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Discectomy: Procedure, Recovery, Cost, Risk & Complication

What is Discectomy?

Discectomy refers to a surgical procedure that involves the removal of a damaged part of a herniated disk (also known as ruptured, slipped, bulging disk or disk prolapse) in the spine. A herniated disk is a condition where a portion of the soft material present in the disk pushes out from a crack in the tough exterior. The herniated disk may cause irritation or compression of the nerves located nearby, resulting in numbness, weakness and pain. These symptoms may affect the neck or the back and even radiate down to the arms and legs.

A doctor generally suggests discectomy to a patient if the symptoms have gradually worsened or the non-surgical treatments have not been effective. Though there are several ways for performing a discectomy, surgeons prefer minimally invasive discectomy, where small incisions are made and a small video camera is used for viewing purpose.


A patient may be recommended to undergo discectomy in the following circumstances:

  • If one has trouble in standing or walking due to a nerve weakness
  • When other conservative treatments such as physical therapy or medication does not bring any improvement in your condition
  • A disk fragment is lodged in the spinal canal, pressing on to a particular nerve
  • Extensive pain in the legs, arms, buttocks or chest that becomes difficult to tolerate

What Procedure is followed :

Pre Procedure

It is important to follow the following pre-procedure instructions before undergoing a discectomy:

  • There may be a few tests like an x-ray or EKG that you need to undergo before the surgery
  • Stop smoking a few days before the surgery. Non-smokers are found to have lesser bleeding problems compared to smokers during a surgery
  • Inform your doctor about the medications, supplements and vitamins that you take. You may have to stop taking medicines like aspirin, blood thinners and anti-inflammatory medicines for a few days before the surgery.
  • You may have to stop drinking and eating anything for a few hours prior to the surgery. Your doctor will provide you with proper instructions. Ensure that you follow them correctly. If you have to take any medicine during that time, take it with very sips of water.

During Procedure

The surgery is performed by administering the patient with general anaesthesia. It can be done by one of the following methods or a combination of both:

  • Sacral: The physician inserts an endoscopic fiber-optic scope through the help of a tiny incision into the sacrum, which is a natural opening at the base of your spine. With the help of direct visualization, the doctor examines the insides of the spinal canal and disc for identifying any ruptures, tears, bulges or other abnormalities. The damaged disc is then shrinked with the help of laser.
  • Posterior lateral: The surgeon inserts a hollow needle through the back side of the lateral spine, directly into your disc tissue. A laser is then passed from into the disc through the needle for shrinking the bulging or herniated disc. Fluoroscopy is used for watching and guiding the progress of the whole procedure.

Post Procedure

After the surgery has been successfully completed, you will be shifted to a general bed where the doctors will monitor you and look for any complications related to the surgery or anaesthesia. You can go home the same day, or you may to stay in the hospital for a few days if you had a pre-existing health condition.

You can get back to work in 4-6 weeks after the surgery. In case your profession involves lifting heavy objects or operating heavy machinery, you may have to wait for 8 weeks before you resume working. Limit activities that involve bending, lifting or stooping for 3-4 weeks after the surgery. Also, avoid sitting down for long hours during this time.

Ensure to take your medications in time. A physical therapist will be able to teach you exercise for improving the flexibility and strength of your muscles around the spine.

Risk & Complication

Discectomy is generally considered to be a safe procedure. However, as with every surgery, there may be some risks that are associated with it. These complications also depend on your age, your general health condition, and how your body reacts to the surgery and the medications. Some of the complications that may occur are:

  • Bleeding from the incision site
  • Infection at the incision site
  • Leaking of the spinal fluid
  • Build-up of fluid in the lungs, leading to pneumonia
  • Injury to the nerves or blood vessels in and around the spine while performing the surgery
  • Injury in the protective layer that surrounds the spine
  • Persistent pain even after the surgery

More Info

A discectomy reduces the symptoms of a herniated disc, but it does not cure the reason why the disc was actually herniated. To avoid injuring your spine once again, your doctor may recommend losing weight, go for low-impact exercises, and limit activities that involve repetitive or extensive twisting, bending or lifting. You can assume your normal diet, from the time you get back home. Fruits, vegetables and extra fluids must be added to avoid constipation.

Attending follow-up session with your doctor is important after undergoing a discectomy. You may also have to undergo an x-ray so that your doctor can analyse your progress.

The cost of discectomy would be approximately Rs. 2,25,000 – Rs. 2,75,000.

Popular Health Tips

Ozone Discectomy For Disc Prolapse!

MBBS, MD, FIMSA, FIPP, CIPS - Certified Interventional Pain Sonologist
Pain Management Specialist, Delhi
Ozone Discectomy For Disc Prolapse!

