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Overview

Spinal Surgery - Treatment, Procedure And Side Effects

What is the treatment?

Spinal surgery, also known as lumbar surgery, concerns any kind of surgery conducted on the lower back. There are two types of lumbar surgery: lumbar fusion and lumbar decompression.

The main objective of a lumbar decompression surgery is to ease the pain caused due to neural impingement (pinched nerve). This pain is referred to as sciatica or radiculopathy. This involves removing a tiny part of the bone above the root of the nerve to address the pinching of the nerves. The commonest types of a lumbar decompression surgery include discectomy and microdiscectomy.

Lumbar fusion concerns itself with easing the pain at a particular portion in the individual’s lower back. Mostly, this type of a surgery is carried out in the case of any disability or pain from spondylolisthesis or a lumbar degenerative disc condition. This technique uses a bone graft to thwart any type of movement in the painful part of the vertebra that in turn takes care of the pain that was caused due to the movement. Bone stimulators, bone grafts, and other medical devices are used in this surgery.

How is the treatment done?

A Lumbar Microdiscectomy is one of the most important minimally invasive surgical procedures carried out to ease pain from pinched nerves. Firstly, a minor incision is made in the patient’s lower back and the affected part (that is in contact with the pinched nerve root) is removed. It has a pretty high success rate (of about 90-95%) in alleviating pain. Often times, the patient experiences instant relief from pain. However, for some, the symptoms might not resolve completely.

A Lumbar laminectomy, on the other hand, is performed to address lower back stenosis symptoms. In this technique, the lamina (the bone that is present at the back of one’s vertebra) at one or multiple segments is taken out that in turn prevents any further pressure to be put on the nerves in the spine.

Who is eligible for the treatment? (When is the treatment done?)

Spinal surgery is carried out because:

  • Spinal fusion can be performed independently or in combination with the surgery to remedy tissues and bones which might be narrowing down the spine canal and thus squeezing the nerves of the spine or the spinal cord in itself.
  • It can also be done as part of a follow-up post any surgery to address conditions such as herniated disc, spinal stenosis, infection, tumors, and injuries.
  • Can be performed to treat problems such as fractures.

Who is not eligible for the treatment?

There is no non-eligibility criterion as such. If the patient experiences pain from a pinched nerve or spinal instability, he/she should consult a spine surgeon and consider the decision of a spinal surgery. However, if any evidence of an anatomic cause isn’t detected through a CT scan or an MRI scan, then spinal surgery should be avoided. In a nutshell, there must be some anatomical lesion that can be considered to be the reason behind such a pain. At the end of the day, however, it is completely the patient’s discretion whether or not to go for spinal surgery.

Are there any side effects?

The possible side effects and complications depend on the patient’s age, the overall state of health, the type of procedure opted for and the problem that is being treated. Some of the possible side effects are:

  • Pain emanating from the site of the bone graft
  • Breakage of the metal implants and/or weakening of the fusion
  • Blood clots that could result in pulmonary embolism
  • Injury to the nerves
  • Infection
  • Rejection of the bone graft by the body

What are the post-treatment guidelines?

After the spinal surgery, the patient will be kept under supervision for a few days. If the patient is recuperating at home, bed rest would not be required. A back brace might be prescribed by the doctor for you so as to speed up the recovery process. Rehabilitation post-surgery can take its own time. Usually walking, swimming and riding a static cycle are some of the activities that constitute the rehabilitation program.

How long does it take to recover?

Post spinal surgery, recovery can take about 4 months’ time. This is because the bones take the time to heal completely and the healing process may continue over a period of one year. In the case of a spinal fusion, the doctor will recommend one to be off work and other activities for about a month or even more (approximately 4-5 weeks); especially if the patient is young and is in otherwise good physical shape.

What is the price of the treatment in India?

The cost of spinal surgery in India lies in the range of approximately Rs.4, 22,500- Rs.6, 17,500.

Are the results of the treatment permanent?

Spinal surgery is important to render stability to the spine after any trauma, accident or injury. However, there isn’t sufficient research about whether it works as effectively for other problems of the spine as well. Studies have failed to come up with stark differences in the way this surgery and intense rehabilitation would work for chronic problems. Though it does provide relief from quite a few problems with the back, it will always be wise to consult with the doctor regarding the risks and benefits, given that it is a costly surgery and entails its fair share of side effects.

What are the alternatives to the treatment?

The possible alternatives include:

  • IDET
  • Posterior dynamic stabilization
  • Artificial disc
  • Disc regeneration
Safety: High Effectiveness: High Timeliness: Medium Relative Risk: Side Effects: Medium Recovery Time: Medium Price Range: Rs. 4,22,500 - Rs. 6,17,500

Popular Health Tips

Benefits of Minimally Invasive Spine Surgery!

