Dr. Vikas Gupte with Dr. Wong Gyu Choi
Dr. Vikas Gupte with Dr. Sang Ho Lee
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Dr. Vikas Gupte

Minimal Invasive & Endoscopic Spine Surgeon

Dr. Vikas Gupte brings to Fortis Spine Centre a very rich experience and expertise in performing Minimally Invasive and Endoscopic Spine surgeries. Dr.Gupte has undergone a one year of Clinical Fellowship training in Minimal Invasive and Endoscopic Spine Surgery at Wooridul Spine Hospital, Seoul, Korea. It is a renowned world-class dedicated hospital for spinal disorders and a recognized training center for American Board for Minimal Invasive Spine Surgery. He is also an active member of Asian academy of Minimal Invasive Spine Surgery. Click here to know more about Dr


Minimal Invasive Spine Surgery

Conventional Spine Surgery involves taking long incisions, forceful muscle retraction for prolonged time, removal of normal tissues like ligaments and bone to approach area of pathology. Most of the times these surgeries are done under prolonged general anesthesia.

This long incisions and injury to normal structures results in

  • • Increased blood loss

  • • Increased scar tissue formation

  • • Increased chance of neural injury

  • • Epidural scarring

  • • Denervation of paraspinal muscles

  • • Delayed Mobility

  • • Longer Hospitalisation Stay

  • All these cause increased morbidity.
Minimal Invasive Spine Surgery involves

  • •Muscle Splitting Approach

  • •Minimal muscle retraction

  • •Less normal tissue damage

  • •Small Incision

  • •Less Blood Loss

  • •Early Mobilisation

  • •Preservation of muscle

  • •Paraspinal Muscle attachment preserved

  • •Less hospital Stay

  • •Targeted treatment of pathology


  • •Many surgeries are done under local anesthesia, hence surgeries can be done even in patients with high risk of anesthesia

  • •There is less blood loss

  • •Minimal morbidity

  • •Patient can be mobilized very early and he can be back to work faster

  • •It prevents complications associated with prolonged bed rest
  • •Less neural tissue damage

Since normal tissues are not removed or damaged, post operative pain is less and also there is less chance of failed back syndrome. To achive these objectives many advanced instruments like Microscope, Endoscope, Radio-frequency and Laser spectal less tissue damaging retractions


Precutaneous Endoscopic Lumbar Discectomy

This is unique type of surgery done for prolapsed intervertebral disc prolapse. This truly minimal invasive spine surgery. This surgery is done using YESS scope and done under local anesthesia with conscous sedation. Endoscope is passed under local anesthesia transforaminally in to affected disc and targeted fragmentectomy done. Wound is closed with single stitch. Patient is mobilized and can be discharged same day.

  • •Surgery done under local anesthesia with conscious sedation

  • •0.5cm skin incision

  • •Endoscope used for surgery

  • •No muscle, ligament or normal tissue damage

  • •Targeted fragmentectomy (directly prolapsed disc tissue removed.)

  • •No blood loss

  • •Patient can be discharged same day

  • •No prolonged bed rest required after surgery. Can resume work sooner

  • •Even prolapsed, migrated, extraforaminal, recurrent discs can be removed

  • •Very good technique for old and medically compromised patients

MED / METRx Tubular Retractor

- Technique similar to microdiscectomy
- Paramedian muscle splitting approach
- Serial Dilators used to split muscle without causing damage to muscle
- Magnification /illumination using microscope on endoscope

Advantages of Tubular Retraction
  • •Paramedian approach spaces muscle,muscle not detached for its attachments

  • •No muscle ischemia

  • •No muscle scanning

  • •Minimal bleeding

  • •Targeted treatment

MED / Microdecompression

Surgery Clone

  • •useful in treating all types of disc prolapse

  • •useful in intervertebral disc prolapse causing root compression with radiculopathy/sciatica

  • •Useful in lumbar canal stenosis where it has both leg pain

  • •Unilateral approach with bilateral foraminotomy

  • •Very minimal blood loss

  • •Same day mobilisation

  • •Discharge in 2-3 days

  • •Superior to microdiscectomy

Microdecompression for Lumbar Canal Stenosis with Unilateral Approach

Lumbar Canal Stenosis is commonest condition affecting older age group. In this condition size of lumbar canal is decreased due to disc degeneration, annular bulging, decreased in disc height, in folding of ligamentum flavum, facetal degeneration and osteophyte formation. Patient presents with leg pains/claudication on walking, neurological deficits and parasthesia and occasionally backache with stiffness.

Traditional surgical treatment of lumbar canal stenosis has been decompression by laminectomy, which gives good symptomatic relief however can cause morbidity due to instability and loss of posterior elements of spine, also can cause lots of epidural scarring.

Using Minimal Invasive Spine Surgical principals, we have been doing micro decompression of lumbar canal bilaterally using unilateral approach. This approach involves minimal normal tissue damage and at the same time achieves complete decompression of lumbar canal and foramen.

