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Dr. V.K.Sharma

MSc, Diploma in Radiology

Radiologist, Delhi

43 Years Experience  ·  300 at clinic
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Dr. V.K.Sharma MSc, Diploma in Radiology Radiologist, Delhi
43 Years Experience  ·  300 at clinic
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Personal Statement

To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. V.K.Sharma
Dr. V.K.Sharma is an experienced Radiologist in Bhagat Hospital, Delhi. Doctor has had many happy patients in his/her 43 years of journey as a Radiologist. Doctor has completed MSc, Diploma in Radiology . You can meet Dr. V.K.Sharma personally at West Delhi X Ray Clinic in Bhagat Hospital, Delhi. Don’t wait in a queue, book an instant appointment online with Dr. V.K.Sharma on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 44 years of experience on Lybrate.com. You can find Radiologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Specialty
Education
MSc - G B Pant Hospital / Moulana Azad Medical College, New Delhi, - 1981
Diploma in Radiology - G B Pant Hospital / Moulana Azad Medical College, New Delhi, - 1975
Languages spoken
English
Hindi

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West Delhi X Ray Clinic

WZ-181, Lajwant Garden. Landmark: Near: Lajwanti Chowk, DelhiDelhi Get Directions
300 at clinic
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Breast Cancer - 6 Ways You Can Prevent it

MBBS, DGO, MD - Obstetrics & Gynaecology
Gynaecologist, Mumbai
Breast Cancer - 6 Ways You Can Prevent it

Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer-

  1. Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
  2. Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
  3. Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
  4. Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
  5. Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
  6. Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.
3959 people found this helpful

She is 63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70 to 200 and more. Today fasting 90 but PP is going high between 200 to 300. She is on Insulin from last 15 years. Can she be treated with you? And I am also suffering from Slip Disc. L4 L5 S1 and taken 15 days Ayurvedic treatment such as Katibastyi, Malish, Steam bath etc but there is nothing complete and permanent. Please advise us to permanent treatment.

PDDM, MHA, MBBS
General Physician, Nashik
She is  63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70...
This means either her diet is wrong or she is not receiving proper treatment kindly mention ongoing treatment in detail and revert. Slip disc is difficult to treat but you should use lumbosacral belt and proper posture is really important in your case. Avoid massages by inexperienced people.
1 person found this helpful
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Liver Cancer - 5 Common Signs Of It!

MS - General Surgery, MCH - Oncology , MBBS
Oncologist, Pune
Liver Cancer - 5 Common Signs Of It!

Liver cancer is when the cells in the liver grow uncontrolled. As the liver filters blood from all parts of the body, one of the most common reasons for liver cancer is perhaps metastasis, which is spread from other parts. Through the blood, cancer cells from other parts reach the liver for filtration and can then make the organ cancerous.

In addition to this, there are other risk factors that can lead to liver cancer. For example, people suffering from obesity, alcohol and tobacco abuse, viral hepatitis (B or C), chronic liver disease (especially in men, who are more prone than women to develop cancer), cirrhosis and someone who has a history of a prolonged use of steroids can suffer from the disease. Also, while liver cancer is very rare in the Americas, it is very common in Africa and Southeast Asia as the prevalence of hepatitis is higher in these regions.

When it comes to the symptoms, it’s acceptable that liver cancer is insidious, and the exact point of origin cannot be identified. It continues to grow until symptoms become evident, which are also nonspecific. Before analyzing your health on your own, it’s always recommendable to seek an expert’s final word on it. Let’s take a look at the top signs that might point out towards liver cancer.

  1. Abdominal pain: When you suffer a strong pain in the abdominal area, especially in the upper portion on the right side, it can signal a lump or a growing tumor in the liver. This can also be accompanied by middle or lower back pain.
  2. Weight lossMany a time, women who suffer from a sudden loss of weight can be going through a deadly disease like this one. In most cases, these weight loss cases show no attempts on the patient’s side, that is, the weight loss occurred for unknown reasons. A loss of appetite, without any reasons, is another indicator. These can result due to unexplained reasons and should be taken seriously.
  3. White, chalky stools:This one is another tell-tale sign of liver cancer. Often, people tend to ignore stools in light, flaky colors. It is always better to consult a doctor, as you might be ignoring a sign of potential cancer.
  4. BloatingWhen you feel certain heaviness or bloating in the upper part of the abdomen due to fluid accumulation it indicates, which is one of the indicators for testing liver cancer.
  5. Frequent body conditions: Apart from the above mentioned symptoms, one can also consider personal health history when facing any liver- related problems. Recurring severe nausea and vomiting and general signs of lethargy and weakness can also indicate liver cancer. Also, personal health history with claims the patient suffered from jaundice (due to the accumulation of bile pigments in the sclera and skin) can also be taken into consideration. If you wish to discuss about any specific problem, you can consult an Oncologist.
1877 people found this helpful

