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Spinal Surgery Health Feed

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

Minimally Invasive Spine Surgery - Know More About It!

Dr.Milind Tanwar 88% (122ratings)
MS - Orthopaedics, Fellowship in Arthroscopy & Sports Injury, MBBS
Orthopedic Doctor, Gurgaon
Minimally Invasive Spine Surgery - Know More About It!

Surgery on the spine is typically performed as an open surgery. This implies that the surgery is performed by making a large incision that allows the surgeon to do the surgery while seeing the spine. However, advancements in medicine have helped surgeons operate on the spine through minimally invasive surgical techniques. This type of surgery involves making a few small incisions instead of a large incision through which the surgeon inserts specially designed instruments to operate on the spine.

Minimally invasive surgery has a number of benefits. Primary amongst these benefits is shortened recovery time. Faster healing is also associated with lesser pain. It also causes less muscle damage. Since the incisions are smaller than normal, they heal faster than a large incision. Smaller incisions also reduce the risk of infections.

There are many different types of minimally invasive surgical techniques. A minimally invasive surgery may be used to treat issues such as spinal fusion and lumbar decompression. These are typically performed only when medication and other forms of non-invasive therapy such as physical therapy have been unsuccessful. Surgery is also advised only when the surgeon can pinpoint the exact cause of the issue.

Like open surgery, minimally invasive procedures on the spine are also performed while the patient is under general anesthesia. The most common minimally invasive surgical procedure involves the use of a tubular retractor. This creates a tunnel from the incision site to the part of the spine to be operated on by pushing the muscles around instead of cutting them. The surgeon can then use the retractor to access the spine with the use of special instruments. Any bone shrapnel or disk material that must be removed can also be taken out through the retractor. Similarly, any rods or screws that need to be inserted into the spine can also be transported through the retractor. Surgeons may also use an endoscope to access the problem area in the spine.

As with any other surgical procedure, there are a few risks associated with minimally invasive surgery. Some patients may experience slight bleeding after the procedure and pain at the bone graft site. The surgery may also cause an infection which can be treated with antibiotics. Blood clots are a rare complication associated with such surgeries. If they travel up to the lungs, it could be significantly dangerous. In rare cases, the blood vessels or nerves around the surgery site can also be damaged during the surgery.

1261 people found this helpful

Spinal Surgery - Know More About It!

M.Ch (AIIMS) - Neuro Surgery, MS - General Surgery, MBBS, IFAANS (USA)
Neurosurgeon, Noida
Spinal Surgery - Know More About It!

Spinal surgery is a process used for correcting the problems in your spine. The process involves welding two bones or vertebrae into one single bone. This reduces the movement of those bones, which in turn, helps to reduce back pain and stabilize the spine.

This type of surgery is performed when physiotherapy and medicines have not helped cure your back pain. The specialists recommend this option when they are able to understand the actual reason behind your pain.

To locate the source of your discomfort, you may have to undergo MRI (Magnetic Resonance Imaging) scans, X-rays and CT (computerized tomography) scans.

Procedure

Prior to the surgery, you will be put under general anaesthesia. Spinal fusion surgery can be performed through different techniques. The most common ones are – cervical spinal fusion and lumbar fusion.

There are two approaches –anterior and posterior. In the anterior approach, the doctor will make an incision in your lower abdomen for the lumbar fusion. For the cervical fusion, this incision will be made in your neck in the front.

For the posterior approach, the incision will be made at your lower back in the middle. Another method (called lateral approach) is where the doctor operates your spine by making an incision on the side.

The next step is preparing a bone graft. A bone graft is used to enhance the healing process of your bones and fuse two vertebrae together. If the graft is developed from your own body, a portion of your pelvis is utilized. If it comes from another person, it is called a donor graft.

The surgeon positions the bone graft between the vertebrae. Screws, metal plates and rods can be used for keeping the vertebrae in place until the bone graft heals. In some cases, doctors may use synthetic substances to help increase the speed of the fusion process. You may be suggested to wear a brace by the doctor.

Applications of Spinal Surgery

Spinal fusion surgery can be used for different purposes –

• Spinal deformities such as scoliosis, where the spine is curved sideways

• Vertebrae fracture

• Tumour

Infection

• Stabilize the spine after removing a herniated disk

• Spondylolisthesis

• Restoring spinal strength that may be caused due to arthritis

• Spinal stenosis

• Degenerative disk disease

Aftercare and Recovery

You will have to stay at the hospital for at least two to three days. Afterwards, you may face some discomfort such as high fever, redness, swelling, and chills. However, these are part of your natural healing process. The fusion process can take several months. During this period, your spine has to be kept perfectly aligned. You must take the medication as per the doctor’s guidelines. As you recover, your doctor will instruct you to start engaging in light physical activity such as walking.

