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Spinal Disorders Tips

Endoscopic Spine Surgery Under Local Anaesthesia!

MBBS, MS - Orthopaedics
Orthopedic Doctor, Navi Mumbai
Endoscopic Spine Surgery Under Local Anaesthesia!

Your spine or backbone is composed of 26 bone discs, known as vertebrae. The vertebra shields your spinal cord and allows you to bend forwards and backwards, and stand. However, a number of problems, such as the following can change the structure or cause the vertebrae and its surrounding tissues to become damaged –

• Injuries
• Infections
• Tumours
• Changes in bone formation due to ageing – herniated disks, spinal stenosis
• Conditions like scoliosis and ankylosing spondylitis

Spinal disorders often lead to pain and discomfort when bony projections put pressure on the spinal nerves or cord. Over time, spinal disorders limit movement and reduce flexibility.
Treatment varies depending on the disease, ranging from medications and therapy to bracing and surgery.

Endoscopic Spine Surgery: what is it?

Contradictory to traditional open surgery, the new age endoscopic surgery is a minimally invasive procedure used to detect and treat a disorder. Unlike open surgery, minimally invasive endoscopic surgery does not require the patient to undergo general anaesthesia. The procedure is possible under local anaesthesia, considering the fact that it can be performed without cutting open the portion of the surgery site.

How does surgery work?

During the procedure, the surgeon first administers local anaesthesia to numb the site of the operation. You will be awake during the entire procedure but will not feel any pain. Then, he/she will make a small incision and insert a slender, tubular instrument – known as an endoscope – with a camera attached on one end through the soft tissues and skin, down to the spinal column. This allows the surgeon to get a clear view of the spinal tissues and understand where the problem exists. The endoscope holds the muscles open, allowing the surgeon to remove the damaged tissues or disk.

Endoscopic spine surgery preserves normal mobility, as the spine is not fused with rods and crews. When performed under an experienced surgeon, the procedure takes less than an hour.

Benefits of the Procedure -

The advantages of going for endoscopic surgery are the following –

• Local anaesthesia
• Surgery and discharge on the same day
• Microscopic incisions
• No removal of bone or muscles
• Zero or minimal blood loss
• Preserves spinal mobility
• Immediate recovery
• Reduced intake of pain medicines
• The high rate of success
• Improved quality of life

Minimally invasive endoscopic surgery has made it possible to rectify spinal problems and disorders without having to go under the knife. With less pain and quicker recovery, you can improve your spine health and get back to your usual activities in a day or two.

Consult a specialist and discuss the procedure in detail before opting for the same.
 

1965 people found this helpful

Spinals Tumors - How To Diagnose Them?

DMRT, MBBS, MD - Radiation Oncology, DNBR
Oncologist, Kolkata
Spinals Tumors - How To Diagnose Them?

Spinal Tumors are an abnormal mass that grows in the spinal cord or around it. Since these tumors occur in the spinal region, whether spinal cord or column, they came to be known as Spinal tumors. The primary tumor originates in the spine, and secondary tumors may grow in the other areas. They can be benign or malignant. Oncologists classify the spinal tumors according to their location and nature of cancer. They can be cervical, thoracic, lumbar or sacrum.

Causes of Spinal Tumor

The causes of spinal tumors are unknown to this day. Generally, cell growth in the tumors are fast and uncontrollably. This makes it difficult for the removal of cancer completely. There can be some harmful components and agents that cause cancer.

Spinal cord cancer generally attacks and affect lymphocytes which are a type of immune cells. People with compromised or low immunity system are more prone to spinal cord lymphoma. There is also a genetic component that can be a probable cause of cancer in people. This genetic disorder creates benign tumors in the tissue layer of the spinal cord.

Symptoms of Spinal Tumor

The symptoms of early spinal tumors are rarely seen. However, with the growth of spinal tumor progresses, patients may feel different symptoms that may affect their blood vessels, bones, and nerves connected with the spinal cord. The symptoms related to spinal tumors include:

  • Back pain

  • Senselessness at back

  • Difficulty in walking

  • Pain at the site of the tumor

  • Loss of bowel

  • Loss of bladder function

  • Weak sensation in the muscles especially in arms and legs

  • Pain originating from the back and radiating to other parts as well

Since the grown of the tumor is unknown, the early symptoms only show back pain. Gradually this pain travels to lower back, hips, legs, and arms which worsen with time. Spinal tumors progress at a different rate.

Diagnosis

Since the symptoms of spinal tumors are prevalent, it is generally overlooked by many doctors and patients. Hence, it is necessary that doctor examining you should be aware of your medical history. The diagnosis includes physical and neurological examinations. The following methods can determine spinal tumors:

  • MRI Scan: MRI is the most effective way to look into the body organs. It uses a compelling, magnetic field, and radio waves to get the images of the spinal cord without operating the patient. Dye is injected into the spinal cord, and the doctors the determine the tissue mass that is developing in the spine region with the accumulation of dye in the region. It is the most preferred method to detect a tumor in the spine.

