Trinidad and Tobago’s first endoscopic spine surgery patient ready to play mas

ON February 12, Dr Renée Cruickshank, consultant neurosurgeon and spine surgeon, did the country’s first endoscopic spine surgery at the Community Hospital of Seventh-day Adventists in Port of Spain.

“It certainly was a monumental occasion,” she told Newsday during a telephone interview on February 14.

Endoscopic spine surgery is the next enhancement of minimally invasive spinal surgery. Cruickshank said this type of surgery collateral led to less damage to the tissues of the spinal column.

The surgeon makes an incision of less than one centimetre to accommodate the working channel and endoscope to perform the procedure. For a herniated disc, the surgeon inserts a needle or guide wire in the incision, places dilators over the needle, inserts a working tube over the dilator to create a portal to the affected spinal disc and an endoscope is placed through the tube.

The tip of the endoscope has lights and a camera that projects to a screen in real-time. The procedure is done using special tools fed through the endoscope.

The primary benefits of endoscopic spine surgery are less bleeding, reduced chances of infection, and less disruption of the natural attachments of muscles, which means reduced pain after surgery, less need for painkillers and faster recovery.

“It really is a game-changer in terms of patients’ outcomes, which is always something that is in the back of my mind.”

Cruickshank said it has been a dream come true for this technology to be available for people in the Caribbean and she is looking forward to the day when it will also be available in public hospitals.

She did her training for endoscopic spine surgery primarily in Germany. She returned to TT about a year ago and brought the technology with her. The Community Hospital provided the infrastructure and the equipment for her to be able to do it.

“Endoscopy is not novel in the sense of the technology. Orthopaedics have used endoscopy for a long time for joints. However, in terms of the endoscopic technology being adapted specifically for the spine, that actually is more recent. And the adoption of technology worldwide really only been in the last ten to 15 years.”

She performed the first surgery on February 12 with her co-surgeon, Dr Alfonso García of Mexico, and a second one on February 13. She said, to the best of her knowledge, it was the first in the English-speaking Caribbean.

Her first TT patient, retired businessman Peter Samaroo, 65, had severe pain in his legs and intermittently would feel as if his legs were buckling under him. An MRI (magnetic resonance imaging) found he had an L3-4 disc herniation or bulge that was pressing on the nerves in his spinal canal. He had what people would call a slipped disc. The bulge was removed and he was discharged the next day.

She recalled visiting him before he was discharged and he was very happy and grateful to be pain-free for the first time in months.

“That’s the best part of it all, knowing we have the opportunity to give patients a better quality of life. Of course, it has to be the right patient, the right pathology and the right surgery, but once you stick to those basics, you see the difference after the surgery.”

Endoscopic spine surgery can be used to treat chronic back pain, sciatica/ leg pain, herniated discs, spinal stenosis and degenerative disc disease.

When Newsday spoke to Samaroo on February 15, he said he was feeling great, as if he could go out and play mas for Carnival.

He said he was in pain for about a year and a half. He had severe pain in his lower buttocks and the back of his thighs when he walked. Sometimes one of his legs buckled. He said he was forced to walk in a bent position, his feet often got numb and it was difficult to stand for any length of time.

He tried several exercises at home that he found on YouTube, but they did not help much. Eventually, his daughter convinced him to see a doctor and she contacted the Fracture and Orthopaedic Clinic Ltd in St Clair.

He visited the clinic in November 2024 and met Cruickshank who told him his problem could not be fixed with exercise and he needed surgery. She told him about endoscopic spine surgery and explained the procedure.

Asked if he was hesitant to have a procedure done that had never before been tried in the country, he said no.

“I was very brave about it because of the pain. I wanted to get better. So I said I would go through with it because she was very professional and confident about it.”

Samaroo was extremely happy with the result.

He said the night he did the surgery, he got up and walked to the hospital bathroom and felt no pain. He was surprised and felt well, and all the doctors and nurses who visited him were surprised he did not feel weak, and that he was up and about. They said it was as if he did not have any surgery.

He added that the medical staff were very professional and friendly, and he had no complaints about the experience.

In his particular case, Samaroo was advised to take it easy for six weeks. He said Cruickshank recommended he start walking for exercise and told him to limit bending and avoid heavy lifting, which, he lamented, included his grandchildren.

He said he was prescribed pain medication but he had yet to take any as he still had no pain.

“I’m so happy. It’s fantastic! I would recommend it to anyone once they could afford it.”