Tiny Cut, Huge Relief

Removal of herniated disc alleviates stenosis, ends leg pain.

David Davis, 53, has been a deputy with the Hillsborough County Sheriff’s Office for 33 years.

Photo by Jordan Pysz.

David Davis

“Most of what I do is administrative,” David says. “When people are released from jail, I process their paperwork and complete the physical process of releasing them from our custody. I love the work because I’m a people person, and I enjoy dealing with people. It’s my favorite part of law enforcement.”

There was a point when David considered working in the field, but he realized how happy he was with his inside role and opted to stay put.

“Fifteen years ago, when I was a little younger, I thought about changing jobs and going out on the road,” he recounts. “But I decided to remain where I was because I love what I do. Besides, those guys on the road have jobs that are a lot harder than mine.

“I’ll be retiring soon, and during my retirement, I plan to sit back and enjoy life, even though my wife says she’s going to find things for me to do. We’re going to do some traveling, and we have a 4-year-old granddaughter I want to spend more time with. I may join my wife’s gym, but mainly I intend to ride my bike around the neighborhood a lot.”

For most of 2019, David couldn’t even think about riding his bike. That was after he injured his back lifting a fire pit while working on his patio last April. The resulting pain was so excruciating and disabling that David required hospitalization to regain his mobility.

“I didn’t lift the proper way,” David explains. “I just bent over, picked up the fire pit, and boom, my back went out and I couldn’t move. I had to spend the night in the hospital. They told me that I had a herniated disc and my spine was narrowing, which they called spinal stenosis. They said that happens as people get older.

“The doctor gave me pain medication, and within a couple of weeks, the back pain was gone. But a sharp pain in my left leg above my knee continued. The pain medication didn’t help the leg pain at all.

“I visited several specialists, and all of them sent me for physical therapy. They said they had no idea why I was having leg pain. I should be having back pain. But I kept telling them, No, the pain is in my leg. From April to September, I suffered daily with intense leg pain. It was a nine on a scale of one to 10.

“Finally, I told my primary care provider that I couldn’t take the pain anymore. There must be somebody who could help me. He recommended Dr. Panchal at the National Institute of Spine and Pain.

“I’d recommend Dr. Panchal in a heartbeat.” – David

“I first went to see him in October, and when he looked at my x-rays he told me why I was in pain, which is something no one else was able to do. He explained how my herniated disc was sitting on a nerve and that was causing my leg pain.”

Sunil J. Panchal, MD, is a board-certified interventional pain specialist. He is the president and medical director of National Institute of Spine and Pain, which has offices in Lutz and Tampa.
“David previously injured his back and had pain radiating to the front of his left thigh,” Dr. Panchal reports. “He was treated with physical therapy, home exercises and opioid pain medications prior to visiting me.Graphic from iStockPhoto.com.

“Upon evaluation, I determined that the disc herniation in David’s lower back was compressing a nerve and contributing to his stenosis, which was causing his leg pain. To give him immediate relief, I performed epidural steroid injections, but their relief was short-lived.

“I gave David several options for fixing the problem and he ultimately chose to undergo a discectomy to remove the herniated disc material. I performed the procedure endoscopically.”

Precision Through Tubes

Endoscopic discectomy is performed through an incision that is less than a centimeter wide. A fiberoptic camera and the surgical instruments are introduced into the body through a tube inserted into the incision. The procedure is less invasive than open surgery, which involves incisions that are several inches wide.

“The first thing I do when performing endoscopic discectomy is identify the damaged disc and the easiest pathway to it using fluoroscopy,” Dr. Panchal describes. “I then inject an introducer needle, and through that, I insert a guidewire. Once the guidewire is in place, I remove the needle and make a small incision in the skin.

“Through that incision, I place a tube over the guidewire to dilate and stretch the tissue, then I place a second tube to further dilate the tissue. That tube serves as the working channel. In that tube, I insert fluid tubing to maintain saline flow, which creates pressure to minimize bleeding and wash away blood, providing a clear view through the camera.”

Through the working tube, Dr. Panchal also places the fiberoptic camera and the surgical instruments, which are long and thin. Using these instruments, Dr. Panchal can shave bone or grab herniated disc material and create space around the spinal nerves that are being compressed and causing pain.

Photo by Jordan Pysz.

Since undergoing an endoscopic discectomy, David has been pain-free.

“There are multiple factors that contribute to reduced space around the nerves that are exiting the spine through openings called foramen,” Dr. Panchal explains. “When a disc bulges, its material seeps into the disc space and takes up room. Arthritic changes may cause bone overgrowth, which also takes up space and contributes to foraminal narrowing and nerve compression.”

“Absolutely Zero Pain”

Dr. Panchal performed David’s surgery on December 16. David reports that he experienced almost immediate pain relief from the endoscopic discectomy and that he has been pain-free since.

“The day of the procedure I was a little groggy, and the next day, there was a little discomfort, but not pain,” David remembers. “After that, I felt much better.

“I was only out of commission for a couple of days, but I was able to enjoy the holidays, and we had a great Christmas. I felt absolutely zero pain.

“I’d recommend Dr. Panchal in a heartbeat, and I’d leave it up to him to determine if endoscopic discectomy is your best treatment option.”

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    • National Institute of Pain

      We treat each patient individually, using the latest equipment and various innovative procedures to diagnose pain and determine your care needs. We then assemble the appropriate interdisciplinary team of health care professionals who can best... Read More

    • Sunil J. Panchal, MD

      Sunil J. Panchal, MD, is board certified by the American Board of Anesthesiology in interventional pain medicine. He earned his Bachelor’s degree in Biology from Rensselaer Polytechnic Institute in Troy, NY, and earned his medical degree from... Read More