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The thought of going under the knife to treat your spine problem may give rise to a range of emotions; make you ponder over a number of things such as the recovery period, procedure and techniques involved and so on. Nonetheless, before opting for the surgery, there are certain points that you should go over and these are:

• Be well aware of the cause of your pain - Identifying the cause that is behind your pain is vital in order to decide whether the surgery is going to prove beneficial in the long run or not. If the cause is not identified as the right one, the surgery may prove futile and you may not get the pain relief that you're looking for.
• Gather detailed information about your spine surgeon - Before visiting the spine surgeon, you should collect detailed information about the specialist so as to be able to come up with appropriate questions concerning the surgery. From questions concerning about the surgeon's success and complication rates, numbers of surgeries performed to qualifications of the surgeon, these and much more should be part of your evaluation process.
• Prepare yourself before a consultation - It's good to prepare yourself before a medical consultation. Whether it's researching about the surgery and your condition or being well aware of your family's medical history, or details about the pain that you experience, or your expectations from the surgery, every aspect should be covered so that you derive the maximum benefit from your meeting.
• Carry out your own research - Carrying out your own research on the alternatives before opting for the surgery can put you on a better footing. It's imperative to compare the opinion put forward by the surgeon from genuine sources so that you're better able to understand the merits and demerits of the treatment.

Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.

Surgery Types-

Knee replacement is mainly of two main types:

1. Total knee replacement where both the sides of knee joints are replaced
2. Partial knee replacement where only single side of the joint is replaced

Procedure-

In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage, and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.

In total knee replacement, four steps are performed:

1. Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone.
2. Replacement with metal components, which help as a recreated surface of the joint
3. Incision of knee cap with a resurface made of a plastic button, which is optional based on the case
4. Insertion of a medical-grade plastic spacer amid the metal components. This creates an effortless gliding surface.

After general or spinal anaesthesia, an incision of 8-12inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material.

After Effects of the Procedure-

After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.

There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.

Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all!

A herniated disc also known as a slip disc or prolapsed disc refers to the problem where one of the discs located in between the bones of the vertebrae(backbone) gets damaged and stacks itself upon the nerves. The tender inner portion of the disc gets protruded over the outer ring. Herniated disc causes severe neck pain and back pain. It occurs when the outer ring gets weak and tears down. The most common symptoms include pain and numbness, especially on one side of the body. The pain extends down to the arms and legs. It worsens during nighttime. The muscles become weak. Overweight people are likely to have this disease, as the discs carry extra weight. Old people are vulnerable to a slip disc.

Effects of Herinated Disc:
- An untreated case of herniated disc may cause permanent damage to the nerves.
- In certain cases, a herniated disc is capable of cutting off nerve impulses to the "caudal equine"nerves, present in the lower back and legs. This leads to loss of bladder control or bowel control.
- Saddle anaesthesia is another long-term effect. Nerves are compressed by the slip disc, causing loss of sensation in the inner portions of your thighs, the back of your legs and surrounding the rectum region.
- Symptoms may improve or worsen.

Diagnosis of Herinated Disc:

Treatment or diagnosis of herniated disc or slip disc can be either conservative or surgical in nature. The nature of treatment is determined according to your discomfort level and the kind of pain you are experiencing, or how much the disc has slipped out.
- The pain caused by herniated disc can be relieved by undertaking an exercise schedule which includes stretching and strengthening the spine and its surrounding muscles.
- A physiotherapist should be appointed for recommending the types of exercises.
- Taking pain relievers also soothes the pain.
- Stronger medicines prescribed by doctors include-muscle relaxers, narcotics to deal with the pain, medicines for nerve pain such as "gabapentin"  or "duloxetine".
- In case of the symptoms not subsiding within a span of six weeks, a surgery may be recommended by your doctor. The surgeon may have to remove the damaged part of the disc. This surgery is called a microdiskectomy.

Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced by artificial joints, such as metallic, plastic and ceramic joints. These surfaces closely replicate the original anatomy.

When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of  people over 50 years when have pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.

Aim of the surgery: Correct the deformity: Relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.

Anaesthesia: Usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes a general anaesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.

Recovery: Stand up and walk a few steps with a walker the day after the procedure i.e. in 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking. progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.

Activities: Normal walks of 3 to 5 km per day Climbing stairs, cycling, swimming, and driving can be performed with the new implant(s) now.

Avoid: Squatting/kneeling Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports Longevity of joints: 15-35 years depending on the materials used.