Spine Surgery is an advanced treatment option for neck or back pains causing disability due to identifiable lesions in a patient’s spinal column. Almost 80% of the people across the globe witness back pain sometime or the other during their lifetime. Although back surgery is a difficult choice, there may not be an alternative option especially in cases where conditions have not adequately improved with nonsurgical treatments.
Spinal cord or spine or backbone is the most important portion of physical anatomy of human being. We cannot do anything without support of spine. It is the most engaging & actively utilized part of individual bodies. There are many things which slowly & steadily affect our spine; normal activities like sitting & walking start to change structure & create gaps in the vertebrae of our spinal column. Some of the issues if diagnosed at an early stage can be treated with physical therapy & by using mere medications, but some of issues are major enough to require a spine surgery.
Conventional spine surgery treatments in India involve lengthy incisions forcing muscle retraction for prolonged periods of time. This is also necessary as methods enforce removal of tissues like bone & ligaments to approach pathological areas. Moreover, general anaesthesia is unavoidable during these surgeries. Increased morbidity also requires patients to stay in bed for longer periods of time. Spine surgery specialists in India are experts with most of them having trained in the west.
India is a specialist destination for Spine Surgery procedures. Spine Surgery cost in India are affordable & just a fraction of what you normally pay in the western developed countries. Offering high-tech medical solutions to a large variety of healthcare problems, it is no wonder that India is one of the most favoured global health care destinations for Spine Surgery today.
Top spine surgeons in India are adept in minimally invasive Spine Surgery using very small incisions with little muscle retraction & less tissue damage can come as an ideal respite in most spinal conditions. With targeted treatment of pathology made simpler, many surgeries can now be performed under local anaesthesia.
While preventing complications associated with high risk of anaesthesia & prolonged bed rest, patients can also get back to normal work routine much faster. Post operative pain is also comparatively much less with far less chances of failed back syndrome. Spinal cord injury treatments in India are cost-considerate & can give best treatments to a variety of spine related medical conditions.
Treatment for spinal stenosis may vary depending upon the location & severity of signs & symptoms. First & foremost, medications to control pains associated with spinal stenosis include NSAIDs, antidepressants, muscle relaxants, anti-seizure drugs & opioids. Physical therapy generally contains spinal stenosis exercises which build-up strength & endurance while maintaining flexibility & stability. The idea is to improve balance positively.
Steroid injections are also an essential part of non-surgical options for spinal stenosis in case your nerve roots have become swollen & irritated at spots where you feel the pinch. Steroids can help reduce inflammation & relieve pressure. When none of the above are found to work, surgery may eventually be considered.
The goal of Spinal Stenosis Surgery is however to relieve pressure on nerve roots & spinal cord. Laminectomy may be utilised to remove back portion of affected vertebra so as to create more space within spinal canal. At times vertebra may need to be fused to maintain spine strength.
However, surgery is able to reduce symptoms of spinal stenosis in most cases. Risks associated with spinal stenosis surgery generally include infection, blood clot in leg vein or tear in membrane covering spinal cord & neurological deterioration.
Surgeries Available for Spine Treatment
Minimally Invasive Spine Surgery (MISS) is also known as Less Invasive Spine Surgery. Specialised instruments are used in this procedure through small incisions to access operating sites in spine. MISS was developed to treat spinal problems with little injury to muscles & surrounding tissue structure in spine.
It also allows surgeons to focus view at problematic area of spine. Other MISS advantages include less bleeding with smaller incisions translating into faster recovery & shorter stays in hospital. However, some back & neck problems cannot yet be effectively treated with minimally invasive procedures.
Surgeons performing Laser Spine Surgery generally remove the source of nerve sensitivity & pain by cutting-off ends & decreasing size of disks between vertebrae. People suffering from back pain would go to any length to reduce or eliminate discomfort. Most patients would prefer to go for laser surgery instead of going under the knife.
Benefits of Laser Spine Surgery
- No Pain
- Take less time to recover
- Minimally Invasive
- Costs half of conventional surgery
Cervical Spine Surgery is normally performed as an elective procedure to treat nerve or spinal cord impingement (Decompression Surgery) or rectify spinal instability (Fusion Surgery). Quite often both these procedures are combined as decompression treatment may destabilize spine so as to create requirement for fusion which will help add stability to spinal cord. Spinal instrumentation can also add a small plate which will provide extra stability to spinal construct. Cervical spine can either be approached from front known as anterior approach, or from back called posterior approach.
