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?

The backbone is made up of multiple small bones which are connected together by a softer bone. The spine is what allows important body movements including bending and walking. The issue is, with age, the backbone also loses its elasticity and becomes rigid. Though this is a natural process with ageing, lack of exercise and sedentary lifestyle makes it worse.

Lumbar spondylosis is the medical term for this chronic, degenerative condition of the lumbar and the sacral spines (the lower portion of the backbone). This leads to chronic stiffening of the spine, affecting movement. This joint is very crucial in all bending movements and spinal movements.

Causes of Lumbar Spondylosis:

Ageing: As the condition progresses, the nerves that run through the spines can get exposed and there could be pain and irritation
Genetic abnormalities that produce a weak bone
Spinal trauma like accident or falls
Sedentary lifestyle: Sitting in front of the computer for prolonged hours also causes lumbar spondylosis
Overuse: People who are weightlifters tend to put excessive pressure on the spine, causing lumbar spondylosis
Symptoms:

Stiffness and pain in the low back
Pain with continued sitting
Numbness and tingling if nerves are getting affected
Loss of balance, leading to frequent falls
Losing control over bowel and bladder movement
Pain radiating to the lower legs
Ayurvedic remedies: This includes a combination of external applications, yoga, and food preparations including kashayas and tailas.

This condition is caused by increased Vata and Kapha. Maharasnadi kashayam, Astavarga kashayam, and Dashamoola kashayam reduce these elements.
Pain and inflammation is relieved by the use of various Guggulu including Mahayogaraja Guggulu, Simhanada Guggulu, Trayodashang Guggulu, and Dhanvantara Vati  
The affected joints can be hydrated with the use of gandha taila and dhanwantharam.
Kukkutandatvak bhasma is known to strengthen the bone.
Ashwagandha is known to lubricate the vertebral disks and joints
External treatments like Abhyanga are useful in improving joint movement. They improve circulation and help in removal of toxins so that pure blood can flow and reduce inflammation.
Vasti: This helps in improving nutrition to the joints and bones, thereby helping them repair themselves and heal.
Yogas for lumbar spondylosis: The five most effective asanas are:

Ardhakati chakrasana
Pada hastasana
Matsyasana
Ardha chakrasana
Vakrasana (sitting in a chair)
Additional measures:

Sit in a comfortable position with adequate back support
Take short breaks to avoid continued sitting
Sleep comfortably, by resting the back adequately
Strengthen the back muscles by regular exercises.
Eat healthy, avoid junk, and drink plenty of water.

Lumbar Spondylosis & Ayurveda - What To Expect

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?

A bone may break due to several reasons starting from a fall or an injury or a condition like osteoporosis that makes the bones brittle and leaves them susceptible to fractures. The fracture usually takes a few weeks to get fixed as the broken bones grow back together with the help of various forms of treatment including a plaster and sling applied by the orthopaedic specialist or general physician. Find out more about how bones heal with this article.

Types of fracture: Before we get to the subject of how bones heal, it is important to understand the various kinds of fractures recognised by doctors. The first kind is the complete fracture where the bone breaks into two distinct parts. The next kind is the greenstick fracture or hairline fracture where there is simply a crack on one side of the bone due to pressure. Further, there is the single fracture which occurs where there is breakage of the bone only in one place. A bowing fracture may occur when the bones bend instead of breaking completely. This kind of fracture is pretty common for children. The comminuted fracture happens when the bone is crushed or broken in many places. And finally, the open fracture is one where the bone ends up protruding from the skin.

Treatment: Once you have broken a bone, the doctor will conduct an X ray which will help in understanding the type of fracture and the extent of the damage caused. The doctor will then apply a cast and plaster that will help in bringing the bone back to its normal position so that it grows back with the main bone. In case the bone has broken into various parts or there is a complete fracture, then the doctor may even insert metal pins.