Ozone local anaesthesia with strict real time radiological control, which ensures the proper placement of Ozone in the center of the disc making it shrink.

Low Sciatica and PIVD

Among working-age people, as many as 20 percent experience back symptoms at least every year. facet arthropathy, sciatica, muscle strain, sacroilitis, bulging or herniated discs and degenerative disc disease. Prolapsed intervertebral discs (PIVD) are the most common cause of low back pain associated with a defined structural Abnormality.

Patients who are not helped by weeks of conservative therapy are often referred for pain that has persisted beyond a four-week period should be referred to a multidisciplinary pain center.

Different Non Surgical Interventions Employed Successfully:

  • Epidural Steroid Inj.

  • Epidurogram & Epidurolysis.

  • Nerve root sleeve/ transforaminal Inj.

  • Intra-discal steroid inj.

  • Nucleoplasty- Thermal & Mechanical

  • Ozone Discolysis

Conventional treatment methods for back pain comprise lamminectomy/ discectomy microsurgery, endoscopic disectomy and percutaneous arthoscopic disectomy, among others. These are invasive methods and their goal is to remove or contain the protruding disc. However, these methods have occasionally demonstrated a discrete incidence of failure and/or recurrence. Outcome studies of lumber disc surgeries ranging from 4% to 15%, have been noted. "In case of surgery, the chance of recurrence of pain is nearly 15 percent as against less than three percent in Ozone treatment.</p> <p><strong>Reasons for the failures</strong> of conventional surgeries are:</p> <ol> <li> <p>Dural fibrosis</p> </li> <li> <p>Arachnoidal adhesions</p> </li> <li> <p>Muscels and fascial fibrosis</p> </li> <li> <p>Mechanical instability resulting from the partial removal of boney & ligamentous structures required for surgical exposure & decompression</p> </li> <li> <p>Presence of Neuropathy.</p> </li> <li> <p>Multifactorial etiologies of back & <a href=">leg pain, some left unaddressed surgically.

Understanding the need for Nano-Technology 

  1. The various treatment options have confused clinicians and investigators due to high failure rate and complications associated with different kinds of surgeries and interventions. There has been a surge of interest in the search for a safer alternative method of decompressing the nerve roots maintaining the structural stability.
  2. Another safe least invasive alternative therapy that has been receiving exposure in Europe is the use of medical Ozone (02/03 mixture) in the treatment of PIVD. Epidural steroid injection, transforaminal epidural decompressions has a high success rate (up to 85%), but chances of recurrences are there specially if these interventions are done at later stage. anaphylaxis following intradiscal chymopapain injection. Injection of Ozone for discogenic radiculopathy (low back pain with radiation to legs) has developed as a revolutionary alternative to chemonucleolysis and disc surgery .

The use of ozone revolution for treating disc diseases 

Muto suggested an intradiscal injection of Ozone for a disc Ozone injection into the intervertebral disc. After that successful outcome has been reported from various European centers. It is very important to note from those reports that complications are remarkably few. Not a serious single life-threatening complication was found even after 120,000 cases of Ozone nucleolysis, which stresses the safety of these procedures.

The most critical portion of performing any of the minimally invasive procedures is the accuracy and safe positioning of the needle (or terminal device) in the centre of the disc space. The risk in ozonucleolysis is particularly minimised, with the use of a very thin 22/25-gauge needle. It may take anywhere from 5 to 30 minutes to position a needle in the centre of the disc space under radiological guidance. Once the needle is safely placed in position, ozonucleolysis is completed in only another 2 to 3 minutes.

How does water contained within the domain of proteoglycans. The water binding capacity of the proteoglycan molecule is partially a property of its size and physical shape, but the main force that holds water to the molecule stems from the ionic, carboxyl (COOH) and sulphate (SO4) radicals of the glycosaminoglycan chains. The ozone can have a direct effect on these carboxyl and sulphate groups, breaking down some of these glycosaminoglycan chains which make up the proteoglycans. The destruction of these cross-linked structures reduces their ability to hold water therefore diminishing the size of the herniation by collagen fibers and signs of regression (vacuole formation and fragmentation)- a sort of disk “<strong>mummification</strong>.”</p>

<p> </p> <p><strong>By Inhibiting inflammatory Nociceptors</strong></p> <ul> <li> <p>Synthesis of Prostaglandins & Secretion of Proteinases</p> </li> <li> <p>Liberation of Bradykinin and Pain Inducing Products</p> </li> <li> <p>Several studies suggest disc inflammation as a mechanism of sciatica due to disc herniation. Ozone has been shown to have an effect on the inflammatory cascade by inhibiting synthesis of proinflammatory prostaglandins or release of bradykinin or release of algogenic compounds; increased release of antagonists or soluble receptors able to neutralize proinflammatory cytokines like interleukin (IL)-1, IL-2, IL-8, IL-12, IL-15, <a href=">interferon, and tumor necrosis factor. Therefore, by reducing the inflammatory components there is a corresponding reduction in pain.

