Spinal fusion is a surgery in which two or more vertebrae in the vertebral column or back are fused or joined to treat a slew of spinal problems and diseases, which cause debilitating back pain. This surgery helps to remove bone and tissue that are narrowing the spinal canal, squeezing the spinal cord and nerves, reducing pain and improving function.

There are many different causes of back pain like injury, poor posture, age, osteoarthritis, herniation of disc between two vertebrae, degenerative disc disease, narrowing of spine called stenosis, and spondylosis or lessening of space between the vertebrae- most of these can be treated using spinal fusion.

All of these causes put tremendous pressure on the vertebrae and pinch spinal nerves that pass through the back and radiate out into the arms, legs and torso. Apart from the pain, patients experience nerve and muscle weakness and irreversible damage affecting normal life.

Spinal fusion started off as just a treatment for fractures but now it has become the surgery of choice for a number of spine problems. Though it can be done anywhere in the spine, it is very effective when done in the lower part of the spine called lumbar spinal fusion or arthrodesis.

Spinal fusion is done by forming a direct bony connection between the vertebrae surrounding the painful discs, the cushioning between the vertebrae. Pain is stopped by stopping the motion of the painful discs.

There are different methods of spinal fusion each with its own advantages and limitations.

Techniques include fusion approached from the front, the back, or both of the vertebral column. Sometimes surgeons decide to use intervertebral cages or metal screws to provide internal structural support while the bone fuses. These cages may be placed between the vertebrae and packed with bone graft material taken from the patient or constructed out of synthetic materials.

What to expect?
Spinal fusion is not a risk-free procedure. It is a major surgery lasting several hours and carrying a number of risks like-

Failure of the vertebral fusion and breaking of metal implants
The vertebrae above and below the fusion can wear away aggravating problems
Blood clots may be formed that can travel to lungs causing embolism
Injury to spinal nerves causing permanent weakness in legs and problem with bladder and bowel function
Infections and blood loss
Heart attack or stroke during surgery
The patient has to be kept in hospital for a couple of days for post-operative care after which he will have to undergo rehabilitation for months. Hence, one should really think before going for spinal fusion. And when it is recommended, seek a second opinion before making a decision. 

Spinal Fusion Surgery - What To Expect?

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

Swimming: Swimming again is a good aerobic exercise and is good for back and over all fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight bearing exercises.

Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically.

How Exercise Can Help In Keeping Your Bones Healthy?

The joints and bones of the body are connected by fibrous band of tissue called as a ligament. When these ligaments are over stretched or are subjected to any injury that could cause tearing of the ligament and a sprain of the ligament happens. Sprains usually occur at the ankle joint, knee joint or the shoulder, since these areas have a connection of bones at a joint. 

During movement, the ligament functions to stretch or expand and move back to its original position. However, sometimes due to an over-stretch of the ligament, it gets pushed or expands beyond its usual position. A sudden twisting movement of the ligament can also cause a sprain. 

While walking, any abnormal movement of the leg can cause a sprain, hence, the ankle joint is the most common location affected by a sprain. Sports injuries are a common causative factor of sprains. In accordance to the body part involved frequently in playing sports, a wrist sprain or an ankle sprain is a common finding. 

Dancers are also prone to frequently sprain their ligaments. If a sprain occurs at the wrist joint, it can also lead to cause the Carpal tunnel syndrome, which leads to the numbness of the wrist joint. Moderate to severe pain around the affected joint, presence of bruising in cases of an injury, swelling around the affected joint and difficulty in movement are the common symptoms of a sprain.



There can be a popping sound heard during an injury to the joint, which indicates a sprain. Sprain of the joint can cause other complications too. If there is an involvement of the nerve in the injury, there can be an associated numbness and tingling sensation at the affected area. A physician performs physical inspection of the area while looking for the symptoms of sprain. If the injury involves a larger surface area and is causing severe pain, an MRI or X-ray can be ordered to detect for the ligament or bone involvement, respectively. 

Classification of sprain can be enlisted as follows: 

Grade 1 sprain (mild): Slight stretching and little damage to the fibers of the ligament. 
Grade 2 sprain (moderate): Includes partial tearing of the ligament.  
Grade 3 sprain (severe): Includes complete tearing of the ligament.  Prevention of a sprain can be achieved with certain measures. Specific exercises that can be targeted for sprain prevention can be learnt from the physical therapist.
Stretching exercises and muscle training are important in prevention of a sprain. Sprain preventing measures are as follows: 

1. Before beginning an exercise routine, it is essential to do warm up exercises. Slight jogging can be done to activate muscle movement. 

2. Stretching before and after an exercise routine is necessary. It ensures that the muscles around the joint are in a relaxed position. It helps in minimizing the risk of an injury. 

3. Some specific exercises that help to strengthen the muscles around ankles should be done. Heel raise exercise is beneficial in strengthening the ankle muscles. 

