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?

Extramedullary intradural tumours are a rarity. Of all the tumours of the nervous system, fewer than 15% are of the spine. And around 45% of them are intradural. And 40% of intradural tumours are extramedullary.

What are some common Intradural Extramedullary Spinal Tumours? 

Some forms of intradural extramedullary spinal tumours are-

Schwannomas

Meningiomas

Gliomas

Neurofibromas

What are the Symptoms of Intradural Extramedullary Spinal Tumours?

Some symptoms of this condition are-

Back pain

Cramps

Loss of feeling along the back

Loss of spinal flexibility

Weakness of the limbs

Slight degrees of paralysis

Hunched-over spine

If treatment is not sought immediately, the effect of the tumours would penetrate all levels of the spine and may lead to complete paralysis.

How are Intradural Extramedullary Spinal Tumours diagnosed?

A basic physical examination will reveal that there are tumours on the spine. Before treatment commences, the person will have to opt for these tests-

An MRI scan

A CT scan

X-rays

biopsy

Treatment of Intradural Extramedullary Spinal Tumours diagnosed?

Doctors do not usually suggest surgery right away. They will first try to vanquish the tumours with chemotherapy and radiation therapy. Sometimes a combination of both might be required.

If therapy does not work, surgery will be suggested. During the surgery, resection is done with the aim to assuage pain and stabilize the spine. Preoperative embolization is performed. A catheter is inserted into a vessel of the groin and directed to the tumour. Then a glue-like agent is administered to the vessels that carry blood to the tumour. When this supply is cut off, the tumour will shrink.

After the surgery, a person will be required to stay on in the hospital for a couple of weeks after which rehabilitation may be required to help the patient get back to a normal lifestyle.

Spinal tumours can be fatal. That is why it is important to pay heed to the symptoms and consult a doctor right away.

Intradural Extramedullary Spinal Tumour - In Depth!

Spine deformity refers to an abnormality of the shape, alignment, or formation of the vertebral column. The spine in the human body is composed of small bones or vertebrae, stacked on top of another. A healthy spine, typically, has gentle curvatures. A displacement or exaggeration of the spine leads to deformities.

Types of spine deformities:

The three major forms of spine curvature deformity are-

  Lordosis - Causes the lower back to turn inward
  Kyphosis - Leads to forward rounding of the back
  Scoliosis - Causes the spine to curve sideways

What are the causes of spine deformity?

The following conditions may cause the spine to be misaligned-

  Achondroplasia - A disorder, which impedes the normal growth of the bones, thereby resulting in short stature or dwarfism
  Spondylolisthesis - When the vertebrae in the lower back slip forward
  Osteoporosis - When the vertebrae become fragile and prone to fractures
  Scheuermann s disease - A developmental disorder of the spine that leads to abnormal growth of the upper back
  Spina bifida - A congenital disorder where the spinal column does not close completely while inside the womb

Symptoms associated with deformed spine:

Signs and symptoms of a deformed spine include-

  Uneven/misalignment of the shoulder and hips
  Uneven shoulder blades (one side is slightly higher than the other)
  Slight bending of the head over the body
  Difficulty in movement
  Discomfort and back pain

How is the condition treated?

The treatment of the condition depends on the severity of your spine deformity. Anti-inflammatory medications and drugs are prescribed to manage pain and discomfort associated with spine deformity/curvature. However, these cannot correct the deformity completely.

Severe cases of spine deformity need another line of treatment.

  Bracing - Back braces are recommended for children and adults alike, depending on the degree of curvature. This can help prevent the condition of your back from worsening.
  Body casting - The doctor places a cast that starts from the shoulders and goes all the way down to the lower trunk. This provides adequate support to the spine and strengthens the back.
  Spinal instrumentation - The surgeon will attach instruments like rods, hooks, and wires to the spine to keep the bones aligned following a spinal fusion.
  Artificial disc replacement - The surgeon replaces degenerated discs in the spine with artificial devices.
  Kyphoplasty - The surgeon inserts a balloon into the spine to stabilize and realign the deformed spine and relieve you from the pain.

Following the treatment, patients with spine deformity are usually advised to go for physiotherapy sessions. Physical therapy and exercise can help you build muscle strength and increase flexibility.

Deformity of the spine is a difficult condition to live with. Not only does it restricts your normal movement but also places you at risk of other musculoskeletal disorders. Therefore, it is imperative that you get the condition treated by a specialist.

Spine Deformity - Everything You Should Know!

Scoliosis is the abnormal twisting and curvature of the spine. It is usually first noticed by a change in appearance of the back. There are several types of scoliosis based on the cause and age when the curve develops; the majority of patients have no known cause.