By stimulating fibroblasts & immunosuppressor cytokines 

  • Local production of Antioxidant Enzymes
  • Another action which may prove to be one of the most important is the stimulation of
  • Release of immunosuppressor cytokines like transforming growth factor, and IL-10 fibroblastic activity by ozone. Fibroblasts initiate the repair process by stimulating the deposition of collagen. Although yet to be validated, this mode of action could explain the resolution of PIVD on CT scans and the small percentage of patients who have relapses after the completion of treatment plan.
  • Ozone may have a reflex therapy effect called ‘chemical acupuncture’, breaking the chain of infection which is healed with antibiotics.


    In fact, over 120,000 patients have been treated successfully worldwide using the injection of medical ozone with a success rate of 80-90% and with a near nil rate of procedure-related complications. “The procedure is a safe and effective alternative to open surgical procedure. Patients get the advantage of going home after a short recovery on the same day. They generally go to work within a week and are spared prolonged absence from work and disability,” The treatment relieves pain substantially and, after two sittings, people "can go back to work under medical guidance".

    Comparison: 1. More hospital stay One day/day care 2. Complications of prolonged surgery& spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular in European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post-operative discomfort or morbidity and low cost.

4672 people found this helpful

Endoscopy Discectomy For Sciatica Slipped Disc!

MD, PDCC, MBBS Bachelor of Medicine and Bachelor of Surgery, FPCI
Pain Management Specialist, Delhi
Endoscopy Discectomy For Sciatica Slipped Disc!

Herniated Disc

We all know that spine is one of the crucial parts of our body. The spine forming bones or vertebrae are protected by spongy and small discs. In healthy condition, these discs play the roles of shock absorbers for our spine and help to retain its flexibility. However, while a disc gets damaged, it might break open or bulge. This particular condition is known as ‘herniated disc’. This condition is also called ruptured or slipped disc. An individual can be suffering from the issue of the herniated disc in any of the part of his/her spine. However, most of the herniated discs influence the lumbar spine or lower back. Sometimes, it happens in cervical spine or neck and rarely this condition is seen in the thoracic spine or upper back.


A herniated disc might be sourced from the disc erosion. With age, the discs start drying out and they become unable to retain their flexibility. Another reason for which this problem can generate is spine injury. It might result in minute cracks or tears in the disc’s hard outer coating. While it occurs, the thick gel (from the internal part of the disc) might be forced out via the cracks or tears in the disc’s outer layer. As a result, the disc can become break open or bulge.



Whenever a herniated disc starts pressing the nerve roots, the affected person can feel pain, weakness, and numbness in the nerve traveling area of his/her body. When the herniated disc issue affects one’s lower back portion, it can generate numbness and pain in his/her buttock, as well as, down his/her leg and this condition is known as sciatica. It is the most prominent sign regarding a low back herniated disc. If a herniated disc does not provide pressure to the nerve, then the affected person might be suffering from a backache. Sometimes, there is no pain absolutely. Generally, a herniated disc heals automatically with the passage of time. The affected person should take patience and strictly follow the treatment plan provided by the doctor. In case, there is no change in the symptoms within the pre-specified period, then that person should consult the doctor about the appropriate surgery.

Endoscopic Surgery

Endoscopic techniques for the purpose of diagnosis have been started since the late 1970s. Experts initiated the utilization of the popular techniques of endoscopic surgery in the 1990s, however, the particular technique is now used for the spine conditions’ treatment. In this procedure, pain and spine specialist make use of specialized instrumentation, as well as, video cameras and perform it through minute incisions. For alleviating interruption to one’s tissue and muscles, the surgeon receives access to the respective vertebrae through the placement of collections of tubes in the endoscopic spine surgery. The Endoscopic spine processes are usually executed in either 23-hour stay or an outpatient setting. The particular minimally invasive spine surgery is utilized for relieving pain sourced from pressing of herniated discs on nerve roots. In case you have a concern or query you can always consult an expert & get answers to your questions!

4116 people found this helpful

Endoscopic Discectomy - Pin Hole Stitchless Techniques

Fellowship in Interventional Pain management , Diploma in Anesthesia, DA, MBBS
Pain Management Specialist, Jaipur
Endoscopic Discectomy - Pin Hole Stitchless Techniques

What's pivd?
Also called as slipdisc pain or sciatica may affect your lumbar or cervical or throracic spine. But most common is l4 5and l5-s1 level or c5-6 level.
Most of painful condition of pertaining to your spine due to bulge, prolapse (protrusion), extrusion, sequestration. In with all condition nucleus pulposus come out from it originally site. Causing pressure over traversing or exiting nerve roots. Most of time patient getting treatment for of slipdisc or sciatica etc without any radiological evidence.