Dr. Akhlaq Ahmed 85% (10 ratings)
Diploma in Orthopaedics, MBBS
Orthopedist, Gurgaon
Benefits of Minimally Invasive Spine Surgery!
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- Smaller incision compared to traditional surgical procedures, where only the injured area is accessed The surrounding tissues are untouched, unless they are injured and require repair Lesser bleeding compared to earlier techniques Lesser painful procedure Reduced hospitalization period 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. Presence of symptoms relating to nerve compression, including pain from the spine down the leg. 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. People with active lifestyle who engage in regular physical exercise are likely to have better benefits from the minimally invasive procedure. 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. 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.
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Spine Surgery - What To Expect After It?
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. Discontinue antiplatelets: Discontinue antiplatelets and blood thinners. It has to be stopped atleast 5 days before Surgery. Prepare for blood loss: Most people experience some blood loss, but not excessive. 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. 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). 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. Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used. 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. 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. Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail 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. 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. Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain. Smoking and alcohol should be completely stopped, as healing can be hampered. With some preparation, spinal surgery can be sailed through smoothly. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
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Minimally Invasive Spine Surgery - Understanding the Benefits!
Humans are prone to much more complex and extensive experiences in life than any other animal species, this is because we also enjoy highly developed cognition and mental abilities in comparison to the other species. However, our cognitive abilities also mean that we are more prone to bad experiences and health issues that may require intensive treatment or even at times surgeries. Having to undergo a surgery may sound like an exceptionally difficult or painful prospect, but with the help of modern medical practices and the use of state of the art technology and equipment, there are times when patents are able to get excellent results. One among many such advanced practices is the use of minimally invasive spine surgeries. There may be times when we may injure ourselves or may develop health issues that make it difficult for us to go about our daily lives and at such times a surgery on the spine may be required. It is however, risky to carry out a full-fledged surgery on the spine because of the fact that our movements in general and the central nervous system may be put at great risk when the spine is tweaked or worked with. This is one of the biggest reasons why modern medical practitioners suggest and prefer carrying out the minimally invasive surgery. Understanding the practice: In order to be able to develop a conviction for the practice, it is important to make sure that you understand the practice in general. As the name suggests, the surgery is done in a manner in which large incisions are not made on the spinal region and the procedure is done only by the creation of a small hole. The surgery is carried out with the use of non-conventional tools that can be manoeuvred through smaller openings and the process is carried out with the help of a small incision around the spinal region. Advantages of the minimally invasive surgery: As opposed to the regular open surgery, there are a lot of advantages for the patients that opt to undergo the minimal surgical procedure. The biggest advantage is that the patients are able to recover much sooner and the pain is also cut down to a minimal level because of the surgical opening being so small. The muscles that get affected due to the surgery heal much faster and they do not have any long term side-effects which is much more common in a conventional surgical procedure. The chances of damage to the spine are cut down to a great extent because it is minimally exposed during the surgery. Finally, the time taken for the procedure and the after care is also brought down because of the simplicity of the surgical procedure. As we step into an era of advanced medical practices, it may be important to quickly adopt and adapt to the new age practices so that a better future for patients may be carved out and established all across the world.
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Postoperative Care for Spinal Fusion Surgery!

Dr. Amit Chakrabarty 87% (10 ratings)
MBBS, Cerebrovascular and Micro neurosurgery fellowship, MS - General Surgery, MCh Neurosurgery
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Postoperative Care for Spinal Fusion Surgery!
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. 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. Prepare for blood loss: Most people experience some blood loss, but not excessive. 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. 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). 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. Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used. 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. 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. Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail 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. 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. Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain. Smoking and alcohol should be completely stopped, as healing can be hampered. With some preparation, spinal surgery can be sailed through smoothly.
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What To Expect Before Spine Surgery?

Dr. Abhishek Kumar Mishra 88% (11 ratings)
MS - Orthopaedics, MCH, Membership of the Royal College of Surgeons (MRCS), MBBS, FJR
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What To Expect Before Spine Surgery?
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. 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. Prepare for blood loss: Most people experience some blood loss, but not excessive. 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. 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). 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. Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used. 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. 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. Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail 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. 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. Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain. Smoking and alcohol should be completely stopped, as healing can be hampered. With some preparation, spinal surgery can be sailed through smoothly.
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Popular Questions & Answers

79 years has been diagnosed with Lung cancer (NSCLC) Adenocarcinoma & Metastatic Spinal Compression too for D9 & D10 vertebrae. Please advise whether Chemotherapy is to be given to him first or Surgery for Spinal Compression is to be done first? He is bedridden currently due to severe pain in the spine. His Spinal MRI & Lung scans are attached for your ready reference in this app under X-ray. Kindly advise asap.

Dr. Ninad Katdare 91% (162 ratings)
Registrar in Surgical Oncology, Fellowship in Gynaecologic Oncology, Masters In Advanced Oncology, Fellowship in advanced laparoscopy and robotic surgery, Fellowship in Gastrointestinal Oncology, Fellowship in CRS and HIPEC, Fellowship in PIPAC
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If the spinal compression is causing symptoms like weakness of arms and legs, then surgery is needed first as failing that the paralysis will worsen. Once he recovers from that, we can immediately start the chemo. For adenocarcinoma we also have lot of targeted chemotherapy oral medicines which can be given, so ask you Oncologist to do tests for those if not already done.
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After my spinal surgery (Interlaminar micro-lumber disectomy) two month back. I was feeling tingling in left arm, I had enquired with my doctor and he said spinal surgery has nothing to do with left hand tingling. Now tingling has gone but I feel numbness and sometimes weakness. Please advise if its a temporary and can be treated at home?

Dr. Sunil Srivastava 89% (498 ratings)
MBBS, Diploma In Orthopaedics (D. Ortho)
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Hi You are on right medicine.just try some local massage, vivaran gel application of affected area and neck, hot fomentation and neurobion forte once daily
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