  • CT Scan: CT scans are a cheaper option than MRI. It is generally used to scan spinal tumor when the patient is claustrophobic or cannot afford for MRI scan. Similar to the MRI scan, the dye is injected in the spinal region of the patient when performing a CT scan.

  • Biopsy: This method is used when doctors observe the development of a mass in the spinal cord of the patient. A small piece of the mass is retrieved and diagnosed under a microscope to understand the type and nature of the tissue mass developing in the spine of the patient.

Spinal tumors once detected requires thorough medical treatment and surgeries. Consult with the expert oncologist and get yourself checked. If avoided, it may lead to a severe threat to life.

 

1443 people found this helpful

Spinal Compression Fracture - How To Avoid It?

Clinical Fellowship In Pain Management, MD - Internal Medicine, Master Of Public Health (MPH), MBBS
Pain Management Specialist, Hyderabad
Spinal Compression Fracture - How To Avoid It?

What is spinal compression fracture?
Spinal compression fractures are getting frequent due to the many lifestyle changes which we undergo. The body should not be made to be put use in a certain way like posture, lifting heavy weights, etc. However, prolonged and repeated usage affects the spine directly and results in compression fractures. Though the condition looks, gratifying, modern science has advanced to levels where the fractures can be addressed very effectively, and the pain symptoms can be eradicated almost completely. Let us have a summary of the treatment methods.

The treatment
The treatment plan of any spinal compression fracture should effectively highlight the pain, the factors leading to the pain and lastly the fracture itself. Our body has been designed in such a way that the spine can withstand an amount of pressure and force. As a result of it, it is one of the strongest parts of the human body. Hence most fractures heal with pain medications and strength exercises. These activities can be embraced as a permanent one- thus eradicating the pain altogether.

Pain killers are administered gradually for a few weeks along with rest and once the pain subsidises strength exercises are imparted as a part of the treatment plan. In a few cases, anti-inflammatory drugs and antidepressants can also help in relieving the nerve-related pain. A back brace like an easily removable cast can also be put when doing the usual activities. This, directly stiffness the spine and provides it with support. The pressure to the spine can be greatly relieved due to the back brace.

Surgery for Spinal compression fractures
As stated, most of the spinal pain can go away with certain lifestyle changes and medications. However, in some extreme cases even after putting all the effort the pain does not go, then a surgical treatment has to be performed to correct the fractures. There are two minimally invasive procedures namely Vertebroplasty and Kyphoplasty and one complicated procedure known medically as the Spinal fusion surgery. In vertebroplasty and kyphoplasty, bone cement is spread across in layers to the affected region.

These blocks of cement have a tendency to get strong in a matter of minutes, thus relieving the pressure immediately. Spinal fusion surgery is done in extremely rare cases where two or more vertebras are connected together using metal screws. Sometimes even a bone graft is affixed to provide support to the fractured region. Doctors, however, do not go for it usually as the procedure causes extreme inconvenience even after the treatment.

Prevention
Spinal compressions are a frequent occurrence nowadays, and a good physician would suggest prevention is better than cure. Making the much-needed changes to life and the activities we perform can drastically reduce the chances of getting a spinal compression fracture.

Spine - How To Ensure Health Of It?

MBBS, MS - Orthopaedics
Orthopedic Doctor, Kolkata
Spine - How To Ensure Health Of It?

The spinal cord is indispensable to your body. It supports your head, keeps your posture erect, and helps you walk. Ailments of the spine are extremely painful to remedy and throw a lot of your other organs in trouble as well. Therefore, you should take the best care of your spine.

While there are a number of ways you can do that, some stand out from the rest. They are:

• Do your exercises properly: There are umpteen ways you can work out and get results that are harmful to your spine. You may easily lift something too heavy for your constitution, or the angle at which the object is placed may be too high for all your muscles to coordinate and work properly. Be aware, and avoid these mistakes. If you feel like the object is too heavy, refrain from lifting it. Even when lifting, make it such that the muscles of your lower body have to do the maximum work.

• Move on: Physical movement is the first commandment of having your spine fit and in a peak condition. This movement can be trivial and every day, like daily walks in the park or going to walk your pet. However, a sustained movement like that is very important, combined with stretching or aerobic exercises.

• Work smart: There are several ways you can avoid injuring your spine at the workplace. You should choose a chair that is adjusted according to your height and supports your lower back well. Your feet should be able to reach the floor properly. You should also avoid unhealthy conveniences like holding your phone between your ear and shoulders to keep your hands free.

