It treats problems such as a slipped disc or a trapped nerve through small cuts.
Dr Imran Salim Malik is a consultant orthopedic and trauma surgeon in Lahore, with more than 20 years of experience in orthopedic surgery. He uses keyhole methods when they suit the patient. If you need an operation, Dr Malik performs it himself.
How does keyhole spine surgery work?
The surgeon works through small cuts, not one long cut (open surgery). The back muscles are moved aside, not cut. A thin tube or tiny camera (endoscope) reaches the spine, guided by live X-rays.
Benefits: smaller cuts, less blood loss, up and about a little sooner
For suitable patients, keyhole surgery can mean less blood loss and getting up a little sooner. For common operations such as disc surgery, long-term results are similar to open surgery. It is not right for everyone.
- Smaller cuts and smaller scars
- Less damage to muscle
- Often less pain after the operation
- Often a shorter hospital stay
Many people return to work sooner than after open surgery. Recovery is different for each person.
Do you need surgery at all?
Not always. For most back problems that are not emergencies, surgery is considered only after other treatment has not helped, such as:
- Pain medicines
- Physiotherapy (guided exercises)
- Other non-surgical pain treatment, if it suits you
Dr Malik will tell you how long to try these. If they do not help, surgery may free a trapped nerve or steady the spine. Emergencies, like the warning signs below, are different and need care straight away.
Go to an emergency department now if you have back or leg pain with:
- Loss of bladder or bowel control
- New difficulty passing urine
- Numbness around the private parts, inner thighs or buttocks
- New or quickly worsening weakness in the legs
Do not wait for a clinic appointment.
Severe back or neck pain after a fall or accident: keep the person still, do not move them, and call Rescue 1122. Do the same if they have numbness or weakness after the fall.
See a doctor within days, not weeks, if back pain comes with fever, weight loss you can't explain, pain that is worse at night, or a past history of cancer or TB.
Types of keyhole spine surgery
The main types are:
- Microdiscectomy (removing the part of a slipped disc that presses on a nerve)
- Decompression: laminectomy or laminotomy (making more room for squeezed nerves)
- Fusion, such as MIS-TLIF (joining two spine bones so they heal as one)
- Percutaneous screw fixation (screws put in through small cuts to hold the spine steady)
- Kyphoplasty or vertebroplasty (bone cement that can ease pain from a collapsed spine bone)
The right one depends on your diagnosis, symptoms and general health.
Which spine problems can it treat?
Common problems include:
- A slipped disc (herniated disc)
- Spinal stenosis (narrowing that squeezes the nerves)
- Degenerative disc disease (wear and tear of the discs)
- Sciatica (leg pain from a squeezed nerve, often caused by a slipped disc)
- Spinal instability (spine bones that move too much)
- Some spine fractures
Dr Malik decides with you whether keyhole surgery suits you, after examining you and checking your MRI or X-rays.
Is it safe? The risks explained
Like any operation, it has some risks:
- Infection
- Bleeding
- Nerve injury
- Blood clots
- Pain that does not fully go away
- Needing another operation
- A small tear in the covering of the nerves (spinal fluid leak)
- Sometimes the operation has to be changed to open surgery
These risks are real but uncommon. Many people fear paralysis; serious nerve damage is uncommon too. Dr Malik weighs your own risks against the expected benefit with you before any decision.
Worried about the risks? WhatsApp your MRI report to +92 300 4890692 and book a consultation to talk them through.
How to prepare for surgery
Preparation may include:
- A medical check-up and scans
- A review of the medicines you take. Do not stop any blood thinner or heart medicine on your own. Dr Malik and your heart doctor will tell you what to do before surgery.
- Stop smoking and all tobacco, including naswar and chewing tobacco. It slows bone and wound healing.
- Fasting (no food or drink) as instructed
- Planning help at home and transport after surgery
How long will I stay in hospital?
It depends on the operation. After disc surgery or decompression, many patients go home the same day or after a short stay. After fusion or screw fixation, the stay is usually longer. Dr Malik will tell you how many nights to plan for.
Care after the operation
- Medicines to control pain
- Slowly returning to light activity
- Follow-up visits with Dr Malik
- Physiotherapy, as advised
Before you agree to spine surgery
Make sure you understand your diagnosis, all your options and the risks.
Already been told you need an operation? A second opinion is your right. Bring your reports and Dr Malik will go through your options with you, including non-surgical ones.
What will it cost?
The consultation fee depends on the hospital you visit. We tell you the exact fee on WhatsApp before you book, so there are no surprises. A follow-up visit within 5 days of your first consultation is free to go through your reports and scans.
The cost of surgery depends on the operation, any implants, the room and the nights in hospital. It is explained to you before you decide, so your family can plan. WhatsApp +92 300 4890692 to book.
Common questions
Is a robot used for keyhole spine surgery?
Some centres use robots, but not every operation needs one. Dr Malik will explain how your operation will be done.
How long does the operation take?
Most operations take one to three hours, depending on how complex the problem is. You are given anaesthesia (medicine so you feel no pain) throughout.
How well does it work?
Results depend on the operation and the reason for it. When a slipped disc presses on a nerve and causes sciatica, freeing the nerve often relieves the leg pain. Surgery for general back pain is less predictable.
How long is recovery?
It depends on the operation. After disc surgery, many people recover over a few weeks. Fusion takes longer, often several months. Recovery also varies from person to person. Dr Malik will tell you when you can return to work.
What will recovery feel like?
Mild pain and stiffness are common at first. They slowly ease with good care and physiotherapy.
When should I get help after surgery?
Watch for these warning signs.
Go to the nearest emergency department now, or call Rescue 1122, if you have:
- Loss of bladder or bowel control, or new difficulty passing urine
- Numbness around the private parts, inner thighs or buttocks
- New or quickly worsening weakness in the legs
- Chest pain, sudden breathlessness or coughing up blood
Call or WhatsApp +92 300 4890692 the same day if you have:
- A wound that is red, hot, swollen or leaking
- Fever or chills
- Calf pain or swelling (a possible blood clot)
- Pain that keeps getting worse
- Clear fluid leaking from the wound, or a bad headache that is worse when sitting up
If you cannot reach the clinic, go to the nearest emergency department.
From the clinics of Dr Imran Salim Malik, orthopaedic and trauma surgeon. MBBS (Allama Iqbal Medical College) · MS (Trauma & Orthopaedics) · PMDC Reg. 39646-P. Every patient is different: Dr Malik will tell you what applies to you.