Lumbar Degenerative Disc Disease

MBBS, Diploma In Orthopaedics (D. Ortho), DNB - Orthopedics, mch
Orthopedist, Delhi
Play video

Different methods to treat Disc problems

Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.

Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.

They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.

All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.

If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.

You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
 

3714 people found this helpful

Pap Smear - All You Need To Know About It

DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
Pap Smear - All You Need To Know About It

A Pap Smear is a screening test done to to test for occurrence of uterine cancer. Carried out in a quick and simple way to extract a sample, the sample is collected from the cervix area of a woman during a pelvic exam. The examination of the sample takes place under a microscope thereafter to find abnormalities that can point towards cancer and pre cancer changes.

There are many reasons why women should get a pap smear screening done:

1. Women who are HIV positive should get this test done regularly so as to detect any anomalies in the cervix. This condition usually comes with higher risk of infections and cancer, which is why regular screening is required.

2. Age is also another factor and women over the age of 30 should go through an annual screening on a compulsory basis. This is also true for women who have been through pregnancy and child birth.

Preparing for a Pap Smear: To prepare for a pap smear test, you need to ensure that you are not menstruating at the time. Also, you may want to avoid sexual activity just before the test so as to get the most accurate readings. During the process, remember to stay calm and relax your body physically.

Procedure: The pap smear procedure is a quick one that might be only slightly uncomfortable. This test is usually carried out on the examination table at the gynecologist's clinic. The legs will need to be spread and placed in stirrups. The doctor will insert a speculum to hold open the vaginal opening so that the spatula can be inserted easily to take a sample from the area. This sample of the cells will be tested in a lab after due preservation.

Test Results: The test results can either be normal or abnormal. An abnormal result does not point at the presence of cancer. Rather it can simply mean that abnormal cells exist in the cervix. The doctor may ask you to go through these tests and screening more frequently so as to study the anomalies in a more detailed manner.

1 person found this helpful

She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.
Maintain your pelvic sit straight equal balance sciatica pain take ultrasonic therapy and swd then start stretching exercise is confirmation.
1 person found this helpful
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Stages Of Kidney Cancer - How They Can Be Managed?

Mbbs, MD - General Medicine, DM - Nephrology
Nephrologist, Ahmedabad
Stages Of Kidney Cancer - How They Can Be Managed?

Kidney cancer or renal cancer is when kidney cells grow uncontrollably and form a tumour. Kidney cancer often begins in the tubules (tiny tubes in the kidneys). The prognosis may depend on the stage of the kidney cancer.

Different Stages of Kidney Cancer
The TNM system helps to categorize each stage of the kidney cancer.
Tumour (T) – Describes the size and location of the tumour.
Node (N) – Describes the spread of cancer to lymph nodes.
Metastatis (M) – Describes the spread of cancer to other body parts.

These results combined with the five stages (0 and 1 to 4) can help to identify the right treatment option for every patient. Zero stage describes no cancer presence. For instance –
Stage 1 – Here the tumour is confined to kidneys and its size is smaller than 7 centimetres. (T1 or T1, N0, M0)
Stage 2 – Here the tumour is confined to kidneys and its size is more than 7 centimetres. (T2)
Stage 3 – Here the tumour is in kidneys or blood vessels or fatty tissues but also a lymph node; cancer spreads to major veins but doesn’t extend beyond renal or Gerota’s fascia (connective tissues surrounding adrenal glands and kidneys). (T3)
Stage 4 – Here the cancer is in the fatty tissues surrounding kidneys and adjacent lymph nodes; has spread to other nearby organs and beyond renal fascia. (T4)

Treatment and management of kidney cancer
Once your doctor has determined the staging of your kidney cancer, a treatment plan can be formulated for you.