• Go for daily checks: You should keep daily tabs on what is happening to your spine. Go for daily checks, and immediately contact your doctor if you experience symptoms like back pain without any evident disease, or if discomfort persists even after medication.

The spine is integral to the proper functioning of your whole body and shouldn’t be ignored even for a day. There are exercises you can do to keep it in good shape and those that you can avoid. There are also triggers after which you should check with your doctor as well. Here’s wishing you good spinal health.

2011 people found this helpful

Post Spinal Surgery Recovery Measures!

MS - Orthopaedics, MCH, Membership of the Royal College of Surgeons (MRCS), MBBS Bachelor of Medicine and Bachelor of Surgery, FJR
Orthopedic Doctor, Delhi
Post Spinal Surgery Recovery Measures!

It is not that very easy to get complete recovery after spinal surgery and for that, you have to rely on different caring tips. Your surgeon can help you in this regard and can provide you a checklist containing different essential caring tips. You should follow those tips sincerely so that unwanted side-effects can be easily avoided. 

Few caring tips after spine surgery

  • Consumption of adequate amount of proteins: If the protein content is increased in your diet, then quickest recovery can be definitely expected. Muscle collagen can be strengthened and healed with the regular intake of the necessary amounts of protein. In fact, infectious conditions can be effectively dealt with by protein intake. 
  • Getting adequate rest: proper rest is needed and you should have enough sleep for getting complete recovery. If your body needs some more sleep than the standard one, then you should go for the same. Your mood, memory and body will get refreshed and rejuvenated by taking proper sleep at night. In fact, you can also get rid of pains and other side-effects after surgery by taking rest. 
  • Taking nutritional supplements: There are a few essential nutrients that are needed after the surgical procedure, and they are vitamin D, vitamin C, Omega-3 fatty-acids, magnesium and others. These nutritional elements are now available in the form of supplements and are readily available in the stores. Though these supplements are completely organic, but still you should start taking the same when doctors permit you. These supplements help in collagen healing and thus speedy recovery can be gained by taking them in a consistent manner. Muscle heath can be effectively protected by consuming these supplements. 
  • Acute hydration: Hydration is highly needed especially after spinal surgery so that toxin accumulation can be prevented. If you want to get proper hydration, then nothing can be a better option than drinking lots of water. In fact, spinal surgeons also recommend the same for avoiding surgical complications. Tea, coffee and sodas need to be completely replaced with water. Your system can be thoroughly cleaned by draining out toxins. 
  • Eliminating refined sugars from the diet: Refined flour and sugary products are to be completely curtailed from the regular diet; otherwise, you might face severe complications. Your blood-sugar level needs to be regulated. If your immunity system gets suppressed, then you will be in great trouble and hence sugar should not be included in your diet at all.
3720 people found this helpful

Spine Health - Know What Can Hamper It!

Dr.Uday Pawar 85% (21ratings)
DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS, Fellowship Trained Spine surgeon
Orthopedic Doctor, Mumbai
Spine Health - Know What Can Hamper It!

With changing lifestyles, the small household chores (daily activities) have become the workouts for most of us. When not done properly, however, these cause more harm than good. The spine often bears the brunt of this damage. Read on to know if you are damaging your spine on a daily basis. Its time to change the way you do these activities for your spine.

  1. Carrying shopping bags - While two bags might look more expensive, carrying one bag tilts the weight to one side and causes the spine to bend. Instead, opt for two small bags, and this weight distribution is friendly on the spine.
     
  2. Cleaning the floor - Either sit down completely or stand and use a mop. Never bend down and try to clean the floor with a cloth. The spine posture created during this is very unhealthy and puts pressure on the spine.
     
  3. Tying up shoe-laces - While it is difficult to sit down and tie the shoe-laces, it is definitely worth the effort. Bending down and tying is harmful to the spine posture, and when repeatedly done, can be damaging in the long run.
     
  4. Washing vessels - Bending and washing vessels is a strict no. It puts too much pressure on the back and the disk wears out faster. Try standing and keep a stool at knee level, on which you can rest the knee. Take turns to do this on the right and left knee.
     
  5. At the washbasin - Bending down to brush the teeth or wash face is bad on the spine. Over a long period, this can put a lot of strain on the spine. Try to rest your hand on the wall or the sink and see the pressure on the spine reduce.
     
  6. Office/school bags - It is very easy to sling a bag onto the shoulder and go on. The bag could contain books of a school kid or laptop of an office goer, whatever may be the situation, this puts uneven pressure on the back and can cause shoulder and spine issues. Always try to put the bag on both your shoulders. This distributes the weight and makes it easy on your shoulders and spine. Especially for people who are going to do some walking with the bag, it is definitely not advisable to carry it on one side.
     
