Rare spine surgery performed on Nigerian patient

Gurgaon: A rare spine surgery was successfully performed on a 28-year-old Nigerian patient, Bello, at a private hospital in Gurgaon.
Bello had been enduring severe lower back and leg pain due to L5-S1 disc degeneration for many years and travelled to Gurgaon for lumbar disc replacement surgery.
Doctors identified Bello as an "ideal candidate for lumbar disc replacement", initially aiming to avoid lumbar spine fusion due to his young age, as fusion can increase stiffness and the likelihood of future revision surgeries. When it became clear that surgery was the only viable option, the medical team proceeded with the disc replacement.
Dr Rajesh Kumar Verma, director of orthopaedics, joint replacement, and spine surgery at Marengo Asia Hospitals in Gurgaon, led the surgery in the first week of August.
Officials from the hospital said that the lumbar disc used is a Swiss, state-of-the-art implant designed to mimic the natural movement of the spine, providing a resilient solution for degenerative disc disease.
"This procedure represents a significant achievement in spine surgery, offering hope to patients with similar conditions. Bello's recovery was swift, and he resumed his daily routine with renewed energy and vitality," said the official.
Bello shared that he had sought numerous opinions abroad and in India, with most recommending L5-S1 fusion.
Dr Verma said that the surgery aimed to restore Bello's mobility and alleviate his pain while minimising the chances of future revision surgeries. "Lumbar disc replacement is designed to treat chronic lower back pain caused by degenerative disc disease (DDD). Unlike traditional spinal fusion, which fuses two vertebrae, this procedure preserves motion at the affected spinal segment, reducing pain and maintaining mobility," he explained.
Dr Verma described that lumbar disc replacement involves an anterior approach with an incision around the belly button and the placement of two titanium plates with a high-quality mobile plastic component between them.
"By preserving motion, lumbar disc replacement reduces the likelihood of adjacent segment degeneration, a common issue with spinal fusion where adjacent discs wear out faster. It also preserves back muscles and avoids damage to healthy bone, facet joints, ligaments, or muscles of the back," he elaborated.
However, not all patients are suitable candidates for lumbar disc replacement. It is typically recommended for younger patients up to 55 years old with one to three levels of disc degeneration. Those with significant spinal instability, facet joint degeneration, deformity, osteoporosis, or previous major abdominal surgery are not candidates.
Consulting a qualified spine specialist is essential to determine the best course of action, said the official.
Lumbar disc replacement surgery is considered more effective and reliable than spinal fusion, with a success rate exceeding 90%.
Unlike hip and knee replacements, which have a lifespan of 20-25 years, lumbar disc replacements typically last indefinitely. Risks include bleeding and infection around the artificial disc. Although the number of cervical total disc replacement surgeries in India has risen by 15–20% annually over the past five years, lumbar disc replacements are still performed at only a few centres in the country.