  1. Surgery
    • Simple nephrectomy removes the affected kidney.
    • Radical nephrectomy is a common surgery for kidney cancer. It removes all affected parts such as the kidneys, adrenal gland, lymph nodes and surrounding tissues.
    • Partial nephrectomy is for small tumours and removes the kidneys and the surrounding tissues.
  2. Interventional radiology: This is a surgery aided by real-time images. An advanced surgery using a nano knife is minimally-invasive and is effective for inoperable kidney tumours.
  3. Targeted therapy: Drugs target specific tumour cells and destroy them.
  4. Immunotherapy: Used for kidney cancer that has spread to other organs, this therapy may use different types of drugs to either help immune cells find cancer growth or regulate the immune system activity to stop or slow cancer growth.
  5. Arterial embolization: It is a procedure to stop blood supply to the kidney tumour, in order to shrink it in size prior to surgery.
  6. Cryotherapy: This procedure involves using extreme cold to kill cancer cells.

Chemotherapy is not very effective for treating kidney cancer. Talk to your doctor about all possible treatment options for your cancer. You can lower your risk of kidney cancer by eating healthy, maintaining your ideal body weight and managing your blood pressure.

 

3 people found this helpful

Herniated disk l3-14 mm L4-11 mm L5-10 mm S1-8 mm My age 23 /M Dr. suggest for surgery but I didn't want that any chances for normal.

MBBS, MD (Anaesthesiology)
Pain Management Specialist, Varanasi
It seems that you are having multiple disc herniation. I cannot comment unless I see you MRI but definitely you having at least two slipped disc at L4/5 & L5/S1. These days non surgical treatment are available like TFSI, Disc Fix and Percutaneous Endoscopic Lumbar Discectomy (PLED) done under Local anaesthesia, no blood loss, no stich required, patient walks within next few days. We will provide you detailed information if you wish or you may see on website. I may need your blood inv. Like TLC/DLC/ESR/CRP/HLA B-27 before giving further opinion.
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Hello sir. I have lower back pain since 2 months back. I have done mri there is disk problem. What is permanent solution is surgery kindly help me.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful Do hot fomentation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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Breast Cancer - What's The Right Way Of Diagnosing It?

MBBS, DGO, DNB
Gynaecologist, Noida
Breast Cancer - What's The Right Way Of Diagnosing It?

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

  1. Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
  2. Mammogram and breast ultrasoundYou will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
  3. Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.

Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3323 people found this helpful

Health Tip

Doctor Of Physical Therapy (DPT), Bachelor of Physical Therapy
Physiotherapist, Bangalore
Health Tip

Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.

6 people found this helpful

Dr. Please tell me can you detect the baby's brain defect in ultrasound and any birth defects clearly in which ultrasound?

MBBS, MD RADIO-DIAGNOSIS
Radiologist, Pune
Dr. Please tell me can you detect the baby's brain defect in ultrasound and any birth defects clearly in which ultras...
Yes, neural tube defects, posterior fossa anomalies, prosencephaly, spinal dysrraphisms, and major structural neural abnormalities can be diagnosed on ULTRASOUND.
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3.6*2.8*1.47 I want to increase this uterus There any process Last age of increasing uterus.

MD PHYSICIAN
General Physician, Delhi
Its not possible to increase the size of uterus but yes you can strengthen your uterus lining enough to carry through a pregnancy successfully. Eat healthy likeVegetables are a great source of calcium, potassium, magnesium and vitamins. Eat a diet rich in vegetables to keep those nasty fibroids at bay. Vegetables also can slow down the progress of fibroid tumors as long as you eat vegetables, such as legumes, cabbage, bok choy and broccoli. Daily consumption of dairy products like yogurt, cheese, milk and butter is essential for uterine health. Green tea is filled with antioxidants. They not just help maintain a healthy uterus but can also treat fibroids in the uterus.
1 person found this helpful
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Brain Structure May Help Boost Care

DIABETES EDUCATOR, PGDND, RMP -ALTERNATIVE MEDICINE, MEDICAL TRANSCRITPTINIST, M.SC, Msc nutrition
Dietitian/Nutritionist, Bangalore
Brain Structure May Help Boost Care

Becoming a mum can lay down a whole lot of stress on you. But now you know that your brain is going to help you with all the adjustment s! ah ah a relief you get when your baby gives you a hug by kissing your cheecks the joy you get is amazing and gratitude to the almighty creater

1 person found this helpful

Spinal Cord Injury - Physical Therapy Treatments For It!

