Severe pain radiating from the lower back to the legs is often a sign of a pinched nerve in the spine. This condition can disrupt daily activities and, in severe cases, make it difficult to walk or even stand.
This was what a 36-year-old man from Jakarta experienced. After previously undergoing surgery abroad but suffering a more severe relapse, he finally found the solution through a 1 cm microsurgery procedure at Mandaya Royal Hospital Puri.
Through a minimally invasive spinal surgery performed by dr. Christian Permana, Sp.BS, FTB, FINSS, FICS, neurosurgeon at Mandaya Royal Hospital Puri, the patient made a quick recovery and regained normal mobility in a short time.
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From Leg Pain to Inability to Walk
The 36-year-old man initially felt mild discomfort in his leg, such as cramping and tension when squatting. However, the symptoms gradually worsened until he could no longer walk.
He explained that at first, the discomfort wasn’t too severe, just an unpleasant sensation in the leg. But over time, the symptoms worsened to the point that he was unable to walk.
The patient sought a second opinion abroad, with no plan for surgery. Unfortunately, his condition suddenly deteriorated while he was there, forcing him to undergo an emergency operation.
However, only a week after returning home, the symptoms recurred — worse than before. He then came to the Emergency Department at Mandaya Royal Hospital Puri due to severe lower back pain radiating to his right leg, making it impossible for him to get out of bed.
MRI Findings and Explanation from dr. Christian Permana
According to dr. Christian, MRI results showed that the patient’s disc was still protruding significantly and compressing the L5-S1 nerve, despite the previous surgery.
“This patient, in his 30s, came to our ER with severe pain in the lower back radiating to the right leg. He had just undergone spine surgery at a hospital in Malaysia, but within five days, his symptoms relapsed — even more painful than before the operation,” explained dr. Christian.
After repeating the MRI scan, it was found that the disc was still bulging and pressing on the nerve. “We could see part of the bone had been removed from the previous operation. In this case, we performed a revision surgery using the microsurgery technique, since repeat endoscopic surgery might be difficult due to possible adhesions,” he added.
dr. Christian explained that the microsurgery technique remains minimally invasive, even though it is more complex than endoscopy.
“Microsurgery is still considered minimally invasive because the incision size is only about 2–3 cm, which falls under the category of minimal invasive spine surgery,” he said.
Fast Recovery and Optimal Surgical Results
After the microsurgery, the patient’s condition gradually improved.
“The next day, the patient hadn’t tried walking yet but reported significant pain relief while lying down. On the second day, he started walking and experienced no complaints,” said dr. Christian.
The patient also noticed a major difference compared to his previous surgery. “The first one I had abroad was endoscopic, but this one was microsurgery. The operation took about three to four hours,” he explained.
He expressed great satisfaction with the outcome. “If I had repeated the same procedure as before, the results might not have been as optimal. That’s why we chose microsurgery — for the best result,” he said.
Now, the patient has returned to normal mobility and feels much more comfortable. “It’s been a while now, and overall, I feel great. Walking feels good again,” he said with relief.
Profile and Schedule of dr. Christian Permana at Mandaya Royal Hospital Puri
dr. Christian Permana, Sp.BS, FTB, FINSS, FICS is a neurosurgeon with advanced expertise in spinal surgery. He completed his medical degree at Atma Jaya Catholic University, followed by specialization in Neurosurgery at Universitas Padjadjaran.
To broaden his skills and knowledge, he pursued various fellowships in Indonesia and abroad, including:
- Fellowship in Spine Surgery – Indonesian College of Neurosurgery
- Fellowship at Ege University Hospital, Turkey
- Fellowship at National Brain Hospital, Indonesia
- Biportal Endoscopic Spine Surgery course – Sae-um Hospital, South Korea
- Fellowship in Microscopic and Endoscopic Neurosurgery for Cerebrovascular Disease and Brain Tumors – Nagoya Daini Red Cross Hospital, Japan
These experiences strengthened his expertise in performing complex neurosurgical procedures with high precision.
As a spine surgery specialist, dr. Christian is highly experienced in treating pinched nerves and other spinal disorders through a range of minimally invasive procedures, such as:
- Percutaneous Laser Disc Decompression (PLDD)
- Percutaneous Endoscopic Lumbar Discectomy (PELD)
- Percutaneous Stenoscopic Lumbar Decompression (PSLD)
- Anterior Cervical Discectomy and Fusion (ACDF)
- Microdiscectomy
Clinic Hours at Mandaya Royal Hospital Puri:
- Tuesday: 13.00 – 17.00 WIB
- Thursday: 13.00 – 17.00 WIB
- Friday: 13.00 – 17.00 WIB
- Saturday: 13.00 – 17.00 WIB
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