Endoscopy refers to inserting microscopic cameras into the body through tiny incisions which throw up pictures of the inside of the body onto a screen. Endoscopy has been used for diagnostic purposes since the 1970s. Endoscopy for surgery has become popular from the 1990s.

Endoscopic spine surgery is a state-of-the-art surgery technique which involves micro incisions and minute tubes that cause almost no damage to surrounding tissues and muscles. It is a minimally invasive surgery and it is also called a pinhole surgery.

What are the advantages of endoscopic pinhole spine surgery?

There are a lot of reasons why doctors opt for an endoscopic surgery-

  It is also called Minimally Invasive Spine Surgery (MISS) because it causes little blood loss
  Recovery is almost immediate. A person can resume everyday activities within a week
  Very little pain around the surgery region so minimum pain medication is needed.
  No muscle or bone is removed.
  Since screws and rods are not used, full mobility of the spine can be restored
  The wounds are minute and do not usually require stitches and thus no ugly scars are left after the wounds heal.

What are the characteristics of an endoscopic spine surgery?

  The surgery is performed under local anaesthesia
  The person is discharged within 24 hours of the surgery
  The incisions that are made are microscopic

What are the different types of endoscopic surgery?

Endoscopic discectomy:
It is the least invasive of all spinal surgeries. It is used for treating herniated discs. Endoscopy reveals images of the spine. Through the same tunnel, surgery tools are inserted and the bulging or herniated disc is pulled out with a grasper. The wound does not always require stitches to close it.

Endoscopic Laminotomy:
This a substitute for open laminotomy. The camera helps locate exactly where the target area is. Then an incision is made below and above the lamina to relieve the pressure compressing the nerve.

Endoscopic facet rhizotomy:
With microscopic cameras, the nerves causing pain are identified and then the laser is used to numb these nerves which relieve pain. This type of surgery can also remedy a previously botched spinal surgery, facet joint arthritis or facet joint pain

Endoscopic foraminotomy:
This type of surgery again uses microscopic surgical tools guided by a tiny camera to enlarge a narrowed neuro of spinal nerve root canal to give it more room to move about without being compressed.

Endoscopic Spine Surgery & Pinhole Technique!

Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.

Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.

Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

Prepare for blood loss: Most people experience some blood loss, but not excessive.

Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used.

Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects overall quality of life, so psychological preparation is required.

Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail

Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain.

Smoking and alcohol should be completely stopped, as healing can be hampered.

With some preparation, spinal surgery can be sailed through smoothly.

What To Expect Before and After Spine Surgery?

If you are suffering from a swollen ankle, you can opt for homeopathic treatment. Swollen ankles are commonly caused because of factors such as trauma, ankle injury, ankle sprains, arthritis, steroids, certain medicines, lymphedema, venous insufficiency and many others. There are various homeopathic medicines, which are commonly used for treating swollen ankles occurring due to different reasons.

Here is a list of the top homeopathic medicines for swollen ankles:

Apis Mellifica and Apocynum: These homeopathic medicines are suggested in case of dropsical swelling over the ankles. The swelling occurs because of water retention in your tissues. Apis is used where the patient s ankles are pale, waxy, and swollen. The ankles become sensitive to touch and stinging pain is likely. Apocynum is used in case of dropsical swellings which occur after cardiac diseases. These dropsical swellings may develop on other parts of the body as well, apart from the ankles.
Ledum Pal: This is an efficient homeopathic medicine for swollen ankles, which develop due to arthritis. This medicine is used when the ankles are hot, swollen, and very painful. It is also used for treating swollen ankles due to gouty afflictions. In such patients, warmth worsens the pain while cold applications soothe the pain.
Arnica: Arnica is one of the best homeopathic medicines for swollen ankles, which occur because of an injury. It is a wonderful and fast working medicine, which resolves swelling and attends to other symptoms related to the injury. The ankles of a patient who needs Arnica feel painful, sore, and bruised to touch.
Ruta: This effective homeopathic medicine is used for treating swollen ankles occurring from a sprain, which is an overstretching of the ligaments. This medicine is ideal for sprained ankles along with weakness and pain in the ankle joint.
Hamamelis: This homeopathic medicine is considered to be very effective for the management of swollen ankles, caused due to varicose veins. It works best when used for the treatment of swollen ankles associated with venous insufficiency. The common symptoms which indicate that a patient requires this medicine include swollen, inflamed ankles, which occur because of congested and engorged veins. Cutting pain and soreness in the ankles are also likely. Swelling in the leg is another probable symptom.

Homeopathy is an effective natural remedy for swollen ankles, without having any side effect on the body. For treating swollen ankles, it is recommended for you to consult a licensed homeopathic practitioner before taking homeopathic medicines on your own.


Best Homeopathic Medicines For Swollen Ankles

Facial paralysis is when there is a loss of voluntary movement of the face on one or both sides. The following are the most common causes of facial paralysis.

Bell s palsy, the most common cause of facial paralysis
Stroke is another major cause of facial paralysis, could be combined with right side arm/leg paralysis
Tumours, affecting the facial region can exert pressure on the nerves and lead to paralysis
Infections such as herpes zoster infections cause paralysis
Symptoms:

Difficulty in speech, eating and drinking
Closing eyelids, movement, and expressions become difficult
Loss of sensation, which may be temporary or permanent
Ayurveda believes in not just correcting the paralysis but improving overall health so that there is no recurrence and other areas are also prevented from being affected. According to it, increased vata causes paralysis and so treatment includes correction of it plus prevention of vata accumulation through diet and lifestyle changes.

