Dr. Vishal Nigam

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.​

1. 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.

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

3. 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.

4. 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).

5. 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.

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

7. 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.

8. 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.

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

2. 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.

3. 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.

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

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

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

The spine plays a very crucial role, both from a person’s movement and sensation point of view. It carries the nervous supply for a lot of internal organs and the lower body. By virtue of its structure, it also helps in movement through the disks. Due to various reasons, spinal injury is common, causing pain along the back, lower extremities, neck etc.

Medicines and exercise are the first line of treatment for most spinal injuries. The issue, however, is that these only provide relief from the pain and the medicines, but do not actually ‘rectify’ the underlying problem. Whether it is a herniated disk or a pinched nerve, the medicines and exercise can relieve the symptoms, but the disk continues to be herniated and the nerve continues to be pinched. Definite treatment is in the form of surgery, and with recent advancements in the field of spinal surgery, there are minimally invasive surgical options, which provide complete cure with minimal recovery time. Some of the benefits of this are listed below-

1. Smaller incision compared to traditional surgical procedures, where only the injured area is accessed

2. The surrounding tissues are untouched, unless they are injured and require repair

3. Lesser bleeding compared to earlier techniques

4. Lesser painful procedure

5. Reduced hospitalization period

6. Quicker recovery and return to normal activities

The question, however, is whether this is indicated in everybody. A detailed discussion with your surgeon keeping the below points in mind will help identify the answer for this. The main driver should be the answer to the question – will the surgery be able to effectively relieve you of the pain and symptoms? Additionally, the following factors help in getting better results out of a minimally invasive spinal surgery.

1. Presence of symptoms relating to nerve compression, including pain from the spine down the leg.

2. Recent onset of symptoms, with pain starting days to months before seeing the doctor. This indicates the condition is relatively new and so damage is minimal, indicating favorable outcome. Chronic pain conditions take slightly longer time compared to recent injuries.

3. People with active lifestyle who engage in regular physical exercise are likely to have better benefits from the minimally invasive procedure.

4. Smoking reduces blood flow to the spine, leading to disk degeneration and weakening of bones. Healing is highly slowed down and recovery is overall delayed.

5. Excessive weight puts strain on the back, and so healing can be delayed or badly affected with more complications. It is not a contraindication, but be prepared for a longer recovery period.

Talk to your doctor keeping these points in mind, and you can bid farewell to your back pain forever. 

Spine deformity is a medical condition that refers to any type of abnormality in the shape, alignment, or formation of the vertebral column. The human spine, in its normal state, has a gentle curvature but when these curves become extreme or move out of place, it leads to deformities. Some deformities are mild in nature while some are serious. The former are not recognizable but the latter mark the personality of the individual and also cause physical problems. Spine deformity is also known as a misshapen spine or curvy spine and can affect anyone – child, adolescent, adult or old.

The signs and symptoms of spine deformity include low back pain, weakness, pain in legs or thighs, muscle spasms, breathing difficulty, uneven shoulders or hips or both, misalignment of the head, protruding shoulder blade, and poor gait.

1. Scoliosis, Kyphosis, and Spondylolisthesis - Spinal deformity is mainly categorized into three conditions that commonly affects people: These spinal deformities include the following:
2. Scoliosis – In this type of spinal deformity, the spine becomes curved from side to side forming an “S” or “C” shape. It mostly affects teenagers in their growing years but can also affect children and adults. It can be caused due to birth defects, genetic reasons, or neurological defects. It can be structural or nonstructural. The former is caused by disease, injury or birth defect and it is permanent in nature. The latter is temporary and can be treated with surgery.
3. Kyphosis – Also known as a hunchback, kyphosis is a condition marked by excessive curvature in the upper part of the spine. This is a very visible condition and the person has a hump on their upper back. It can affect anyone and is generally known to result because of poor posture but an infection in the spine, injury, slipped disc, muscle weakness, arthritis, and aging can also trigger kyphosis.
4. Spondylolisthesis – In this condition, a bone in the spine moves out of position, either forward or backward, causing a deformity in the spine. It is caused by aging, arthritis, or general degeneration caused by wear and tear.

Treatment: Spinal deformity, in most of the cases, is treatable if it is detected on time. In cases of kyphosis or where the patient is experiencing symptoms such as pain or other tangible signs, physical examination by an orthopedist is necessary. Upon further screening through an X-ray or MRI scan, the degree of deformity is determined and then the doctor starts treatment. Some cases can be treated through braces or physical therapy or exercise. They correct the abnormal curvature of the spine and the individual can get a normal curvature after the treatment but in some cases, surgery is the only option left as only surgical intervention can rectify the deformed curvature. The surgical techniques include spinal fusion and insertion of implants.

Prevention: Spinal deformity is painful as well as personality diminishing condition and hence, needs timely treatment but it can be prevented as well. For it to happen, causes such as poor posture, arthritis, and slip disc need to be addressed in time. One should be extra careful about pain in the back or legs and take immediate help from the doctor. Also, one should try to maintain a healthy weight and do regular exercise.

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

A disc prolapse or herniated or slipped disc refers to the condition of the spine in which the outer fibers (the fibrous ring) of the intervertebral disc gets injured. It makes the soft central portion known as the nucleus pulposus bulge out of its enclosed space. This ruptured material then enters the spinal canal, putting pressure on the spinal cord as well as the spinal nerves. A disc prolapse can be caused by several reasons. These include age-related degeneration of the spine, trauma or accident, injuries incurred while lifting heavy objects, strain, and bad posture.