What causes pivd?
*unwanted prolonged exposure to sitting posture
*acute forward flexion
*unwanted weight lifting
*trauma or accident
*overweight body
*undesirable exercise
*keep on exercise for chronic pain condition

What is symptoms?
Paresthesia, numbness, tingling sensation, burning sensation, spasms in thigh's and calf muscles, radiating pain upto knee or foot. Unable to sitting or standing for long hours, bowl or bladder incontinence, motor power affected

What are basic investigation?
X-rays only show alignment and fracture and displacement of vertebrae,
Mri scan shows all soft and hard structure of spine-all disc, nerve, ligaments, joint, vessel and muscles etc can be seen in perfect way
Emg, ncv, neurometry etc

Treatment options?
There's two types of options for your spine pain, one is conservative treatment with bed rest, exercises and medicine. But upto certain duration 6week to 6month you can try with. If no red flag sign like loss of motor power. Or bowl bladder involvement should take opinion from surgeon.

Second way is surgical procedure-like conventional open surgery or endoscopic minimal invasive techniques choice of your surgeon. As common man had reservation about spine surgery as thoughts to be risky, chance of bowl and bladder incontinence, or power loss of limbs, because in conventional surgery a small percentage of cases use to face failed back surgery syndrome. Where such complaint were invitable. Big skin incision. Long bed rest. Long hospital stays. Even with expert surgeon these complications were enviably there.
Secondly there is minimal invasive like pin hole stitchless techniques are now choice for spine disc pain problem. Day care surgery with out any blood loss. 24hrs hospital stay, no incision like conventional surgery. Done under local anaesthesia and sedation. Patient can resume daily activities same day. Can go to work with safety measures after 2weeks. And safety precautions to be followed for strengthening your back spine. Now like day care surgery endoscopic discectomy for slipdisc pain can be managed in our hands. All surgery can be seen even by patients on screen, what exactly happened to your spine and disc material.

Post procedure- follow up-
Regular physiotherapy and rehabilitation services is mandatory for strengthening of your spine.
Prognosis-success of procedure is 95%with all precautions and safety measures.


Pain Management Specialist, Hyderabad

Disc prolapse can be easily treated by nerve root injection or removal of disc fragment by endoscopic discectomy under local anesthesia

1 person found this helpful

Micro Lumbar Disectomy - Signs You Need It!

DNB - Orthopedics, D ( ORTHO), MBBS
Orthopedist, Trivandrum
Micro Lumbar Disectomy - Signs You Need It!

A microdiscectomy is performed on the herniated disc of an individual to relieve the pressure from the spinal nerve root by eliminating the material which is causing the pain. Being minimally evasive in nature, this technique of disectomy is carried out to provide much-needed relief from the pain caused due to a lumbar herniated disc.

The procedure of the micro lumbar discectomy is not very complicated. During the procedure, a small part of the bone which is present over the nerve root or the disc material is taken out for relief. A microdiscectomy is also known as microdecompression which is more effective in leg pain.

Indications For Micro Lumbar Disectomy

It is very much important to understand that micro lumbar discectomy can be very important if the patient is suffering from serious pain and problems. Here are some indications which show that an individual needs such a disectomy:

● Excruciating pain in the affected areas which does not allow the person to work or carry out normal activities that he or she does.

● Inflammation or redness around the area which is caused due to the constant pain.

● When the leg pain is the major thing affecting a person rather than a back pain as well.

● A kind of leg pain which exceeds more than 6 weeks and keeps affecting.

Advantages And Disadvantages

No surgery comes without both sets of advantages and disadvantages. So, micro lumbar discectomy also has both the sides of advantages and disadvantages which you should be knowing about.

Advantages - Micro Lumbar Discectomy is minimally evasive which makes it possible for the patients to undergo much less pain and trauma. In most of the cases, the doctor separates the muscles instead of cutting it. This helps to minimize the trauma and helps to heal in a better manner. The removal of the muscle is therefore done more precisely giving the patients a quicker way to recover and carry on with their normal activities.

Disadvantages - Even though the risk and complications are reduced because of the minimally evasive nature, there are certain risks associated to it. Postoperative infections can be a real risk when a person goes through a micro lumbar discectomy. A dural tear can occur when incisions are made around the area which is affected. Although it is very rare, but nerve damages can also be a risk in the case of a lumbar discectomy.

So as you can see that the micro lumbar discectomy is a brilliant way to help an individual who is suffering from herniated disc and immense leg pain rather than back pain. You must always visit a reputed and recognized surgeon to make sure that you undergo a safe and sound treatment for the problem you are facing. Any kind of wrong treatment can cause a serious damage to your lifestyle.