Typical signs include:
1. Visibly curved spine
2. One shoulder being higher than the other
3. One shoulder or hip being more prominent than the other
4. Clothes not hanging properly
5. A prominent ribcage
6. A difference in leg lengths

Back pain is common in adults with scoliosis. Young people with scoliosis may also experience some discomfort, but it's less likely to be severe. Seeking medical advice If you or your child has signs of scoliosis, make an appointment to see your spine specialist. They can examine your back and can refer you for an X-ray for confirmation. If you or your child are diagnosed with scoliosis, it is important to see a scoliosis specialist to talk about treatment options.

What causes scoliosis?
In around eight out of every 10 cases, a cause for scoliosis is not found. This is known as idiopathic scoliosis. A small number of cases are caused by other medical conditions, including:
1. Congenital scoliosis: Caused by birth defects.
2. Neuromuscular scoliosis: Common conditions are
- cerebral palsy
- a condition associated with brain damage
- muscular dystrophy
- a genetic condition that causes muscle weakness
- marfan syndrome
- a disorder of the connective tissues
3. Idiopathic Scoliosis: What causes idiopathic scoliosis is still unknown.
4. Adult scoliosis: In adults, age related changes in the discs and joints of the spine and a reduction in bone density may cause scoliosis. Adults can also experience worsening over time of previously undiagnosed or untreated scoliosis.

Diagnosing scoliosis
Scoliosis can usually be diagnosed after a physical examination of the spine, ribs, hips and shoulders. You may be asked to bend forward to see if any areas are particularly prominent. For example, one of your shoulders may be higher than the other or there may be a bulge in your back. Scans The specialist will take an X-ray to confirm the diagnosis of scoliosis.The X-ray images will also help determine the shape, direction, location and angle of the curve. The medical name for the angle the spine curves is known as the Cobb angle.In some cases, scans such as a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan may also be recommended. Treating scoliosis in children If your child has scoliosis, their treatment will depend on their age and how severe it is. The main treatment options are:
- observation
- casting
- bracing
- surgery

Observation treatment is not always necessary for very young children because their condition often corrects itself as they grow. However, if the curve does not correct itself, it can reduce the space for the internal organs to develop in, so careful monitoring by a specialist is important. Casting in some cases affecting young children, the spine may need to be guided during growth in an attempt to correct the curve.

In a child aged under two years of age, this can sometimes be achieved by using a cast. A cast is an external brace to the trunk made out of a lightweight combination of plaster and modern casting materials. The cast is worn constantly and cannot be removed, but is changed regularly to allow for growth and remodelling. Bracing If the curve of your child's spine is getting worse, your specialist may recommend they wear a back brace while they are growing.

A brace cannot cure scoliosis or correct the curve, but it may stop the curve from getting worse. If a brace is used, it will need to be carefully fitted to your child's spine. Braces are often made of rigid plastic, although flexible braces are sometimes available. In general, modern back braces are designed so they are difficult to see under loose fitting clothing. It's usually recommended that the brace is worn for 23 hours a day, and is only removed for baths and showers.

However, it should be removed during contact sports and swimming. Regular exercise is important for children wearing a brace.The brace will usually have to be worn for as long as your child's body is still growing. For most children, this will mean they can stop wearing it when they are around 16 or 17 years old. Surgery is recommended, if your child scoliosis is severe and in case, other treatments have been unsuccessful, corrective surgery may be recommended. They type of surgery will depend on your child's age.

Surgery in children for younger children, generally those under the age of 8 to 9, an operation may be carried out to insert growing rods. These rods aim to allow for continued controlled growth of the spine while partially correcting the scoliosis. After surgery to insert the rods, your child will need to return to their specialist every 4 to 6 months to have the rods lengthened to keep up with the child's growth. In some cases, rods that can be lengthened using external magnets during an outpatient appointment may be used.

Surgery in teenagers and young adults operation where the spine is straightened using metal rods attached with screws, hooks, and/or wires, and bone grafts are used to fuse the spine in place. This metalwork will usually be left in place permanently, unless they cause any problems. After the operation, most children can return to school after a few weeks and can play sports after a few months. Possible complications of scoliosis Physical complications of scoliosis are rare, although serious problems can develop if it's left untreated.

Emotional issues having a visibly curved spine or wearing a back brace may cause problems related to body image Lung and heart problems In particularly severe cases of scoliosis the rib cage can be pushed against the heart and lungs, causing breathing problems and making it difficult for the heart to pump blood around the body. Nerve compression In some cases of scoliosis, particularly those affecting adults, the bones in the spine compress nearby.

All About Scoliosis

People with spine problems face tough choices when considering treatment. Depending on the severity and scale of the disorder, you will have to decide which treatment works the best for you, and keep an eye out for its long-term impact. Owing to the numerous myths and misconceptions surrounding spine surgery, many patients are unreasonably reluctant to consider this as a treatment option.
Before you make your mind, learn the truth behind these myths about spine surgery. 