The disc prolapse mainly occurs in young and middle-aged men and women and it can affect a person anytime. In some cases, it takes months to surface while in others, it can erupt over several weeks. These cases are the result of the gradual weakening of the outer fibers or sedentary lifestyle that puts constant pressure on the disc, making the fibrous ring bulge out. In case of accidents and injuries, when one falls from a major height or bends forward putting high stress on the intervertebral disc, the eruption is instant and the disc sustains severe injury.

Spots of disc prolapse: A disc prolapse can occur in three places – Lower back (lumbar spine), neck (cervical spine), and mid-back (thoracic spine).

Signs and symptoms of disc prolapse: Disc prolapse is normally characterized by pain in the above-mentioned places but it can also be painless. The symptoms of slipped disc include numbness and tingling sensation in arms and legs, weakness in arms or legs, pain behind the shoulder or in the buttock, running pain in one or both arms and legs, loss of control over bowel and bladder movement (in extreme cases), numbness in genital area, and impotence in men (in extreme cases).

Diagnosis and treatment: A slipped disc can be diagnosed through an X-ray, CT scan, or MRI scan. The neurosurgeon or spinal surgeon prescribes the course of treatment after proper diagnosis. In most of the cases where the condition is a result of bad posture or sedentary lifestyle or age-related degeneration, the treatment involves administration of painkillers and physiotherapy. In such cases, the symptoms go away within six or eight weeks. It is only cases of trauma or severe injury that need surgical intervention.

Prevention: A disc prolapse can be prevented in a lot of cases through counseling and education. Many times, people are not aware of the symptoms or tend to take back or neck pain lightly, which aggravates the condition leading to more damage and late recovery. Also, bad posture and sedentary lifestyle are known to put pressure on the spinal cord, which can cause slip disc. So, if one is aware of these facts, one can avoid disc prolapse. Last but not the least, regular exercise and adequate rest keep the back and bones healthy. It is the best prevention against back pain and disc prolapse. So, one should keep it in mind and follow it as well.

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

A neck strain and sprain is not a serious injury. However, they can still cause significant dysfunction and pain.
Causes of Neck Strain
The anatomy of the cervical spine is such that it not only houses, but also protects the spinal cord. Along with this it supports the head and allows it for mobility and motion. But this area, which allows the spine to be flexible can also leave it vulnerable for injury.

Triggers for the onset of neck muscle strain can be:

1. Too much time spent in an uncomfortable position, such as humping over the steering wheel while driving, bending over the computer monitor, talking on the phone while placing it in the crook of the neck.

2. Sleeping on a very high or too firm pillow can lead to an uncomfortable position of the head thus leading to the strain of the neck

3. Carrying heavy objects on one side of the body

4. Any trauma that might have impacted the neck, such as an accident, whiplash or a fall that might have had a head landing

Most events of a neck muscle strain or the soft tissue sprain, such as the tendons and ligaments lead to stiff neck along with pain in shoulders. There is also pain and difficulty in moving the neck or head.

Neck muscle strain remedies

Minor strains in the tendons, ligaments and muscles of the neck usually heal within a day or two. But till the symptoms subside, there are a few self care remedies that are effective in reducing the stiffness and pain. These are:

1. Application of cold or ice packs: The cold reduces the inflammation, which in turn allows the strain to heal. This ice pack should be applied for 20 minutes interval in the first 24 hours.

2. Application of heat: Heat helps in bringing the nutrient rich blood to the affected area in order to stimulate a healing response. Moist heat as well as heat from a hot shower or bath can be used. Some people might find relief from applying heat wraps such as thermacare.

3. Over-the-counter or OTC medications: Anti-inflammatory medication, such as naproxen and ibuprofen reduces inflammation, thereby leading to the reduction in pain. Pain relieving medicines such as acetaminophen can also be taken as this reduces the perception of pain.

4. Massage of the affected area: A gentle massage in the affected area helps in stimulating the blood flow of the area which in turn helps in a quick healing. In case you have a concern or query you can always consult an expert & get answers to your questions!

Slip disc is a condition of the spinal column which consists of a stack of vertebras from the cervical, thoracic and the lumbar spine.The bones of the spine are cushioned by discs that are present to absorb shocks. Trauma to the spine may cause the disc to bulge or be ruptured. This may lead to pain in the neck and the back. 

Causes of slip disc

Slip disc is caused when the jelly like substance present in the discs bulges out. The damaged disc thus puts pressure on the adjacent nerve causing excruciating pain. The various causes of a slipped disc are:

1. Incorrect form during exercise: If you are into weight lifting, it is important that you use proper form during exercising. Moves like barbell squat and deadlifts can put pressure on the spine and lead to disc problems, if not done correctly. Make sure you work on your core strength and keep your lower back straight while exercising. 

2. Smoking: Smoking causes the discs to lose their flexibility and thus, increases the risk of slipped disc.

3. Ageing: Ageing decreases the content of water in the spine, thus leading to inflexibility.

The symptoms of slip disc are:
1. Pain on one side of the body that tends to aggravate over time
2. Activities such as sitting and coughing may lead to pressure on the spine causing pain

Prevention
1. If you are overweight, try to reduce weight and then focus on maintaining healthy weight levels
2. Maintain proper posture while sitting or standing
3. Exercise on a regular basis to build strength and keep your joints healthy
4. Don't remain in seated position for an extended period of time. Take small breaks in between to stretch

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