Medical news July 12: Minimally invasive spine surgery for the elderly

Minimally invasive spine surgery for the elderly

Vinmec Phu Quoc International General Hospital has just successfully performed surgery on an 85-year-old patient with lumbar spinal stenosis. This is a difficult case due to old age and many underlying diseases.

In the elderly, any surgical intervention needs to be carefully evaluated.

Just one day after surgery, the patient was able to sit up, walk and eat normally, marking a new step forward in the ability to provide specialized treatment at the island's medical facility.

The patient, an elderly woman named NTC, residing in Phu Quoc, was admitted to the hospital with severe back pain that lasted for more than a month, seriously affecting her mobility. She had a history of hypertension, type II diabetes, and ischemic heart failure, making surgery more dangerous.

The results of the examination and imaging diagnosis showed that Mr. C had a narrowed lumbar spinal canal, causing compression of the nerve roots, causing pain and limited mobility. After a thorough interdisciplinary consultation, the doctors decided to intervene using minimally invasive endoscopic surgery to decompress the nerve roots at the L3-L4 vertebrae.

The surgery was successful with a short intervention time, limited blood loss, significantly reduced postoperative pain and no postoperative complications. Notably, after only 24 hours, the patient was able to sit up, walk lightly and live normally, a result far exceeding expectations for an elderly patient with a complex health background.

Endoscopic surgery to treat spinal stenosis is a modern technique, usually only performed at central hospitals. However, at Vinmec Phu Quoc, this method has been routinely applied, helping local people and tourists to access high-quality medical services right on the island, without having to be transferred to the mainland. Endoscopic techniques bring many benefits such as pain relief, shortening hospital stays, minimizing risks and are especially suitable for the elderly with many underlying diseases.

According to Dr. Hoang Nguyen Nhat Tan, a neurosurgeon at Vinmec Phu Quoc, for the elderly, all surgical interventions need to be carefully evaluated.

Compared to open surgery which has many potential risks, minimally invasive endoscopic surgery helps improve safety and shorten recovery time. This successful surgery once again affirms that advanced techniques can be effectively implemented at island hospitals such as Vinmec Phu Quoc.

The success of the surgery not only opens up effective treatment opportunities for elderly patients with spinal diseases, but also clearly demonstrates the professional capacity and outstanding development of the Vinmec healthcare system in Phu Quoc. This is a testament to the continuous efforts in bringing high-quality medical services closer to the community and tourists on the Pearl Island.

Patients escape dialysis thanks to timely treatment and lifestyle changes

A 53-year-old patient, who was prescribed dialysis after a stroke, was fortunate to escape dialysis thanks to early detection and timely treatment at Tam Anh General Clinic in District 7 (HCMC).

Mr. L., 53 years old, started dialysis for more than a month at a hospital near his home after being diagnosed with end-stage chronic kidney failure. However, during a visit to Tam Anh General Clinic in District 7 to register for dialysis, the doctor there discovered that he was still able to urinate, a sign that his kidney function had not been completely lost. Realizing that there was still a chance to save his kidney, the doctors decided to intervene with intensive medical treatment to delay dialysis as much as possible.

Dr. Do Thi Hang, Head of the Nephrology and Dialysis Unit, said that we discussed with the patient's family that there is still hope. If kidney function is maintained, Mr. L. will not have to be attached to a dialysis machine, avoiding costs and improving his quality of life. Delaying or getting rid of dialysis is an important treatment goal in cases of kidney failure with the potential for recovery.

Upon admission, Mr. L. not only had kidney failure but also had a series of comorbidities including long-term high blood pressure, type 2 diabetes, mixed dyslipidemia, hyperuricemia, and ischemic heart disease.

To deal with this complex situation, the medical team has developed a personalized treatment regimen that includes drugs to regulate blood pressure, control blood sugar, prevent atherosclerosis and prevent stroke. Clear treatment goals are set: blood pressure below 140/90mmHg, HbA1c below 7%, LDL-C below 1.8 mmol/L.

Along with medical treatment, Mr. L. strictly adheres to a scientific diet: reducing protein, limiting salt, fish sauce, soy sauce, fatty foods, offal and red meat. He completely stopped drinking alcohol, smoking, did not use painkillers or functional foods indiscriminately, and maintained a moderate lifestyle.

After three months of following the regimen and changing his lifestyle, Mr. L.'s kidney function improved significantly. His eGFR and glomerular filtration rate increased from 24 to 31 mL/min/1.73m², meaning he had moved from end-stage chronic kidney failure to stage 3, no longer needing regular dialysis.

Dr. Hang added that the patient had acute renal failure on top of chronic renal failure after a stroke, but was discovered and treated promptly during the golden period. This was a source of happiness for the doctor, the patient, and the family.

Now, Mr. L.'s spirit has returned after months of fighting the disease. He said that in the past, due to the nature of his freelance business with international partners, he often stayed up late, ate irregularly, consumed fast food and alcohol.