  Myth: Spine surgery invariably leads to paralysis

Fact: With the introduction of modern technology in the field of medical science, the efficacy and success rates of spine surgery has improved significantly. The chances of paralysis following surgery are less than 1%. Latest advancements in operating techniques have made the procedure safer and more effective than before.

  Myth: You might require multiple surgeries following spine surgery in the future

Fact: In over 90% of all cases, one successful spine surgery at the right time is all you need to treat the disorder. Majority of patients can do without a second surgery. However, it is essential that patients follow all the instructions and preventive measures to make the surgery successful. The post-treatment guidelines include simple things, such as   eating healthy, reducing and maintaining body weight, exercising regularly, quitting tobacco etc. In rare cases, failing to keep up with these instructions may lead to the need for a second surgery.

  Myth: Spine surgeries are painful

Fact: This was once true when open spine surgeries requiring long incisions were performed   but not anymore. Spine surgeries are now relatively painless as compared to earlier times   all thanks to technological advancements. The modern-day minimally invasive procedure has made spine surgery less painful with no or minimal complications, as you need not go under the knife, literally. In fact, patients do not require anaesthesia before opting for the procedure.

  Myth: You will be bed-ridden for life after the surgery

Fact: The common belief among people is that they will never be able to walk again after spine surgery. But that is not true. With minimally invasive techniques and keyhole surgery, the patient is able to walk the very same day of the surgery. In most cases, they are discharged in a few hours following the procedure. Moreover, pain management techniques and physiotherapy have made it easier for patients to move about without much difficulty.

  Myth: The complication rates are very high in the case of surgery

Fact: With advancements in technology, the overall rates of complications have reduced drastically   less than 3% precisely. The state-of-the-art neuro-monitoring system monitors every nerve during the surgery and allows no scope for error. Surgeons have reportedly been able to avoid all nerve-related complications and offer a 100% success rate using this technique.
The decision to undergo spine surgery can be difficult and the misconceptions floating around do not make it easier. Nevertheless, distinguishing the facts from myths is important. Be sure to discuss any concerns or questions you may have with your physician. They can clear your doubts and help you find out if surgery is the appropriate approach to treat your condition.

Myths About Spine Surgery - Debunked!

Spine surgeries are complicated and have serious repercussions if the procedure doesn t go as planned. Probing your doctor is therefore very critical to ensure a safe operation and early post-op recovery. Questions can range from the type of treatment chosen for speedy recovery to side effects. Here is a list of questions that you need to ask your spine surgeon:

1. Why is the surgery recommended?
Typically, there could be more than one treatment option for a particular problem. Your doctor should be able to tell you very precisely as to why the surgery is recommended and how it is going to address the problem.

2. Is there any non-surgical option?
Many spine related issues can be treated with medicines and physiotherapy. Ask your doctor if such options exist.

3. Explain the surgical procedure in detail
Your doctor should explain the whole surgical procedure, explaining the minute details and help will help you to understand the implications.

4. What is the duration of the surgery?
Spine surgeries do not take more than 2 hours. It, however, depends on the procedure that is being performed.

5. How will the surgery address the pain?
It is important to know the source of the pain. Exploratory surgeries are not performed on the spine. Ask your doctor how he intends to address the pain through the surgery.

6. What are the risks involved?
Risks and side effects vary from patient to patient. For instance, a person with obesity, spondylitis and smoking has greater chances of complications associated with the operation.

7. Will the doctor perform the whole procedure or he will use practicing surgeons and intern for the job?
Many senior surgeons use interns and junior surgeons to perform a minor procedure. Get a clear understanding of the role of the doctor and his assistants. It is a good idea to know the background if the surgical team who is going to perform the procedure.

8. What is the success rate of the doctor for the procedure he is going to perform?
A successful spine surgeon should be able to give you valid data on his/her success rate and the overall success rate of surgeons all across the country.

9. How many days do you need to spend in hospital?
Your hospital stay is directly related to your insurance. It is essential to get a clear picture on the same.

10. Whether a back brace is necessary after surgery?
Limiting the spine movement speed the process of healing. Most Doctors suggest braces after a spine surgery.

11. What is the time required for recovery?
The recovery greatly varies from patient to patient. What you should ask your Doctor is the expected time required for you to join your job/school.

12. Will there be any physical limitation after the operations?
Many spine surgeries require you to refrain from strenuous jobs for a while. For instance, certain surgeries require you to stay away from driving for a while. Address all these apprehensions from your doctor.

12 Questions You Must Ask Your Spine Surgeon

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