Spine surgery is conventionally performed as  open surgery , which means the region being worked on is opened with a long entry point to permit the surgeon to view and access the area. Technical and scientific advances have permitted more back and neck conditions to be treated with a less obtrusive surgical technique. The minimal invasive spine surgery (MISS) does not include a long cut, and it prevents causing damage to the muscles around the spine. As a rule, this causes less pain after the surgery and a speedier and healthy recovery.

Spine surgery is normally suggested when non-surgical treatments like medicinal or exercise based methods have not helped in lessening the excruciating symptoms of your back problem. Moreover, surgery is just considered if your doctor can pinpoint the correct reason of your pain, for example, a herniated circle or spinal stenosis. 

MISS is also called less obtrusive spine surgery. In these procedures, surgeons utilise particular instruments to get to the spine through little cuts. The surgery process is as follows:

During the surgery, a little entry point is made and the tubular retractor is embedded through the skin.
It is also inserted into the delicate tissues down to the spinal cord.
This makes a passage to the little range where the problem exists in the spine.
The tubular retractor holds the muscles open and is set up all through the surgery.
The surgeon gets to the spine utilising the little instruments that fit through the focal point of the tubular retractor.
Any bone or disk material that is expelled goes out from the retractor.
Any gadgets needed for the fusion process, for example, screws or rods, are embedded through the retractor.
A few surgeries require more than one retractor.
Keeping in mind the end goal to see where to put the entry point and embed the retractor, the surgeon is guided by fluoroscopy.
This strategy shows ongoing X-ray pictures of the patient's spine on a screen throughout the surgery.
The surgeon additionally utilises a microscope to enlarge the view through the retractor.
Towards the end of the procedure, the tubular retractor is expelled and the muscles come back to their original position.
This restrains the muscle damage that is more ordinarily found in open surgeries.
It is very important to talk about these risks with your doctor before your surgery or procedure.

Infection: Antibiotics are consistently given to the patient some time before, during, and regularly after the surgery to reduce the danger of infections.
Bleeding: A specific measure of bleeding is normal; however, this is not commonly dangerous.
Pain in the grafted area: Some patients will encounter surgical pain at the bone joint site.
Recurring symptoms: A few patients may encounter a repeat of their side effects.
Pseudarthrosis: Patients who tend to smoke are more prone to pseudarthrosis. This is a condition wherein there is insufficient bone formation. In case that this happens, a minor surgery may be required.
Nerve damage: It is possible that the nerves or veins might be harmed during these operations. These complications are extremely uncommon.
Blood clots: Another complication is blood clots in the legs. This poses a threat because these clots can break off and settle in the lungs.

Minimally Invasive Spine Surgery - A Guide On What To Expect?

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

Disc prolapse   or what is popularly known as a herniated disc   occurs when the soft, rubbery tissues of the spinal discs push through a crack in the tougher exterior casing. It usually results from wear and tear of the spinal discs over time.

Risk Factors-
The following factors may put you at risk of a disc prolapse  
  Genetics   You may have a tendency towards developing a disc prolapse
  Occupation   People who are engaged in physically demanding jobs are more likely to develop back pain
  Weight   Excessive body weight puts pressure on the discs in the lower back

Signs to Watch Out for-
Signs and symptoms of disc prolapsed may include the following  
  Pain in the legs, particularly in the calf, thigh, and buttocks
  Pain in the arms and shoulder that intensify when you sneeze, cough, or even move your spine into certain positions
  Tingling or numbness in the affected areas
  Muscle weakness
  Inability to hold an object

If the pain deteriorates i.e. if the pain shoots down from your back or neck to the extremities, consult a doctor immediately.

Acupuncture for Disc Prolapse-
Although there are certain non-surgical and surgical treatment methods, many healthcare professionals and doctors nowadays recommend acupuncture as an alternative cure.

Acupuncture is an ancient Chinese practice that believes that people possess  Chi  or an energy force. When the force is unbalanced or blocked, your body becomes susceptible to illness and pain. Traditional acupuncturists strive to free up these energy channels (known as meridians) by inserting needles into specific points in your body. It activates the release of endorphins in your blood, which acts as natural pain relievers and reduces pain.
The process involves inserting multiple needles, depending on your diagnosis. Most people do not feel pain when the needles are inserted. In fact, they feel relaxed or energized. The acupuncturist will leave the needles in for about 20-40 minutes   this may cause temporary soreness but do not pose serious complications.
Acupuncture can help relieve pain associated with bulging, herniated disc. If you are considering this option, you should visit a complementary and alternative medicine practitioner.