Dietary and lifestyle changes:

Avoid cold and sour foods like curd, buttermilk, ice creams, cold foods like cucumber, banana, watermelons, etc.
Avoid fermented foods as they aggravate Vata
Reduce or avoid pulses like dal as they can worsen gas accumulation
Substitute rice with wheat
Substitute cow s milk with buffalo milk
Avoid smoking and alcohol completely
Diet must be easily digestible and simple with lot of green leafy vegetables
Avoid foods which can cause constipation
Ayurvedic remedies:

Beejband or country mallow: This has nerve stimulating properties and so useful in paralysis of any sort
Kali Mirch or black pepper: Used as a water gargle, it is beneficial in correcting paralysis
Lavanga or cloves: People with Bell s palsy were given water to which some drops of clove oil were added, and they showed remarkable benefits.
Mulethi or licorice: This is proven to be effective in stopping the progression of paralysis. People with Bell s palsy, in whom there was involuntary tearing, had a stoppage of the symptom.
Ashwagandha capsules: They treat paralysis and also reduce anxiety and stress and depression. It helps by calming and rejuvenating the entire nervous system. It also helps control muscle and joint pains and reduces stiffness. It also helps control insomnia and allows for improved blood pressure.
Curcumin: This is very beneficial in Bell's palsy patients. With its rich antioxidant content, it reduces free radical release and helps control inflammation and reduces oxidative stress.
Nirgundi oil: It also cures the imbalance between Vata and Kapha in the body. Massaging with this oil heals injured facial muscles and nerves and improves paralysis. It also eliminates toxins and prevents greying of hair. Its anti-inflammatory properties provide relief from inflammation and pain.
Pranayam, meditation is sure useful in this condition. Do start asanas, slowly begin with surynamaskar. Along with this, one can take Shastrokta medicine, that are-- 1. Ekangvir Ras vati 1 or 2 bd + Maharasnadi kashay ghan vati 2+2 during the day.

Paralyses - Can Ayurveda Treat It?

What is spinal stenosis: The narrowing of the gaps in the spine or the backbone is called as spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.

Causes of spinal stenosis: It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine

Symptoms of spinal stenosis: There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.

Treatment of spinal stenosis:
-  A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.

-  Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.

-  Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.

-  Medications such as the anti inflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case antidepressants might also be given to provide relief from pain. 
Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.

Treatment For Spinal Stenosis - 4 Things That Are Part Of It!

Sarcopenia refers to the loss of muscle mass caused by the natural process of ageing. Over time, the loss of muscle mass may reduce a person s strength and affect his or her balance and the ability to walk. Sarcopenia can make it difficult for one to carry on with their routine activities, such as walking, lifting objects, or climbing stairs.

The reduction in muscle mass involves both a decrease in their size and the loss of muscle fibres. Sarcopenia becomes noticeable by age 40   and the loss of muscle tissues progress more rapidly by the time you reach the 60s or 70s. Doctors believe that certain hormonal changes due to ageing are the main reason for this condition. 

Apart from that, poor nutrition and a sedentary lifestyle also contribute to muscle loss. Health experts and doctors suggest that following a proper, nutritious diet can help treat or delay sarcopenia.

Diet recommended for sarcopenia patients 

If you are diagnosed with sarcopenia, your dietician or healthcare provider will likely recommend a diet that has an abundance of proteins, omega-3 fatty acids, and vitamins to prevent further muscle loss and boost their growth.

Here is a close look at the nutrients  

Proteins

The protein in your diet signals the muscle tissues to strengthen and build. As your muscles become more resistant to this signal with age, it is important that you consume more protein to increase muscle growth. A study found that people over age 70, who consumed a wholesome meal containing 35gms of protein, saw significant growth in the muscle mass. Leucine, an amino acid, is especially essential for regulating muscle growth. Some of the best sources of leucine include meat, eggs, fish, soy, and whey protein. 

Research has shown that the optimal intake of dietary protein should be somewhere between 0.6-0.9g/pound/d of protein in older adults with chronic or acute diseases. Besides eating more protein with meals, health experts recommend adding other protein-rich foods to their daily diet, including peanuts, almonds, edamame, and chickpeas. 

Vitamin D

Vitamin D is important for maintaining and building healthy bones. This is because the main component responsible for bone health, calcium can be absorbed only when your body has sufficient vitamin D. Milk, soymilk, cheese and other dairy products, egg yolks, and fatty fish like salmon, tuna, and mackerel are some of the foods offering sufficient amounts of vital vitamin D. While natural food sources are the best way to get your daily dose of vitamin D, you can also opt for supplements to increase muscle endurance and lower the risk of falling. However, be sure to discuss with your doctor before taking vitamin supplements. 

Omega-3 fatty acids

Fish oil extracted from fatty fish contains high amounts of omega-3 fatty acids, DHA, and EPA. Due to its anti-inflammatory properties, fish oil is known to boost muscle sensitivity to resistance training and protein, allowing for growth in strength, size, and muscle mass as you age. A study conducted over 16 weeks revealed taking omega-3 supplements regularly witnessed a significant increase in muscle growth. 

Sarcopenia becomes more apparent with age and may affect your quality of life. Eating high-quality protein and enough calories can delay the rate of muscle loss. Consult a dietician and ask for a diet plan comprising these nutrients to improve muscle strength and deter sarcopenia.

What Type Of Diet Should Be Taken In Sarcopenia?

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