2106 people found this helpful

Things To Keep In Mind Pre & Post Spinal Surgery!

Dr.Abhishek Kumar Mishra 90% (14ratings)
MS - Orthopaedics, MCH, Membership of the Royal College of Surgeons (MRCS), MBBS Bachelor of Medicine and Bachelor of Surgery, FJR
Orthopedic Doctor, Delhi
Things To Keep In Mind Pre & Post Spinal 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. 

  1. Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

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

  3. Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

  4. Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

  5. Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

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

  7. Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

  8. Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery - Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects the overall quality of life, so psychological preparation is required.

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

  2. Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

  3. Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

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

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

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

2005 people found this helpful

Post Spinal Surgery Recovery Measures!

Dr.Abhishek Kumar Mishra 90% (14ratings)
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

Minimally Invasive Spine Surgery - Knowing Merits Of It!

MBBS, MS - Orthopaedics, fellowship in Arthoplasty
Orthopedic Doctor, Bangalore
Minimally Invasive Spine Surgery - Knowing Merits Of It!

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 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 of 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 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 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.

  1. 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.
  2. 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.
  3. The chances of damage to the spine are cut down to a great extent because it is minimally exposed during the surgery.
  4. Finally, the time is taken for the procedure and the aftercare 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.

4609 people found this helpful

Know More About Minimally Invasive Spinal Surgery!

Dr.Nitin Jagdhane (Jain) 92% (34ratings)
MCh Neurosurgery, Fellowship in Spine surgery, MS - General Surgery
Neurosurgeon, Mumbai
Know More About Minimally Invasive Spinal 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-

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

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

  3. Lesser bleeding compared to earlier techniques

  4. Lesser painful procedure

  5. Reduced hospitalization period

  6. Quicker recovery and return to normal activities

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

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

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

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

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

  5. Excessive weight puts a 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.

3267 people found this helpful

Spine Surgery - Know Before & After Requirement!

Dr.Uday Pawar 85% (21ratings)
DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS, Fellowship Trained Spine surgeon
Orthopedic Doctor, Mumbai
Spine Surgery - Know Before & After Requirement!

Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.

Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.

  1. Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

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

  3. Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

  4. Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

  5. Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

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

  7. Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

  8. Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects the overall quality of life, so psychological preparation is required.

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

  2. Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

  3. Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

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

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

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

3956 people found this helpful

Minimally Invasive Spine Surgery - Know Merits Of It!

Dr.Uday Pawar 85% (21ratings)
DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS, Fellowship Trained Spine surgeon
Orthopedic Doctor, Mumbai
Minimally Invasive Spine Surgery - Know Merits Of It!

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

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

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

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

  3. Lesser bleeding compared to earlier techniques

  4. Lesser painful procedure

  5. Reduced hospitalization period

  6. Quicker recovery and return to normal activities

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

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

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

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

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

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

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

3983 people found this helpful

RFD -3 D Navigation In Spine Surgery!

MS - Orthopaedics, AO Fellowship in Trauma, Fellow Spine Surgeon, fellow in Endoscopic Spine Surgery
Orthopedist, Gurgaon
RFD -3 D Navigation In Spine Surgery!

3d image-guided computer-assisted spine surgery (icss)- the new standard-of-care

Minimally invasive techniques have revolutionized the field of spine surgery by enhancing surgical precision and diminishing complication rates.

Image-guided computer assistance is the central pillar of minimally invasive spine surgery which involves an intra-operative 3d scan of the spine and creates a navigable image just like a google map used by motorists while driving. This enables even the most complex spinal surgeries to be performed with few millimeters of skin incision and minimal damage to surrounding tissues like muscles, ligaments and bones. Smaller skin incisions and tissue exposure are advantageous in reducing surgery-related blood loss and infection rates.

Just like google maps tracks like the location of a vehicle, 3d navigation allows the surgeon to track the live location of implants in the spine while instrumentation, which enhances placement accuracy.

Another significant advantage of 3d navigation is a reduction in radiation exposure because a single 3d scan is enough for the whole procedure and the surgeon doesn't need repeated x-ray images to confirm implant position.

Minimal collateral damage to surrounding tissues, accurate placement of implants, shorter surgery duration, lesser complication rates, faster rehabilitation translates into predictable and excellent clinical outcomes.
 

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