Popular Questions & Answers

Respected Doctor I would like to know the cost of anterior cervical micro discectomy surgery in India.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology, Positive Psychiatry and Mental Health
Psychologist, Palakkad
Dear user. I can understand. Anterior cervical discectomy and fusion is a surgical procedure to treat nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine with a discectomy in order to stabilize the corresponding vertebrae. For More Details google the below strings: Slipped Disc Replacement Cost in Fortis Memorial Research Institute Cervical Discectomy Cost in Fortis Flt. Lt. Rajan Dhall Hospital Cervical Discectomy Cost in Apollo Hospital Chennai Cervical Discectomy Cost in Indraprastha Apollo Hospitals We are here to help you in every aspect of your mental and physical health. Any sexual or psychological problems can be cured with the help of various methods and therapies. I suggest you to post your query with every detail here. We will help you in overcoming your problems certainly. Take care.

Hello sir, I am 43 years old and have back pain for the last 2 days. Please help me. I underwent a discectomy 10 years back.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Patient needs to be examined in detail & be investigated. Anyway you may try- sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5 days then inform me.

Hi Sir, I had endoscopy Discectomy surgery 2 days back because of my MRI shows disc herniation of l5-S1 level. I have only lower back pain no sciatica pain. But still I have pain when sitting please tell me actual problem I did not understand after surgery still pain please tell me.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
Back Pain:This is a general low back ache and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try which will help you relax as well will reduce the pain. It looks like you are anaemic. If you have back pain after you sit for long hours then it is due to your haemoglobin levels as it is important to check that. Anaemia always leads to the symptoms of being tired and also having back / leg pain though there may not be any pathological reasons for back pain. •Standing hamstring stretch: Place the heel of your injured leg on a stool about 15 inches high. Keep your knee straight. Lean forward, bending at the hips until you feel a mild stretch in the back of your thigh. Make sure you do not roll your shoulders and bend at the waist when doing this or you will stretch your lower back instead of your leg. Hold the stretch for 15 to 30 seconds. Repeat 3 times. •Cat and camel: Get down on your hands and knees. Let your stomach sag, allowing your back to curve downward. Hold this position for 5 seconds. Then arch your back and hold for 5 seconds. Do 3 sets of 10. •Quadruped arm/leg raise: Get down on your hands and knees. Tighten your abdominal muscles to stiffen your spine. While keeping your abdominals tight, raise one arm and the opposite leg away from you. Hold this position for 5 seconds. Lower your arm and leg slowly and alternate sides. Do this 10 times on each side.•Pelvic tilt: Lie on your back with your knees bent and your feet flat on the floor. Tighten your abdominal muscles and push your lower back into the floor. Hold this position for 5 seconds, then relax. Do 3 sets of 10. •Partial curl: Lie on your back with your knees bent and your feet flat on the floor. Tighten your stomach muscles. Tuck your chin to your chest. With your hands stretched out in front of you, curl your upper body forward until your shoulders clear the floor. Hold this position for 3 seconds. Don't hold your breath. It helps to breathe out as you lift your shoulders up. Relax. Repeat 10 times. Build to 3 sets of 10. To challenge yourself, clasp your hands behind your head and keep your elbows out to the side. •Gluteal stretch: Lying on your back with both knees bent, rest the ankle of one leg over the knee of your other leg. Grasp the thigh of the bottom leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the top leg. Hold this for 15 to 30 seconds. Repeat 3 times. •Extension exercise: Lie face down on the floor for 5 minutes. If this hurts too much, lie face down with a pillow under your stomach. This should relieve your leg or back pain. When you can lie on your stomach for 5 minutes without a pillow, then you can continue with the rest of this exercise.

Table of Content

What is Discectomy?


What Procedure is followed :

Risk & Complication

More Info

Play video
Most Common Spine Condition
Hi Friends!

My name is Dr. Himanshu Gupta. I am an orthopedic spine specialist. And today I will be talking about spine elements and different type of spine conditions that we see in OPD. Most of the patients suffer from this because of the long sitting on the computer. They suffer from neck pain, back pain, postural pain, mid back pain or long-term standing, sitting while at work in an awkward posture. So the myth is that all is not only related to disc pain.

2nd all these pain can be corrected with a few activities, exercises and posture modifications. Another myth is if you have slip disc, you can never be treated for life. But this is not true. There are multiple treatments available. In most cases, the patient gets better with medicines, exercise, physiotherapy. Very rare cases when there is instability or some neurological weakness, we go for surgical correction. But there is a condition which is called interventional pain. There is the scope of minor interventions for correcting these spinal elements with simple procedures like pulse radio frequency, an endoscopic discectomy. They all are day care procedures. The patient can be discharged the same day. The results for all of these are very good.

