This case study highlights how a minimally invasive procedure performed by Dr. Ashutosh Jadhav, a leading orthopedic surgeon in Pune, helped a patient regain mobility and escape debilitating leg pain.
Patient Background and Main Complaint:
The patient, a 45-year-old IT professional from Pune, presented with acute, shooting pain starting from the lower back and radiating down the left leg to the foot (Sciatica). The pain was so severe that the patient could not sit for more than ten minutes or walk without a limp. Over-the-counter painkillers and bed rest had provided no significant relief.
Clinical Examination and Diagnosis:
Upon consultation at Ayush Orthopedic Clinic, Dr. Ashutosh Jadhav, a renowned spine specialist in PCMC, Pune, conducted a thorough physical assessment.
- Symptoms: Numbness in the left calf and a “pins and needles” sensation.
- Imaging: An MRI scan revealed a lumbar disc herniation at the L4-L5 level, which was compressing the specific nerve root.
- Diagnosis: Lumbar Radiculopathy (pinched nerve).
Why Selective Nerve Root Block Was Recommended?
Since conservative treatments failed, Dr. Ashutosh Jadhav recommended a Selective Nerve Root Block (SNRB). This was chosen for two reasons:
- Diagnostic: To confirm that the L4-L5 nerve was indeed the exact source of pain.
- Therapeutic: To provide immediate inflammation reduction and long-term pain relief without major surgery.
About the Selective Nerve Root Block Procedure:
An SNRB is a minimally invasive injection of a local anaesthetic and a steroid anti-inflammatory medication. It is placed directly near the compressed spinal nerve as it exits the spinal column. It is an excellent alternative for patients looking to avoid “open” spine surgery.
Procedure Details and Approach:
The procedure was performed by our spine surgeon in a sterile day-care setting using advanced imaging guidance.
The Step-by-Step Process:
- Positioning: The patient lies face down on a specialized X-ray table.
- Local Anaesthesia: The skin over the lower back is numbed so the patient feels minimal discomfort.
- Fluoroscopic Guidance: Ashutosh Jadhav uses a real-time X-ray (Fluoroscope) to guide a thin needle precisely to the target nerve root.
- Contrast Dye Injection: A small amount of dye is injected to ensure the needle is in the “Safety Zone” and not in a blood vessel.
- The Medication: A mixture of a rapid-acting anaesthetic (for immediate relief) and a long-acting steroid (to reduce swelling) is injected.
The entire process takes approximately 15 to 30 minutes, and the patient remains awake and communicative throughout.
Immediate Pain Relief and Patient Response:
Within 15 minutes of the injection, the patient reported a 70% reduction in the “shooting” leg pain. This immediate response confirmed that the correct nerve root had been identified and treated. The patient was monitored for an hour and discharged the same day.
Recovery and Return to Daily Activities:
The recovery period for SNRB is remarkably short:
- First 24 Hours: Mild soreness at the injection site (managed with ice packs).
- Day 2: The patient was able to walk comfortably and perform light household chores.
- Day 5: The patient returned to office work with an improved ergonomic setup.
By avoiding a major incision, the patient bypassed the lengthy hospital stay and muscle healing time associated with traditional surgery.
Message from Dr. Ashutosh Jadhav:
— Dr. Ashutosh Jadhav
Conclusion:
Selective Nerve Root Block is a powerful tool in the hands of an experienced orthopedic surgeon in Pune. For this patient, it served as a bridge from constant agony back to a productive, active life.
If you are struggling with chronic back or leg pain, visit Ayush Orthopaedic Clinic for a consultation with the best spine specialist in PCMC, Pune.