After facing the risk of lifelong dialysis, he was determined to completely change his lifestyle, absolutely not drinking alcohol or smoking, and strictly following a healthy lifestyle as instructed by his doctor.

Mr. L.'s story is also a wake-up call about the state of kidney disease in Vietnam. Currently, there are more than 10 million people with chronic kidney disease, accounting for about 12.8% of the adult population.

Every year, about 8,000 new cases are recorded, mainly related to unhealthy lifestyles. Doctor Hang warns that common habits such as eating salty foods, drinking a lot of alcohol, using processed foods, staying up late, working under stress and being sedentary are silently destroying the kidneys, especially in young people.

Doctors recommend that people should adjust their lifestyle: eat scientifically, increase green vegetables and fruits, limit processed foods, sugary drinks, alcohol and tobacco; at the same time, maintain a regular health check-up schedule every 6-12 months to detect and treat kidney diseases early before it is too late.

Dangerous complications when injecting joints to treat shoulder and neck

A 70-year-old male patient in Quang Ninh province suffered from complete quadriplegia, loss of sensation, and acute respiratory failure after he self-administered an injection to treat neck and shoulder pain at a private clinic of unknown expertise. Despite receiving timely emergency care, doctors said the patient's recovery prognosis was very poor, with a risk of permanent disability.

The Emergency Department of the Central Hospital for Tropical Diseases admitted Mr. D.D.B. (70 years old, Quang Ninh) in critical condition with complete paralysis of all four limbs, loss of motor reflexes, loss of sensation, severe respiratory failure and emergency tracheostomy. Although he was still conscious, he could not breathe or move any limbs on his own.

According to his family, Mr. B. had previously suffered from prolonged pain in his neck and shoulders, but did not go to the hospital for a check-up, instead opting to get painkiller injections at a private clinic of unknown professional qualifications.

After the injection, the condition not only did not improve but also became more severe, with weakness in the limbs, loss of sensation, difficulty breathing, and then quickly leading to paralysis of the whole body and requiring emergency referral.

MSc. Dr. Le Son Viet, Department of Emergency Medicine, said that the patient was admitted to the hospital in a state of complete quadriplegia, with zero muscle strength, no tendon reflexes, and severe respiratory failure due to respiratory muscle paralysis.

Magnetic resonance imaging (MRI) results showed that Mr. B. had a severe cervical disc herniation at the C2-C3 vertebrae, causing spinal cord compression and leading to widespread cervical myelitis, one of the most serious injuries to the central nervous system.

The medical team immediately coordinated between the Emergency Department and the Department of Orthopedic and Spinal Surgery to perform emergency spinal decompression surgery.

However, the surgery revealed that the patient's cervical cord was severely swollen and adhered to the spinal canal wall. At the same time, the patient also showed signs of sepsis and purulent meningitis. It is known that Mr. B. had a history of tuberculosis treatment, leading to immunodeficiency, increasing the risk of widespread infection.

Dr. Nguyen Thanh Tung, Deputy Head of the Department of Orthopedic Trauma and Spinal Neurology, said that although the decompression surgery was successful, the damage to the cervical cord in the high areas such as C2-C3 was extremely serious. The ability to recover mobility was almost non-existent. Although the patient's life was saved, he was still on a ventilator and the prognosis for his ability to walk and live independently was only about 40%.

Cervical myelitis caused by a herniated disc, especially at high positions such as C2-C3, is a very serious and rare neurological disease. According to Dr. Viet, self-injection of drugs at unlicensed facilities not only poses a risk of infection but also delays proper diagnosis and treatment, causing irreversible nerve damage.

The elderly and people with underlying diseases such as diabetes, chronic lung disease, immunodeficiency, etc. are more susceptible to serious complications.

From the above case, medical experts recommend that people absolutely do not arbitrarily inject, infuse, acupuncture, acupressure or take medicine of unknown origin at medical facilities without an operating license.

When there are signs such as prolonged neck pain, numbness in the hands, weakness in the limbs or abnormal neurological symptoms, you should go to a specialized neurological or spinal hospital for proper diagnosis and timely treatment.

“If cervical disc herniation is detected early, it can often be treated conservatively with medication and physical therapy, without necessarily requiring surgery. However, if left too late, damage to the spinal cord, the risk of paralysis and needing a ventilator is very high,” Dr. Tung warned.

At the Central Hospital for Tropical Diseases, doctors have received many cases of late arrival after treatment with "tricks", causing the disease to not only become more severe but also losing the golden time for effective intervention.

“We have seen many patients become completely paralyzed and lose the ability to live independently because of improper painkiller injections. This is an expensive consequence that no one wants to repeat,” said Dr. Viet.

Source: https://baodautu.vn/tin-moi-y-te-ngay-127-phau-thuat-cot-song-it-xam-lan-cho-nguoi-cao-tuoi-d328519.html