If you are looking for any of these treatments for the neck, back, shoulder, sciatica, arm pain or slip disc, you can contact me or reach us at Nivaran Pain Relief Centre. We are available in Gurgaon. We also have other branches outside of Delhi. But there we are available once in a month.

Thank You.
Play video
Tips on Lower Back Pain
Tips on Lower Back Pain
Hello, I am Dr G.P. Dureja, senior consultant and director at the Delhi pain management centre, in New Delhi.

Today, I am going to discuss a very important topic, Back pain. As we all know, the prevalence of back pain in India is rising tremendously. Not only in younger people, but middle-aged and older people are also suffering from persistent back pain may it be lower back pain or upper back pain.

The causes of back pain are tremendous and numerous. But the most important cause is absolutely you have a back posture and because of our back posture which results in disk collapse which causes pressure on the nerves and results in excruciating lower back pain which radiate to the leg. This is very commonly seen nowadays in younger people who are always having bad postures and are always working beyond their scheduled time, working very hard with no emphasis on their back care.
When we talk about emphasis, I mean that they do not do any exercises, they do not walk, their muscles are all weak and when they sit for a long time in front of their computers, it results in severe back pain. In older people, of course, the common causes are lumber canal stenosis where because of the degenerative changes happening in the spine because of osteoporosis it results in pressing of the nerves or impingement of the nerves and that results in very severe back pain which is relating to the leg and the old people are generally not able to walk because of this.
So as I said, prevention is very important. Once you have been able to find out the cause of the pain which is causing the excruciating pain in the back, we should always look towards treating this and preventing this.
Preventing, we always emphasise on good posture. We always tell the patients how to sit properly, not to bend forward, not to lift weight and please take care of your both upper back and lower back. That means the cervical spine and the lumbar spine. That is why we tell the patients to continuously exercise. There is a set of exercises which you have to do it for 5 minutes a day and that is sufficient for strengthening your back muscles and preventing this severe pain to occur in you and your friends if you can guide them to.
There are various types of treatment available. We call it as a conservative management when a patient can take medicines or just be on rest. And after adequate rest and medicine, when the pain is relieved, he does continuously exercises takes care of his posture, sits properly at his job place and does not do any forward bending or weight-lifting activities. Most of the patients will get relief at this manoeuvre or this conservative treatment and get relief in pain. Of course, there are people who do not get relief in pain because they have a bulging disc which is irritating the nerve and therein the role of a pain physician comes in. A pain physician can help a patient by injecting into the spinal column or in the spinal cord, giving drugs or even doing discectomy by needles and getting rid of the pain, avoiding a certain surgery.
In younger people, we generally tend to avoid surgery and that is the reason interventions in the spine done by pain clinicians are becoming very popular and can help a large number of patients.
After the pain has gone down, we rehabilitate the patient, give them the advice as in how to sit/ how to stand and how to exercise and takes care of the pain completely and patient just has to follow the simple instruction throughout the life.
If you want to consult us at Delhi pain management centre you can contact us through Lybrate and also we can give you an appointment if you want to show any of our consultants here and they will tell you all about how to look after your spine and how to do the exercises.

Thank You.
Play video
Stroke: What You Need To Know?

I am Dr. Devesh and I would like to speak to you about waist pain. Waist pain is a very common disease these days. Earlier, we used to come across cases of waist pain in patients aged 40+ but these days, even 20 years old are affected by this problem. There are multiple causes of this disease and one of the major reason for the increment in such cases is our unhealthy lifestyle. It is the major cause of waist pain among the youngsters. Talking about multiple causes - one of the biggest reason is distorted daily routine, causing the imbalance in your circadian rhythm. Also, the usual posture of sleeping and sitting is hugely distorted and prolonged sitting sessions even in the correct posture is damaging to your body. An accidental damage to your bone due to some previous injury, you can also face waist pain in that case. In case, your cancer has reached to your spine, or the bones of your waist which has formed any tumour/lump in the neurons concerning the lower portion of your body, you can also face waist pain in such cases. Your waist pain is not a disease but a full syndrome. There are so many health issues related to this syndrome that it needs proper diagnosis and clinical evaluation with the help of MRI. It was impossible to manage your waist pain without a proper evaluation of the symptoms.

Waist pain related with the distorted lifestyle is mostly treated with a change to proper lifestyle, rest and improvements in the sitting, lying and walking posture, which leads to full recovery in 80% of the cases. But the remaining 20% cases are mostly treated with drug therapy and in severe cases, we opt for surgical treatments. In the routine degenerative disease of the spine, what we refer to as Spondylitis - in which the spinal vertebrae - wait, I'll show you - in this model, the middle disc gets distorted outwards which leads to the increase in pressure of nearby neurons and veins. This pressure in the vein supplying to the lower portion also transfers pain to that portion and that is referred to as Referred Pain . It is very important to know about the presentation in the case of waist pain - the presentation is concerned with the pain in the waist and the portion of the referred pain. The referred pain is transferred in the fixed dermatomal pattern, hence dermato-neurological pattern examination is mandatory for all the spine patients.

