open spine surgery significantly riskier.
- · Trailblazing uniportal endoscopic procedure helps 84-year-old patient with a pacemaker walk again, avoiding major open spine surgery
- · Complex spinal compression caused by multi-level stenosis and degenerative scoliosis treated through a single 8 mm incision with remarkable precision
- · High-risk surgery on elderly patient with prior bypass surgery and permanent cardiac pacemaker showcases the power of multidisciplinary expertise
- · Minimal blood loss, no muscle stripping, no sutures and faster recovery highlight the transformative potential of next-generation endoscopic spine surgery
- · Medical breakthrough reinforces SIMS Hospital’s leadership in minimally invasive orthopaedics and advanced patient-centric care
Defying conventional surgical practice, the multidisciplinary orthopaedic team at SIMS Hospital successfully treated the condition through a full endoscopic uniportal lumbar decompression performed via a single 8 mm incision, eliminating the need for traditional deformity correction using pedicle screws and rods.
The highly specialised procedure was carried out by Dr. G. Venkatesh Kumar and Dr. Vignesh Jayabalan, Senior Consultants in Orthopaedics, in close collaboration with a cardiologist, ensuring meticulous planning and intraoperative monitoring throughout the surgery.
The operation posed exceptional technical challenges because the patient’s severe degenerative scoliosis had significantly distorted the natural alignment of the spine, narrowing the spaces surrounding the spinal nerves. Navigating these compressed neural structures through a single tiny portal demanded extraordinary surgical precision and expertise.
Explaining the complexity of the case, Dr. G. Venkatesh Kumar said: “The patient presented with severe functional limitations. He suffered from debilitating leg pain and was unable to walk more than a few steps. Our evaluation revealed severe degenerative scoliosis, a spinal deformity that had caused significant nerve compression in the lumbar region. Traditionally, patients with this condition often require extensive deformity correction surgery using pedicle screws and rods. However, advances in spine surgery enabled us to perform a full endoscopic uniportal lumbar stenosis decompression through a single 8 mm incision. The procedure successfully relieved the nerve compression, and the patient was mobilised pain-free shortly afterwards.”
Highlighting the advantages of the advanced technique, Dr. Vignesh Jayabalan said: “One of the biggest advantages of this advanced endoscopic technique over conventional open spine surgery is that it achieves the desired outcome with minimal disruption to normal tissues. The procedure involves negligible blood loss, no muscle stripping, less postoperative pain, no sutures, faster recovery, and precise decompression of the pain-generating pathology while preserving the spine’s normal anatomy. Our philosophy is simple: to preserve the spine’s natural supporting structures while removing only the diseased tissue responsible for nerve compression and pain.”
Describing the procedure as a milestone in orthopaedic innovation, Dr. Vijay C. Bose, Joint Director and Senior Consultant, Department of Orthopaedics, said: “Medical knowledge in orthopaedics is vast, and research continues to expand it further. It’s impossible for one person to be an expert in everything. At SIMS, we have five sub-units under the Department of Orthopaedics. Each unit focuses on a specific area such as joint replacements, sports injuries, trauma, and foot and ankle conditions. Very few institutions across the country have this kind of in-house expertise, and we are fortunate to be one of them. In this context, this particular case marks a breakthrough in spine surgery.”
Emphasising the hospital’s commitment to innovation-driven healthcare, Dr. Ravi Pachamuthu, Chairman of SIMS Hospital, said: “This case exemplifies SIMS Hospital’s commitment to delivering advanced, patient-centric care through innovation and multidisciplinary collaboration. With only a handful of specialists in the city performing uniportal endoscopic spine surgery, we are proud to offer patients access to cutting-edge treatment that enables faster recovery, reduced surgical trauma, and an early return to mobility. We remain committed to investing in advanced technologies and clinical excellence to provide world-class care, even for the most complex cases.”
The success of this highly complex intervention underscores the rapid evolution of minimally invasive spine surgery, where advanced imaging, endoscopic technology and multidisciplinary expertise are enabling surgeons to treat even the most challenging spinal disorders with unprecedented precision.
For elderly patients and those with serious co-morbidities, procedures such as uniportal endoscopic lumbar decompression are emerging as a game-changing alternative to conventional open surgery—offering smaller incisions, reduced blood loss, minimal tissue damage, shorter hospital stays, quicker rehabilitation and significantly improved quality of life.