  7. Sitting - For those who end up sitting for long hours, there is too much stress on the back and so support is advisable. Take short breaks and avoid sitting for more than an hour at a stretch.
     
  8. Bad mattress - While a soft mattress is very inviting, it does not support the spine and does not leave you fresh in the morning. Choose a mattress that supports the spine and see the difference.
     
4454 people found this helpful

Treating Spinal Stenosis The Right Way

MBBS, MS - Orthopaedics
Orthopedic Doctor, Kolkata
Treating Spinal Stenosis The Right Way

What is Spinal Stenosis

The narrowing of the gaps in the spine or the backbone is called as Spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.

Causes of spinal stenosis

It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine

Symptoms of spinal stenosis

There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.

Treatment of spinal stenosis

-  A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.

-  Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.

-  Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.

-  Medications such as the antiinflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case anti depressants might also be given to provide relief from pain. 

Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.

4740 people found this helpful

Spinal Cord Tumours - Know More!

MBBS, MS - General Surgery, MCh - Neuro Surgery
Neurosurgeon, Delhi
Spinal Cord Tumours - Know More!

Our spine is made of a column of bones. It has 33 vertebrae. Each vertebral segment creates a bony circle, called the spinal canal, that protects the spinal cord and nerves.

Tumour is an abnormal growth of cell mass. Spinal tumours can  grow outside the spinal cord covering i.e. duramater & are called extradural. They can grow from bones surrounding the spinal cord i.e. vertebra, muscles, nerve roots, duramater.  Examples include metastasis, aneurysmal bone cysts, ewing’s sarcoma, lymphoma, neurofibroma.

Intradural extramedullary tumours grow inside the duramater but outside the spinal cord. They cause direct compression of the spinal cord. Here tumours can grow from nerve roots, duramater. Examples include neurofibroma, schwannoma, meningiomas, dermoids, epidermoids, lipomas, teratomas.

Intramedullary tumours grow inside the spinal cord substance. Examples include ependymomas, astrocytomas, hemangioblastomas, cavernomas.

The majority of tumours are benign.

Clinical presentation depends on the location of tumours in the spinal canal, size & severity of compression caused by the tumour.

  • Local Pain – especially in Extramedullary Tumours

  • Radicular Pain

  • Backache

  • Neck Pain

  • Paresis & Numbness

  • Sensory & Motor deficits

  • Gait disturbance

  • Bladder / Bowel involvement

  • Scoliosis

Many a times, the symptoms of spinal tumours may be confused with those of prolapsed intervertebral disc or simple low backache or neck pain.

Diagnostic workup includes detailed history and neurological examination of the patient. Investigations include MRI spine with contrast; MRI brain and CT scan of spine may be required on a case to case basis. Uroflowmetry and urodynamic studies may be required in some cases where bladder seems to be involved.

Management of spinal tumours includes surgical excision without compromising neurologic function. Radiotherapy and/ or chemotherapy may be required in some cases. Neurophysiological monitoring should also be used in cases where the borders of the tumour are not well defined.

Microscope, neuromonitoring, high speed drill, CUSA, irrigation cautery systems and microneuro instruments further enhance safety in spinal tumour surgeries.

Surgery should be done as early as possible in symptomatic & large tumours

RAPID IDENTIFICATION AND INTERVENTION OF MALIGNANT SPINAL TUMORS, OFTEN CAUSING SPINAL CORD COMPRESSION, IS KEY TO MAINTAINING QUALITY OF LIFE IN PATIENTS

 

2624 people found this helpful

Spine Deformity - Everything You Should Know!

MBBS, M.S. Ortho, DNB (Orthopedics)
Orthopedic Doctor, Patna
Spine Deformity - Everything You Should Know!

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

Types of spine deformities:

The three major forms of spine curvature deformity are-

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

What are the causes of spine deformity?

The following conditions may cause the spine to be misaligned-

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

Symptoms associated with deformed spine:

Signs and symptoms of a deformed spine include-

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

How is the condition treated?

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

Severe cases of spine deformity need another line of treatment.

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

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

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

4322 people found this helpful

What To Ask Your Spine Surgeon?

Dr.Uday Pawar 85% (21ratings)
DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS, Fellowship Trained Spine surgeon
Orthopedic Doctor, Mumbai
What To Ask Your Spine Surgeon?

Spine surgeries are complicated and have serious repercussions if the procedure doesn’t go as planned. Probing your doctor is therefore very critical to ensure safe operation and early post-op recovery. Questions can range from the type of treatment chosen for a speedy recovery to side effects. Here is a list of questions that you need to ask your spine surgeon:

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

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

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

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

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

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

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

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

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

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

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

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

4206 people found this helpful
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