This confirms our clinical diagnosis which gets double assured on the basis of CT and MRI scans, according to which further treatment is given to the patients. If we take a sample of 100 patients, then, 80 patients recover with normal symptomatic treatment in which the discs get inwards within 3-4 weeks and patients feel better with reduced pressure in their veins. The rest of the 20 cases are treated with the discectomy, in which the disc is surgically removed by cutting of through this vertebra. There is a classical pattern where this bone is cut through to remove the disc. Another pattern is the endoscopic pattern where the lamina and pedicle are cut through to remove the disc. Even after so many treatments available, prevention is always better than cure. You can easily prevent your waist pain with a healthy lifestyle, regulated weight in accordance to your height. Always go for a morning walk or any physical exercise which suits you - e.g. Yoga, aerobics, or even a visit to the gym where you're not doing any heaving weight exercise or any power requiring activity. Anything which doesn't exert weight on your spine and waist and is increasing your mobility is good for your body.

If you'll take care of all these important points along with the right posture of sitting, you'll hopefully delay your problem of waist pain. Eventually, it's normal to get affected with waist pain as it is a degenerative disease with age. The more you are accustomed to prevention, the longer your spine will stay protected.
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Ways to Avoid Spine Surgery

I am Dr Siddharth Verma and welcome to this educational video. The topic of this educational video is, how to avoid a spine surgery? So you have been suffering from some kind of back pain or you have got some injury or maybe you have a mixture of both maybe you didn't have anything but you still are undergoing a spine surgery. So don't worry, we are here to help you and an interventional pain physician or spine and pain specialist can definitely help you in this case. Prevention is always better than cure so you must stay fit and stay lumber, by saying lumber. Most of the back injuries, strains, sprains they occur because the person is not very flexible and if you are not very flexible and you have to do even a trivial work like maybe getting a file from a cabinet, lifting a 10 kg load, gunny bag or small bucket full of vegetables or something like that. This trivial work can lead to a strain, repetitive strain can lead to various issues with your back which can be as trivial as a myofascial syndrome, in which your muscles are affected or as severe as a disc herniation.

So in my other video, you can see how I have described various pain generators in the back. But for this video, we will concentrate on how to avoid this? So the first step is prevention, if you can prevent by staying fit, by controlling your weight, by physical activity, by following the correct technique of lifting weights. This is the first step. Now the second step is early treatment, so if you know that you have been suffering from a backache but if the back pain is persisting one week has passed 2 weeks have passed and you still have back pain, then don't ignore and don't think that this will pass or I will get better by the day let us do some work and something like that. Immediately go and seek treatment you visit a spine and pain specialist and talk to him about your problem and I am sure he will be able to sort it out.

Now the next step supposing you didn't pay heed to what your doctor said you continue to gain, weight you continue to be lumber, the non-flexible and still you had this kind of pain, of course, you will have this kind of pain and now the problem has increased and magnified and you go to a surgeon one fine day and he suggest an MRI and there is a big bulging disc and it is compressing on your nerves and now your doctor says you need a surgery. So can you avoid the surgery, in many cases, yes you can and in many cases, you cannot?

So when you can and when you cannot, it depends on the opinion of your treating surgeon and your spine and pain specialist. There is some movement which is happening while you flex or extend your back. So if this is not there then in most cases you can avoid an open surgery and how it can be done, it can be done with as trivial a procedure and as transforaminal neuroplasty procedure. Number 2 nowadays we have a very nice procedure which is known as endoscopic foraminoscopy or foraminoplasty or endoscopic discectomy. This is a very noble procedure which is done by the spine and pain specialist and in this procedure, what we actually do is we just give a small neck of the size of maybe smaller than a centimetre also. Then we reached this foramen from where this nerve comes out and we actually put in a camera through this small hollow tube, which is of the size of this pen, which is very hollow.

The patient stays awake is under local anaesthesia doesn't feel any pain till the point, this hollow canal touches his nerves on his sensitive nerve fibre, he says feels a slide pain and then we put our camera inside the foramen and we see the nerves, we see the disc and we take this material which is compressing on these nerves, we clean it, we wash it. We see very small tissue, this small tissue we see under a big T.V. So we can very accurately take out the tissues which are causing this compression and help you get relief from your pain. So need not go for any open surgery in these cases because in these cases we can help you by avoiding the surgery and going in for this percutaneous procedure which is way less invasive than a surgery.

