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!

Pain causes a lot of discomfort in the body no matter whether the pain is in the back, legs or in the head. Almost all people experience lower-back pain at some point in their lives, which can be extremely painful and can cause considerable annoyance. The first medical specialty that comes to mind for relief of lower-back pain is Orthopedics. The other two specialists that play a vital role in treating lower-back pain are the neurosurgeons and the physiatrists.

Pain in the Back
It is very difficult for the body to source the pain when it is deep and this pain could be due to infection, disease or injuries in the back, stomach and heart. It is even possible that the pain radiates to different places in the body. Often back pain is accompanied by body changes like redness, fever, neurological problems, heat, and changes in body functions and for that diagnosis of the back pain may be very severe. Patients suffering from lower-back pain and with symptoms that comprise of weakness in the foot or other symptoms of a neurologic insufficiency must definitely see a neurosurgeon.

Back pain that occurs due to reversible problems is known to vanish in a few hours or in a day. However, if it continues longer and is accompanied by body changes, then there are chances that the condition can become worse. Visiting a doctor becomes a must for back pain if any of such characteristics are witnessed. It is always better to get evaluated by a physician.

When to Consult a Doctor Immediately

    Back pain that is followed by a shock like a car accident.
    The pain in the back worsens and is constant
    Back pain continues for more than 4-6 weeks
    The pain does not improve even after taking typical remedies such as taking pain relievers or after resting.
    Severe pain in the back in the night and that is alleviated by rest
    The back pain is accompanied by abdominal pain
    Numbness in the upper thighs, buttocks, groin or in the genital area
    Weakness or tingling sensation in the arm or legs

Role of a Neurosurgeon
The neurosurgeon provides non-surgical as well surgical care depending upon the nature of the illness or the injury, and he does not just operate. The neurosurgeons are experts and offer treatment to patients suffering from any injury or disease in the spine, brain or peripheral nerves that deal with arms, hands, feet and legs. But there are many other neurosurgeons that confine their practice to treating back pain.

Lower Back Pain - 8 Signs When You Must Visit Your Doctor

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

The core muscles, mainly concentrated around the abdomen, hips, lower back, trunk, and glutes, are indeed a powerhouse that gets you going. The stronger the core muscles, the fitter you stay. Without a proper core strength, a lot of the day to day activities including lifting or bending gets affected. Certain health conditions can weaken the core muscles. But how to know if the core muscles are weak? There are many signs and symptoms associated with weak core muscles. 

Mentioned below are some important signs that may be an indication of weak core muscles.

For your posture to be correct, the spine and pelvis need to be stable: The muscles of the lower back and the abdomen does exactly that, ensuring a steady and correct posture. However, when the core muscles weaken, they are unable to provide stability to the spine and the pelvis resulting in a poor posture. Left unattended, poor posture, in turn, can trigger a myriad of complications and discomfort.
The body loses its balance: As already mentioned, the core muscles go a long way in stabilizing the body and helping you to maintain the body balance. You can perform a small test to know if your balance is affected. Close your eyes and stand on one foot. Repeat the procedure with the other foot as well. If you have a developed core, you will be able to hold the position for at least 10 seconds, if not more (both the legs).
A pain concentrated to the lower back: Do not ignore a lower back pain. It could be an indication of your core muscles not being strong enough, especially the ones adjacent to the spine. The weak muscles fail to provide the necessary support to the discs and the vertebrae resulting in pain (mild to severe depending on the severity of the condition) and discomfort. Timely medical intervention may help improve the condition.
Weakness throughout the body: The strong core muscles are an indication of a healthy and fit body. When the muscles start to lose its strength, the entire body gets affected. A person finds it difficult to even lift things. Doing even a small and regular work leaves a person weak and tired.
You can also perform the Hollowing Test to check your core strength: Sit in a comfortable position. Starting breathing in and out. As you breathe out or exhale, try to pull your stomach inwards towards the spine for at least 10 seconds. Unable to pass this test (can't hold the position for 10 seconds) indicates weak core muscles.
You can also try the plank test: Get yourself in a push-up position with the entire body resting on your elbows, arms, and toes. The hip should be level and steady. Failing to stay in this position for 50 seconds is indicative of weak core muscles

Core Muscles - How To Know If They Are Strong Or Weak?

Knee pain is referred to as a condition when the knee joints (which are responsible for walking, running, sitting and standing along with bearing the maximum body weight for most forms of physical activities) are significantly inflamed, giving rise to a severe pain in particular areas or the entire knee joint. There might also be severe stiffness around the knee joint which might make it very difficult to function.

Knee pain might occur due to obesity, old age, different forms of arthritis, severe injury in the knee or the associated ligament or bones, knee cap dislocation, overuse of the knee joint and infections of the knee joint.

Homeopathic Treatment For Knee Pain:

Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homoeopathy is not only to remove the symptom of knee pain but to cure its underlying cause. As far as therapeutic medication is concerned, several well-proved medicines are available for knee pain that can be selected on the basis of cause, location, sensation, modalities and extension of the knee pain. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. The effective homeopathic remedies for knee pain are as follows :

Bryonia Alba   This homeopathic preparation is effective in curing knee pain with the symptoms of severe pain in the knee joints during walking. Pain stops when you stop walking or moving and you may also have an abnormal growth in the knee joints. If the knee pain is caused due to osteoarthritis, Bryonia Alba can prove to be a useful remedy as well.

RhusTox   If the knee pain comes with the symptoms of severe pain in damp weather, intense pain after initial movement which tends to gets better in continuous motion, a prescribed dosage of RhusTox might help in the elimination of the pain.

Colchium   The medicine is useful in treating knee pain which worsens due to movement and subsequently improves in warm weather or after getting appropriate rest.

Silicea   This preparation is useful in curing knee pain which retains the sensation of being tightly bound during all times.

Lachesis   If the knee pain is caused due to rheumatoid arthritis, Lachesis can be an effective treatment. Lachesis can also be prescribed if the pain is accompanied with an abnormal growth around the affected area.

These are just a few of the commonly used Homeopathic remedies and are mentioned only to create awareness about the effectiveness of Homeopathic medicines for Knee Pain. It is not advisable to resort to self-medication for any disease.

Treating Knee Pain With Homeopathy Treatment

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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