Fourways-based doctor pioneers SA first in alternative to spinal surgery

The procedure, performed in April for the first time in South Africa, is minimally invasive, only requires local anaesthesia and usually allows the patient to go home the same day as the procedure.


Doctor Avinash Kolloori is the first medical professional in the country to offer sufferers of slipped discs an alternative to open spinal surgery, reports Fourways Review.

The specialist neurosurgeon based at Life Fourways Hospital was invited to Seoul, South Korea, by medical device company Vivid Surgicals last year to train in the technique, which is called a percutaneous plasma disc decompression (PPDD).

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In April of this year, Kolloori performed the procedure for the first time in South Africa, which is minimally invasive, only requires local anaesthesia and usually allows the patient to go home the same day as the procedure.

Doctor Avinash Kolloori

A herniated or ‘slipped’ disc is when one of the connecting parts between the bones of the spine slips out of its proper position, causing pain. The injury can be corrected with open spinal surgery, but this is more stressful for the body, increases the chance of infection, and means a recovery time of a few weeks.

“During a PPDD, a specialised catheter is inserted into the [affected] disc in the patient’s neck or spine under X-ray guidance,” he explained to the Fourways Review.

“The plasma tip of the catheter is heated to between 40 and 70°C.”

The heat coagulates (or hardens) the tissue in the disc, which aids in reducing pressure within the disc and allows for the withdrawal of the herniated disc fragment away from the nearby compromised nerve root, thus reducing or eliminating the pain which the patient is feeling.

Steph Acar from North Riding was one of the first people to undergo the procedure after she suffered from a dehydrated disc, meaning that the gel-like fluid usually found in the disc had been lost, causing her pain and stiffness.

“It was a sharp, burning pain which would shoot down my leg, and I still don’t know how it was caused,” Acar said.

“Dr Kolloori recommended the surgery, and so on 20 April I was one of the first five people to undergo the procedure.”

Acar had to be awake while Kolloori and surgeons from Korea completed the procedure to pinpoint the area of pain, but she estimates that she was in theatre for only 45 minutes and was able to walk out the hospital a few hours later.

“On the day of the procedure I had slight pain, and I needed bed rest for a few days afterwards. After about three weeks I saw the full result and that disc has not bothered me since.”

Acar did add that she does pilates twice a week because it is important for her to maintain the health of her back. She also pointed out that the procedure is not always covered by medical aid, and patients sometimes need to pay for a PPDD out of their own pocket.

Kolloori added that there are risks with a PPDD, as there is with any medical procedure, and that patients should not assume that they automatically qualify. “People do need to manage their expectations. Not everyone is a candidate as it is based on the results of their MRI [magnetic resonance imaging scan] and their clinical symptoms.”

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