However, surgeons prefer the anterior approach in most conditions as it results in less disruption of normal musculature. It is also easier to maintain normal alignment of spine from the anterior side.
Spinal Fusion Surgery is utilised to fuse or join two or more vertebrae mostly in the lower back region. This is a major surgery which normally lasts several hours. It employs different methods of spinal fusion depending upon individual medical condition of the patient. In some cases, bone is taken from pelvic bone or a bone bank & which is used to make bridges between vertebrae next to each other.
This bone graft is meant to help new bone grow. Sometimes, metal implants are used to hold vertebrae together for as long as it takes new bone grow between them. Spondylolisthesis is treated with spinal fusion surgery
Vertebroplasty is basically an outpatient procedure used to stabilize compression fractures in spine. The procedure involves injecting bone cement into back-bone vertebrae which is cracked or broken, most often due to osteoporosis. This cement subsequently hardens thereby stabilising fracture & supporting spine.
Vertebroplasty is a boon which can greatly reduce back pain & allow you quickly return to normal activity. This procedure is considered minimally invasive as is done through a small puncture in patient’s skin. Moreover, it just takes about an hour to complete.
Herniated Disc Surgery is considered when you have leg pains which have not improved over at least a month with non-surgical treatment & the symptoms have been bad enough to interfere with normal activities. Alongside pain, most patients also experience weakness, abnormal sensitivity & loss of motion. Such people when they undergo Herniated Disc Surgery most often feel better faster. Some patients may also require additional disc surgery after the first surgery.
Though patients may gradually resume work & daily activity after surgery, doctors often recommend a rehabilitation program as well, which includes home exercises & physical therapy. Non-Traumatic Discectomy or Lumbar Endoscopic Discectomy is a surgical process which is used to remove herniated disc material.
Scoliosis is a medical condition of spine portraying sideways curvature which generally occurs during growth spurt before puberty. Conditions like cerebral palsy & muscular dystrophy are found to encourage scoliosis, but the actual cause of this condition is still not known. Most scoliosis cases are mild, but some kids develop spine deformities which continue to get worse with age. Severe scoliosis is disabling. Severe spinal curvature reduces amount of space in chest, creating difficulties for lung functioning in the process. Children with mild scoliosis are closely monitored with X-rays to watch if curvature is getting worse.
Some cases of scoliosis will require wearing a brace to stop curve from getting worse, while others may need surgery to straighten severe curvature conditions. Common signs & symptoms of scoliosis include uneven shoulders, one shoulder blade appearing more prominent than the other, uneven waist or one hip higher than other; all because the spine will also twist or rotate with curvature.
The disc is nothing but a soft cushioning arrangement presented between the vertebras of the spine. It is developed by tissues like cartilage & has the outer part known as annulus, & the inner portion is called nucleus. Generally, the disc is supple & so allows the spine to bend. It is placed into spine to simulate the normal disc’s functions.
There are numerous disc designs available & which are divided into 2 types -
- Total Disc Replacement
- Disc Nucleus Replacement
Spinal decompression surgery is a common term which states the various methods applied to relieve symptoms caused by compression or pressure, on the nerve roots or on the spinal cord. The Spinal decompression surgery is utilised to ease pressure on the spine or on the nerve roots, which it successfully relieves pain in around 80% to 90% of total patients dealing with spinal decompression issue. The surgery is limited to relieve the pain; it does not restore the present degeneration due to aging affects of wear & tear of tissues in the vertebrae.
Discectomy is a surgical method to eliminate the broken portion of herniated disc located in your spine. If not removed, it can cause numbness, pain or weakness in nearby nerves of spine. All these symptoms initially affect your back & neck & slowly radiate towards your legs & arms. On radiating symptoms, Discectomy is a better option when it comes to spine surgery. You can opt for different non-surgical treatments of neck & back pain like physical therapy or medications for pain.
If the nonsurgical treatment is not able to relieve your symptoms, then the spine surgeon might suggest you with Discectomy Surgery. This surgery is advanced & is minimally invasive, utilises small cuts & a video camera to see issues & treat them effectively.
Kyphoplasty surgical procedure aims to stabilize, restore & stop pain caused by spinal fractures. This procedure is, in fact, a type of vertebral augmentation designed for compression fractures. A small incision is made in the back during Kyphoplasty surgery through which a narrow tube is inserted. Fluoroscopy is used to guide this tube to the fractured vertebrae area.