Disc Prolapse - Know How Acupunture Can Help!

A broken bone is medically termed as a fracture.Fractures are linked with age as bones tend to become weak as one ages, so, the chances of a fracture occurring also increases. Fractures are usually classified into four types-
1. Closed fracture - In this type of fracture, the breaking of the bone does not result in an open wound
2. Open fracture- The opposite of closed fracture, the bone breaks through the skin. This may result in infections
3. Non-displaced fracture - in this type of fracture, the bone cracks but is not shifted out of its regular position.
4. Displaced fracture - A displaced fracture occurs when the affected bone is shifted out of its natural position.

Causes
Fractures can be caused by a number of factors, they are
1. Road accidents
2. When someone falls from a height
3. When the bone is directly exposed to a strong blow
4. When the bone is exposed to a repetitive force from activities such as sprinting
5. Osteoporosis, which is a condition where the bones become weak
6. The bones in the body tends to weaken with age, so at this time they become highly susceptible to fractures

Symptoms
1. Swelling in the area accompanied by pain
2. Limited movement of the affected joint
3. Muscle spasms
4. The affected area may also become numb

Diagnosis
The first step to diagnose a fracture is the knowing about the medical history of the patient and conducting a physical exam. The diagnosis is further confirmed by using imaging tests such as -
1. Magnetic resonance imaging (MRI) - In this procedure, images of internal body parts are taken with the help of a magnetic field and pulses of radio energy. MRIs can pick up signs of fractures very quickly, that is within the first week of injury. It is also easier to distinguish fractures from other related injuries in case of MRI.
2. X-rays -X-rays are a procedure that involves sending x-ray particles through an area to detect a fracture. Signs of a fracture may take several weeks to show up in x-rays.
3. Bone scan - In bone scans, some radioactive material is put inside the body through intravenous methods. These material tend to accumulate in the fractured area which then shows up in the images as a bright spot. If you wish to discuss about any specific problem, you can consult an Orthopedist.

How Is A Fracture Diagnosed?

Spinal trauma, also referred to as spinal cord injury, occurs when a section of your spinal cord or the nerves at the edge of your spinal canal is damaged. The spinal cord acts as a messenger between the brain and other parts of your body. If the spine sustains an injury, all or some of these impulses may not get through. This may result in complete loss of mobility and sensation below the site of injury. An injury closer to the neck can cause paralysis throughout a larger part of the body than in the lower back region.

How do such injuries occur?

Often, spinal trauma or injury results from a violent event or an unpredictable accident. The following may severely damage your spinal cord-

  A violent attack (a gunshot or a stabbing)
  A motor vehicle accident that may cause trauma to the neck, back or head
  Falling from a great height
  Spinal or head injuries during some sports activity
  Electrical accidents

What are the signs of a spinal cord injury?

The followings signs and symptoms can be observed after an injury to the spinal cord-

  Difficulty walking
  Restricted movement of the legs and arms
  Stiffness, pressure and intense pain in the neck/back
  Loss of sensation
  Muscle spasms
  Loss of bowel or bladder control
  A twisted neck or back
  Lack of coordination, weakness or paralysis in any of the body part

When should you see a doctor?

If you experience significant trauma to the neck or head, accompanied by the above symptoms, then visit a doctor immediately. Spinal trauma or injuries is a debilitating condition and can deteriorate further if you do not seek medical intervention. In fact, if such an injury is not detected on time, you may have to face more severe complications. For instance, paralysis or numbness may develop immediately or gradually as blood clots and swelling occur in the surrounding region of the spine.

The doctor can detect spinal injuries using any of the following methods-

  CT Scan
  MRI
  X-ray

What is the treatment for spinal trauma?

An orthopaedic will recommend the correct treatment for spinal trauma or spinal cord injuries, depending on the severity of the condition.

  Medications - Intravenous medications can help reduce the pain and symptoms of acute spinal cord injury
  Immobilization - Braces, corsets, or neck collar can help realign and stabilize the spine
  Surgery - Surgery may be performed to remove bone fragments, herniated disks, foreign objects, or fractured vertebrae that are compressing the spine. Surgery also prevents deformity and pain in the long run.

Recovery starts typically within a week after the treatment. If you undergo surgery, you will have to wait a little longer to get back to your day-to-day activities. It is advisable that you follow up with your doctor and carry on physiotherapy for the first six months at least.

Spinal Trauma - When Should You Consult A Doctor?

At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

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