The main difference is that you don't get any general anaesthesia. You can walk on the same day of the procedure, you can go to the washroom come back to stay in a hospital for a couple of days, get a discharge and you can resume your active life then maybe 4, 5 days or so you will be given some precautions but more or less, your mobile, you don't have any loss of work hours and you can be very productive. This is one of the very latest techniques which are the practice nowadays, by the spine and pain specialist. Now another reason why people come to us is not to avoid the first surgery but how to avoid this second surgery? Because many of the patients have already undergone under 1 surgery and this still have this kind of pain which is left and the treating doctor has suggested them another surgery. Now they don't want to undergo a second surgery, in those cases, many of them provide there is no instability of these bony spines. We can help them with these procedures there is the variety of other procedure for more details you can always visit my website and this can be avoided. If you want to know more you can also visit me on my Lybrate website which is

Thank you for watching, have a good day.
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Improve Posture For A Healthy Back

Mai Dr. Devesh, consultant surgical Neurology. Aaj apko kamar dard ke bare me btana chahta hun. Kamar dard aaj ke zamane me bhut hi common ho gya hai. Pehle iske lia 40 se upar ke marij aate the lein aaj 20 saal ke bache bhi is bimari se grasit hain. Kamar dard hone ke bhut sare karan hain. Iska karan ye hai hmari lifestyle. Hmari lifestyle bilkul bhi shi nhi hai. Bilkul bhi healthy nhi reh gyi hai. Jiski vjha se hum bhut hi kam umar me kamar dard se garasit ho jate hain. Kamar me dard hone ke bhut sare karan hain. Ek apka dincharya shi na hona, apka uthna, baithna, sone ka tarika galat hona. Dusra aap lambe samay tak baithe hue hain. Prolonged sitting is not good. Aap kbhi gir gye hai jis vjha se apki rid ki haddi me kisi trha ki koi chot aa gyi hai. Ya apka kisi trha ka cancer hai jo apki rid ki haddi me phuch gya hai. Ya kamar ki jo haddiyan hai or andar jo taar hai, usme kisi trha ki ganthe banti hain. Usme bhi kamar dard hota hai.

So, kamar dard is not a disease, it is a full syndrome. Iska bilkul ache se evaluation, along with MRI or x-ray ki help se proper diagnosis bhut jruri hai. Jyadatar 80% kamar dard ke patient apne aap thik ho jate hain with the routine treatment, proper rest, proper way in the sitting posture. Llekin jo bache hue 20% log hain usme utni sudhar nhi hoti. Or usme se bhi kuch logon ki final surgery krni pad jati hai. Jyadatar patients sirf dawa se hi thik ho jate hain. Jo degenerative spine or spondylitis bolte hain, sume hota kya hai ki rid ki haddi ki bich me jo disc hoti hai, ye fut ke bahar aa jati hai or jo aas pass ki nasen hoti hain unme dabav hone lgta hai. Is dabav ki vjha se hi, jis part ke pair ko supply kar rhi hogi, jhan niche ja rhi hogi, us hisse me dard jata hai. To kamar ke dard me ye janna jruri hai ki presentation kya hota hai. Dermato neurological examination is mandatory in all the spine patients.

Is se hume pta chalta hai ki clinical diagnosis kya hai. Agar is trha ke 100 mariz kia jaye jisme disc futti hai to usme se 80 logon ki disc, agle 3-4 hafton me ke andar apne aap kam ho jati hai or nus ka dabav khatam ho jata hai. Ye patient apne aap thik ho jate hain with normal treatment. Lekin bache hue jinme disc ka dabav bna rehta hai, usme disc ko nikalna pdta hai. Us surgery ko discectomy bolte hain. To piche se hum haddi ko katte hain or iske bhut sare tarike hain disc nikalne ke.

Dusra endoscopic tarika hota hai. Usme bhi hum ise thoda sa katte hue, andar jake ise nikalte hain. To ye sare tarike hain iske management ke . Ye to hui management ki baat. Prevention is always better than cure. To prevention ke toor pe apni lifestyle shi bnaye rkhen. Apna vajan control me rkhen apni height ke hisab se. Or morning walk ya koi bhi physical exercise jo apko suit krti hai like yoga, morning brisk walk, aerobics, regular gym hogya. But gym me koi bhi heavy weight ya power exercise nhi krni hai. Only jisme apka mobility jyada hai taki apki spine pe vjan na aaye. Ye sari baaton ka agar aap dhyan denge, hopefully apki problem delayed hoti jayegi. Aani sabko hai problem because these are degenerative spine. Umar ke sath spine ghista hi ghista hai. Lekin jistna aap ise ache se handle krege, apke spine ki life utni hi jyda hogi.
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