M.P.T. (Neuro), BPTh/BPT
Physiotherapist, Lucknow
Spinal Cord Injury - Physical Therapy Treatments For It!

A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.

The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.

If the spinal cord sustains an injury, some or all of these impulses may not be able to ‘get through’. The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

Causes-

A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:

  • a violent attack such as a stabbing or a gunshot
  • diving into water that’s too shallow and hitting the bottom
  • trauma during a car accident (specifically trauma to the face, head and neck region, back, or chest area)
  • falling from a significant height
  • head or spinal injuries during sporting events
  • electrical accidents
  • severe twisting of the middle portion of the torso

Symptoms -

Some symptoms of a spinal cord injury include:

  1. problems walking
  2. loss of control of the bladder or bowels
  3. inability to move the arms or legs
  4. feelings of spreading numbness or tingling in the extremities
  5. unconsciousness
  6. headache
  7. pain, pressure, stiffness in the back or neck area
  8. signs of shock
  9. unnatural positioning of the head

If you suspect that someone has a back or neck injury:

  • Don’t move the injured person – permanent paralysis and other serious complications may result
  • Call 911 or your local emergency medical assistance number
  • Keep the person still
  • Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
  • Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck

Treatment

Treatment should be focused upon that individual and tailored specifically to their condition. A treatment programme is formulated following a thorough physical assessment which might include:

  1. Stretching activities to maintain muscle and tendon length and reduce or keep muscle spasms/spasticity to a minimum.
  2. Flexibility and strengthening exercises for the whole body.
  3. Breathing exercises to maximise lung function and prevent chest infection.
  4. Balance and posture exercises which can help to reduce pain associated with poor posture and balance impairment and ensure correct transfer techniques (in/out of wheelchair, bed, toilet/bath, car etc.)
  5. Functional activities to improve fundamental movement patterns such as rolling over and sitting up, and standing where appropriate.
  6. Walking re-education, if there is sufficient muscle activity and power in the legs.

Your physiotherapist might also be able to advise an individual on use of appropriate equipment such as wheel-chairs and pressure releasing cushions, exercise equipment and electrical muscle stimulators.

Prevention

Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.

 Some risk-reducing measures include:

  1. Always wearing a seatbelt while in a car
  2. Wearing proper protective gear while playing sports
  3. Never diving into water unless you’ve examined it first to make sure it’s deep enough and free of rocks

In case you have a concern or query you can always consult an expert & get answers to your questions!

3280 people found this helpful

What is the reason and precautions for Lumbo Sacral pain in having Disk Slip problem?

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hi apply pranacharya restopain oil or prasarini oil on your affected part then give hot fomentation. Take maha rasnadi kwath 2-2 tsf twice a day. And agni tundi vati and maha yograj guggul 1-1 tab twice a day.
1 person found this helpful
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Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc element
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Results / Outcome

  • PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
  • Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  • PVP does augment height of VB but ideal would be kyphoplasty
  • Patient is either off medicine or on reduced doses.
  • Patient feels so well that he almost forgets if he had VB
     

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are  Metastatic VB,  Multiple myeloma VB, VB haemangioma,  Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF)   which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis.  Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient  back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
  • GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc elements.
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics.
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.

Morbidity and complication of spinal surgery 

  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

  • Cementing of fragments.
  • Thermal neurolysis of VB nerve ending due to heat of polymerization.
  • Washing away of nociceptor chemicals.
  • Neurolytic action of liquid monomer.
  • By allowing early ambulation decreasing pains of immobility & bed rest.

Complications 

  1. PVP is generally safe with low risk.
  2. Ectopic cement leak is frequent but generally inconsequential.

Outcome 

  1. PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
  2. Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  3. PVP does augment height of VB but ideal would be kyphoplasty.
  4. Patient is either off medicine or on reduced doses.
  5. Patient feels so well that he almost forgets if he had VB

In case you have a concern or query you can always consult an expert & get answers to your questions!

4342 people found this helpful

Just recovered from slip disc. What exercises can I do now? Is walking or Treadmill is recommended?

B.P.T, M.P.T(ORTHO), Certification in Gym Instructor & Prenatal and Post natal
Physiotherapist, Gurgaon
Dear sir, You need to strengthen your back first with floor exercises. Then you cn start with treadmill with simple walking fr 20 min at a stretch with no running no inclination. Back exercises you hv to do fr 3mths religiously U cn further contact us
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