  • •3cm skin incision

  • •Operating microscope used for surgery

  • •Midline structures of spine like spinous process and ligaments preserved

  • •Complete decompression of neural tissue

  • •Patient can be mobilized earlier. No bed rest required post-operatively

  • •Short hospital stay

  • •Surgery can be combined with soft tissue stabilization techniques like ligamentoplasty

  • •No prolonged bed rest required after surgery. Can resume work sooner

SpS Microdecompression

In degenerative canal stenosis multilevel,without instability and with medical co-morbidities we prefer spinous process splitting microdecompression. This method of surgery is developed by us

- Spinous process split in middle without touching muscle attachment which is kept intact

- Decompression done using microscope

- Normal anatomy restored at end of surgery

- Muscle attachment preserved

- Fusion can be avoided

- Can also be combined with fusion surgery using cortical screws


Spinal fusion may be required for many pathologies causing instability of spine. In lumbar spine area, I have been doing posterior lumbar interbody fusion surgery using interbody cages with bone grafts and posterior stabilization using pedicle screw fixation.

With further refinement of surgical technique I have have been doing transforaminal lumbar fusion using minimal invasive technique. This technique preserves midline structures of spine, also reduces chances of epidural scarring.

Trans Foraminal Lumbar Fusion( MISS ):

  • •Fusion surgery done with help of microscope

  • •Midline structures preserved

  • •Complete decompression of nerve roots

  • •No epidural scarring

  • •Early post-operative recovery

  • •Less morbidity
Used in spinal pathologies regaining fusion

  • •use of interbody cages & bone graff.

  • •Midline structures preserved.

  • •percutanous screw fixation.

  • •Fixed tubular retractor used.

  • •2.5 cm incision

  • •No blood transfusion.

  • •Same day mobilisation.

  • •Discharge on 3-4 days.

  • •Useful in revision/failed back surgery.

  • •No morbidity


Osteoporotic compression fracture is very common occurrence in elderly even after trivial trauma. Inspite of adequate conservative treatment, pain of fracture persists. This can cause great morbidity and disability in elderly. I have been doing vertebroplasty under local anesthesia and IITV control. In this procedure special type of needle is inserted transpedicularly in to fractured vertebral body under local anesthesia and bone cement is injected. This bone cement after hardening supports fractured segment and pain is relieved. Since patient can be mobilized immediately, morbidity and complications associated with prolonged bed rest are reduced. Same technique is also used for metstatic bone fractures.

  • •Treatment method for osteoporotic compression fractures / also painful metastatic fractures

  • •Immediate pain relief

  • •Improves quality of life of elderly

  • •daycare procedure

In selected cases I do balloon kyphoplasty,where fractured compressed vertebra is expanded to restore height


Vertebroplasty with Fixation


Percutaneous Spinal Biopsy

Using same technique of vertebroplasty, spinal veretebral body biopsy can be done. These are done under local anesthesia .

Percutaneous Transpedicular Stabilisation

Advantages of percutaneous pedicle screws -
  • •Muscle preservation.

  • •Stabilisation of vertebres

  • •Multiple ting stab incision for pedicle screw and rod insertion

  • •C-arm guided procedure

  • •Paraspinal muscle preserved

  • •immediate mobilisation

  • •useful in fracture/deformity correction

When indicated I do minimal invasive,percutaneous pedicle screw fixation / stabilisation.

Cervical Spine Surgery

I commonly do Cervical Spine Surgeries for Cervical Disc Prolapse, Cervical Myelopathy, Cervical Trauma, Unstable Cervical Spine conditions using Minimal Invasive Spine Surgery principals.

Anterior cervical Fusion / Foraminotomy
  • •Surgery for spondylosis/radiculopathy

  • •Operating microscope used

  • •Small incision

  • •Less blood loss
cervical posterior decompression
  • •Surgery for OPLL,cervical canal stenosis

  • •Combined with / without lateral mass screw fixation

MECD ( Micro Endoscopic Cervical Discectomy )

Minimal Invasive Technique applied to cervical spine surgery

  • •In selective case of cervical disc prolapse.

  • •Muscle splitting approach with serial dilators & Metrix Tube & Microscope

  • •micro-foraminotomy done for prolapse disc / root canal stenosis

  • •Small incision 1.5 cm

  • •Preservation of paraspinal muscles.

  • •Minimal blood loss

  • •Immediate mobilisation.

  • •hospital stay - 2 days.

  • •preservation of normal disc & can avoid fusion surgery.

Case Study

Cervical Spine Surgery
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Koch's Spine
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SpS Microdecompression
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Vertebroplasty / Kyphoplasty
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Fracture Spine 87 years old
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Malignancy Pain Relief
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Interesting Cases
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Medical Camp at Aden
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Nass Dallas
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Visit to Bhagdad
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Dr. Kim Visit
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Press Coverage
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Other Photos
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Fortis Hospitals
Mulund Goregaon Link Road,
Mulund-400 078, Mumbai
Tel- 91-22-43654365


Spine care Clinic
303,Neptune-Uptown,N.S road,
Mulund(West)-400080, Mumbai
Mobile: - 9821052348

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