The surgeon inserts a special balloon through the tube into the vertebrae & which is then inflated very gently & carefully. The balloon in the process elevates fracture until vertebrae pieces return to a normal position. It also compacts, soft inner-bone creating a cavity inside vertebrae. The balloon is now removed & doctor using specially designed instruments under low pressure fills the cavity with a cementing material known as polymethylmethacrylate (PMMA) which hardens quickly to stabilise the bone.
Normally performed under local or general anesthesia, Kyphoplasty takes about an hour’s time for each vertebra. Patients will subsequently be observed closely immediately after surgery. This procedure may require patients to spend at least one day in hospital after surgery.
Micro Endoscopic Decompression
Micro Endoscopic Decompression procedure is also known as MED & is performed for the treatment of symptomatic spinal stenosis. The microscope in this procedure provides 3D imaging while endoscopic view is 2D. Both allow good vision & illumination which are critical to operation since tissues & structures which need to be removed appear similar to the surrounding normal tissue including spinal nerves.
Both these procedures are excellent in performing micro decompression surgery & provide similar outcomes. However, it is your surgeon who will decide the appropriate procedure most suitable in your case.
Micro Endoscopic Discectomy
Micro Endoscopic Discectomy is a minimally invasive procedure utilised to remove herniated disc material which is on the nerve roots or spinal cord. Performed through a tubular device, this procedure uses a specialised microscope so as to view discs & nerves.
Usually an outpatient procedure which allows patients to leave the hospital the same day, Micro Endoscopic Discectomy in no way changes the mechanical structure of lower spine. It may take weeks or months for nerve roots to completely heal after surgery, but most patients feel relief from pain immediately after operation.
Percutaneous Endoscopic Discectomy
Percutaneous Endoscopic Discectomy is a newly developed technique utilised for removing ‘contained’ lumbar disc herniations & small ‘un-contained’ lumbar disc herniations through posterolateral approach with aid of specifically developed instruments.
Techniques in this procedure combine flexible, angled & rigid straight forceps with automated high-power shaver & cutter systems so as to achieve purpose. Performed under local anaesthesia, Percutaneous Endoscopic Discectomy is monitored using endoscope angled at 70 degrees alongside television & video units. Access to the dorsal parts for this procedure can be gained through the intervertebral space where disc herniation is located.
Percutaneous Laser Disc Decompression (PLDD)
Percutaneous Laser Disc Decompression or PLDD is another so-called ‘minimally invasive’ procedure for contained lumbar disc herniation. As this treatment is performed percutaneously, morbidity is lower & convalescence period after operation is shorter than conventional surgery. PLDD appears to be an interesting alternative procedure when compared to conventional counterpart as return to work is possible within a few days after treatment.
Posterior Lumbar Interbody Fusion (PLIF)
Posterior Lumbar Interbody Fusion or PLIF involves adding bone-graft within spine so as to set up a biological response causing bone to grow in-between vertebral elements, thereby stopping motion at that juncture. PLIF achieves inter-body spinal fusion in lower back by inserting a cage made-up of allograft bone or synthetic material directly into disc space. Since approach to this surgical procedure is from the back, it is called Posterior Lumbar Interbody Fusion. Quite often PLIF is supplemented by Posterolateral Spine Fusion Surgery.
Spinal Fusion with Instrumentation & Stabilisation
The basic role of Spinal Fusion with Instrumentation & Stabilisation is to provide additional spinal stability while setting-up an environment for fusion. Various types of medical instrumentation devices have been developed to aid successful spinal fusion as bones tend to fuse effectively in a stabilised atmosphere with little motion.
Instrumentation is a type of implanted medical device which helps fusion set-up by limiting motion at the fused segment. Usually made of titanium or stainless steel, instrumentation devices typically come in many shapes & sizes to suit specific set-ups.
Transforaminal Interbody Fusion (TLIF)
Transforaminal Interbody Fusion or TLIF is a surgical procedure utilized to stabilize spinal vertebra & the disc which act like a shock-absorber. TLIF is designed to create solid bone between adjoining vertebrae by eliminating any movement between bones so as to reduce pain & nerve irritation. TLIF is commonly recommended for disc herniations, spondylolisthesis & degenerative disc diseases. Normally approached from posterior part of spine, TLIF allows surgeons to insert bone graft & spacer into disc space without having to forcefully retract nerve roots so as to reduce injury & scarring.