4. Exercises that target the improvement of overall body s balance should be done on a regular basis. These exercises help in preventing twisting of ankles during walking or moving down the stairs. 

5. In case of a previous ankle injury, it is recommended to wear an ankle brace to prevent any twisting caused by a dis-balance. 

Treatment of the sprain is done by following the RICE procedure. This procedure includes the protocol of rest, ice, compression and elevation. Analgesics can be taken for pain relief. Ice pack application helps in reducing the swelling. Using a compression bandage helps in immobilizing the injury.

Sprain - Effective Tips To Prevent It!

Damaged hips can cause great distress in carrying out daily activities, such as walking, getting dressed and many more. If you have damaged one or both of your hips, and it causes you great pain, you may require a hip replacement. It is a common form of surgery in which a damaged hip joint gets replaced with an artificial one. This is known as prosthesis.

Conditions which lead to hip replacement

Osteoporosis where the cartilage inside a hip joint gets worn out, and the bones rub with each other as a result
Rheumatoid arthritis, which is caused when the immune system attacks the hip joint lining by mistake
If the hip joint gets damaged severely during an accident or fall
The purpose of a replaced hip joint is to provide pain relief, improve the hip s function, improve your ability to carry out day-to-day activities and improve your overall quality of life.

Procedure
A hip replacement is usually carried out under general anesthesia. An incision is made in the hip by the surgeon and the damaged hip joint is removed through it. It is replaced with an artificial metal alloy or a ceramic joint. The surgery takes approximately 60 to 90 minutes for completion.

Recovery
After the surgery, a walking aid such as crutches is required for up to four to six weeks. You may enroll for an exercise program, which aims at regaining and improving the new hip joint functions. Regular activities can be restored within two to three months. A year is required for utilizing the new hip joint normally.

Risks of hip replacement
There may be several complications as a result of a hip replacement. They include:

Dislocation of the hips
Infection at the surgery wound
Injury to nerves and blood vessels
Difference between the lengths of two legs
Fractures
Alternative
Hip replacement surgery has an alternative type of surgery, which is called hip resurfacing. During this surgery, the damaged surfaces of the bones within the hip joint are removed and replaced with a metal surface. Less bone is removed in this surgery. However, the metal surface may cause complications and health hazards.

Hip replacement is being improved upon with the advent of technology. Stronger and newer materials are being developed for prosthetics, which will allow enhanced joint mobility and a longer wear. New cement-less implants are also being developed. Also surgery assisted by computer is being used for generating an image of the hip joint.

 Hip Replacement - An Overview!

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?

Muscle sprains and ligament tears are one of the most common injuries that medical practitioners encounter on a regular basis. These injuries are painful and can also limit one s movement, needless to say. However, there are simple things that can be done as soon as the injury happens so that the impact of the injury can be reduced, the symptoms minimised, and recovery improved.

A sprain is a tear of the ligament. The ligament is responsible for connecting the tissue strands that connect the bone to the muscle. When this sprain affects the muscle or even the tendon, it is known as a strain.
Sprains are very common and can occur due to a fall, twist, or impact. Most commonly affected areas are the ankles and wrists. Sprains happen when there is a pull or a twist of the ankle or the joint. This is very common in athletes and can be caused by repetitive motions in the knees, wrists, elbows, etc.

The most common symptom is pain, swelling, limited movement, and sometimes bruising. The degree of these injuries depends on its severity. The most common ways to treat such injuries are as follows.

RICE therapy: RICE is an acronym for rest, ice, compress, and elevate. Rest the affected area immediately by stopping any further activity. Ice the area using an ice wrap, with the ice cubes wrapped in a towel or a cotton cloth. Repeat this exercise if possible for every 20 minutes. This will reduce the swelling and pain. Compress the area using a sling or a wrap. This will help in reducing the swelling. Elevate the affected area if possible above the heart. This will help control the blood flow and thereby reduce the swelling and pain.
Pain control: If there is pain that needs medication, go for the non-steroidal drugs like ibuprofen or acetaminophen. If it is a child that is injured, it is advisable to give non-aspirin ones.
Seek professional help: Most sprains can be self-limiting over a couple of days. However, it is advisable to seek medical help if there is significant pain, swelling, or numbness, open wounds or bruises, or inability to move the joint.
The doctor may decide to do the following.

Scanning or imaging to rule out any internal hard/soft tissue injury like fracture or tear
Immobilise the joint with a splint or a cast
Start physical therapy if there is severe pain and immobility
Surgical repair if there is a ligament injury
A word of caution to athletes or people who are very active physically is to go easy on the joint. In an eagerness to quickly get back to their routine, more and severe damage may be caused. This can be avoided by allowing time for complete healing.

Muscle & Ligament Sprain - Tips To Help You Deal With It!

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