Natural healers: Bones are known as natural healers that can heal with the process of new cells and vessel production which rebuilds the bone by covering the broken ends and closing the gap caused due to the damage or the crack.
Clot: Once a bone has broken, a blood clot or a callus forms in the surrounding region, which kind of acts towards sealing the area.
Threads: Once these clots have formed, the new threads of the bone cells begin to grow slowly from the ends of the broken bones. This will grow on both sides of the affected and fractured bones, almost as if drawing a line from one broken end to another.
Absorption: Finally, the callus will be absorbed by the new cell and the gap will close.
See a doctor is you are experiencing any noticeable symptoms that may point towards bone fractures.

Broken Bones - How Do They Heal?

The sciatic nerve is the longest nerve in the human body. It runs from the lower back, through the buttocks, your hamstrings and into the lower leg. Sciatica means pain in the leg, numbness or any kind of weakness in the lower back. There can be many reasons for a leg pain such as an injury to the leg or it can be due to the main nerve which travels in the lower back. Many times, it is not diagnosed properly and hence it will take a lot of time to respond to the treatment or in some cases, it may not respond at all. 

Symptoms of Sciatica: 

You will experience pain in the lower back only on one side of the body. 
The pain continues from the lower back to the sciatic nerve. 
Rarely, you will see the pain on both sides of the body or buttocks. 
The pain is very sharp. 
In some cases, the patient may experience a needles or pins sensation in the leg and in some cases, it is weakness or numbness in the lower back. 
The pain gets so severe that you will not be able to walk or even stand. 
If you have lower back pain combined with leg pain, then lower back pain is not going to be as severe as the leg pain. With the help of the symptoms, your doctor will be able to diagnose sciatica but in order to know the exact cause and origin of this pain, you will have to undergo other tests and examinations. 
Physiotherapy for Sciatica: 
There are many surgical treatments available for sciatica, but it is always good to go for non-surgical treatments. So you can opt for physiotherapy. You will be able to see better and long lasting results with this treatment. As it involves a thorough assessment of it on which the treatment protocol is laid. 

Physiotherapy involves four phases: 

Pain relief 
Restoration of normal flexibility 
Restoration of full functionality 
Prevention of recurrence 
In sciatica, it is due to unbearable pain, you seek treatment. So that has to be treated initially. When you can see that the pain is under control, then the physiotherapist will start working on the range of motion for your joints. The muscle tension will be reduced and muscle strength will be improved. In the third stage, your physiotherapist will start working on restoring the normal function of your body, especially your legs and your lower back. In the last stage, the physiotherapist will help you with some exercises that will stop its recurrence. Usually, sciatica will return after some time but taking a little care at the early stage can prevent it.

Physiotherapy For Sciatica - Why Is It The Best Treatment Option?

Are you suffering with pins and needles in your hand? You may be suffering with carpal tunnel syndrome. Carpal tunnel is a tunnel made of bones in the wrist. Roof of the the tunnel is made of a ligament. This tunnel contains a nerve and some tendons which help in bending of fingers.

This nerve is called median nerve and it acts as a electrical wire carrying sensation from certain parts of hand. It also functions as a wire carrying power signals from brain to hand. Increased pressure of the tunnel causes compression of the nerve and this condition is called as carpal tunnel syndrome. This syndrome gives symptoms of pins and needles in part of hand and weakness in grip. (Pins and needles in Hindi is commonly known as झुनझुनाहट or झुनझुनी or सुन्न पन). Often patient will wake up in night because of pins and needles and shake their hand to relieve the symptoms. It can also manifest as burning sensation or pain in hand.

Carpal tunnel can be caused due to multiple factors. It is commonly seen in pregnant females. Repeated use of hand in certain postures can also lead to carpal tunnel syndrome. Other causes are thyroid problems, diabetes, rheumatoid arthritis and injury to wrist.

Diagnosis of carpal tunnel is mainly clinical and nerve conduction study is a useful tool in confirming the diagnosis. Special (Neuropathic ) pain killers can help with the symptoms. Physiotherapy and posture training can also reduce pins and needles. Night splints are often helpful. If symptoms fail to improve with non operating measures, surgical decompression of carpal tunnel is indicated. Carpal tunnel surgery is performed as a day case procedure under local anaesthetic. It has very satisfying results and a quick recovery.

This article is for information purpose only and not a substitute for proper medical advise.

Pins & Needles In Hand - Carpal Tunnel Syndrome!

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