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Overview

Spondylosis - Treatment, Procedure And Side Effects

What is the treatment?

Spondylitis is a chronic condition that causes severe back pain, damages the nerves and can even lead to degenerative neurological symptoms. Doctors rarely resort to surgery for the treatment of spondylitis. But in certain cases, spinal surgery for spondylitis becomes essential. Some of the symptoms of spondylitis include chronic back pain, leg pain and in some cases, difficulty in walking.

If other methods of treatment such as injections, physical therapy, and medications have been proven ineffective, then the doctor will suggest surgery. There are many types of surgeries for the treatment of spondylitis. The two main types of surgery are for decompression and stabilization. The decompression method involves removal of the tissue that is causing the pain while the stabilizing surgery fuses the spinal cord in order to grant more control over movement.

The surgery procedures that are available for the treatment of spondylitis include; laminectomy, facetectomy, foraminotomy, discectomy and many others.

The main surgery that is used in the treatment of spondylitis is called a laminectomy. The procedure involves removal of nerves and bones from the spine in order to enlarge the spinal column. This relieves the pressure and also helps to alleviate the pain.

Laminectomy decreases the pressure from the spinal cord by removing some part of the lamina. The lamina is the bony plate that covers the spinal canal and cord. In spondylitis, the lamina could be pressing against the spine, and this pressure leads to severe pain and other symptoms.

How is the treatment done?

A laminectomy is one of the most common surgeries performed on the spine. It is a decompression surgery that helps create space in the spinal canal. The doctor might ask you to avoid eating or drinking for a few hours before the surgery.

For the procedure of laminectomy, the surgeon will administer the patient with general anesthesia. This ensures that the patient is unconscious during the procedure and does not feel the pain. The patient will be able to breathe with the help of a breathing machine.

First, the surgeon will make an opening in the back to expose the spine. The surgeon will then remove parts of the spinal cord such as the vertebra, lamina, and ligaments that are causing the compression of the spine. Once the surgeon creates this space, the spinal canal will be enlarged allowing the process of decompression.

In some cases, the surgeon may have to remove a herniated disc or fuse the spine together using a special implant. This fusion process enables stabilization of the spine and involves widening the openings in the spinal canal for the nerves to exit. However, this is only required for some patients.

Once this process is completed, the surgeon stitches the incision over the spine and closes the wound. When the surgery is over, the anesthesia is switched off and the breathing machine is removed.

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

People who are eligible for a laminectomy would include:

  • People who suffer from arthritis of the spine which can lead to spondylosis.
  • Patients who have a herniated disc in the vertebrae.
  • People who have severe back pain and find it difficult to walk due to the condition of spondylosis.

Who is not eligible for the treatment?

People who might not be eligible for a laminectomy surgery could be:

  • People who suffer from other severe health conditions such as diabetes or hypertension; therefore, it is advisable for them not to undergo this surgery unless it is absolutely essential.
  • Patients who are older might not be eligible for this surgery since it can lead to several health complications.

Are there any side effects?

There are a few health complications and risks that could result from a spinal surgery like a laminectomy. However, some of these side effects might not affect all patients. The possible side effects are as follows:

  • Bleeding and infection
  • Trouble while urinating
  • Swelling of the veins in the leg
  • Nerve damage and spinal cord damage
  • Herniated disc
  • Heart attack or stroke
  • Quadriplegia or paraplegia
  • The condition does not improve

What are the post-treatment guidelines?

There are certain guidelines that a patient should follow after the spinal surgery. After the surgery, the patient is kept under observation for a period of 1 to 5 days. The vitals of the patient are monitored, and any improvement or deterioration is observed.

The patient will experience pain in the back and the affected area for some time. The doctor will prescribe certain medication to relieve this pain. These medications are strong. Hence, it is advisable not to undertake any activity like driving a vehicle, traveling in a plane or riding a bike for a few weeks after the laminectomy.

The patient should keep the incision wound clean and go for a follow up two weeks after the surgery. The doctor will then remove the stitches.

How long does it take to recover?

The recovery process for spinal surgeries is slow; it is better to be patient and wait for your body to heal. Rushing the recovery process might aggravate the condition. It might take a few weeks or even up to several months to fully recover. The patient might not feel any improvement just after the operation. The wound from the incision will take a week or two to heal.

What is the price of the treatment in India?

The treatment for spinal surgery in India is very affordable. The price for a laminectomy surgery in India would range from Rs 5,500 to Rs 10,000.

Are the results of the treatment permanent?

In most cases, the patient does get relief from the chronic back pain. The symptoms of spondylosis are alleviated. However, the symptoms may recur after a period of time. There are some cases in which the condition does not improve and can even deteriorate. The results and improvement are discernible only six weeks after the treatment.

What are the alternatives to the treatment?

The alternative procedures to a laminectomy are cervical laminoplasty, cervical disc replacement surgery or laser spine surgery.

Safety: Medium Effectiveness: Medium Timeliness: High Relative Risk: High Side Effects: High Recovery Time: High Price Range: Rs. 5,500 - Rs. 10,000

Popular Health Tips

Cervical Spondylosis - Symptoms, Causes, Treatment

BPTh/BPT
Physiotherapist, Lucknow
Cervical Spondylosis - Symptoms, Causes, Treatment
Cervical spondylosis: Cervical spondylosis is a medical term for neck pain caused by age-related wear and tear of bones and tissues. The degenerative process chiefly affects the vertebral bodies, the neural foramina, and the facet joints. If it may cause severe pressure on nerve roots with subsequent sensory or motor disturbances, which causes pain, paresthesia, and muscle weakness in the limbs. Causes of cervical spondylosis Spondylosis is caused from years of constant eccentric pressure, from joint subluxation or poor posture, being placed on the vertebrae, and the discs between them. The aberrant stress causes the body to compose new bone in order to compensate for the new weight distribution. This eccentric weight bearing from bone displacement will cause spondylosis to occur. Poor postures and loss of the mundane spinal curves can lead to spondylosis as well. Spondylosis can affect a person at any age; however, older people are more affected. Cervical spondylosis is a very prevalent condition. It's estimated that 8 out of 10 adults will have some degree of cervical spondylosis by the time they are 60 years old (but many will not have any conspicuous symptoms). The most cases outlook of cervical spondylosis is generally good. Most cases respond well to treatment after a few weeks. Symptoms of cervical spondylosis Cervical spondylosis includes neck pain and shoulder pain. The pain can be rigorous in some cases. Infrequent headaches may occur, that customarily start at the back of the head, just above the neck, and peregrinate over top of the forehead. Pain conventionally comes and goes, with flare-ups followed by symptom-free periods. Around 1 in 10 people develop perennial (chronic) pain. Other, more severe, symptoms customarily only occur if you develop: Cervical radiculopathy where a slipped disc or other bone pinches or irritates a nerve The most common symptom of cervical radiculopathy is the sharp pain that" travels" down one of your arms (known as brachialgia). You may experience some numbness or" pins and needles" in the affected arm, and stretching your neck and turning your head makes the pain worse. Diagnosis of cervical spondylosis The spurling test may be used to evaluate patients with cervical radiculopathy. The sign is elicited by extending, rotating, and laterally flexing the patient s neck toward the symptomatic side. Then, the doctor applies axial pressure on the spine. Pressure applied on top of the head may increase symptoms. The spurling test has a sensitivity of 30% to 60% and a specificity of 90% to 100%, quite similar to those of other provocative maneuvers (low sensitivity but high specificity). This test help confirms the diagnosis of cervical radiculopathy. X-ray, and mri scans are helpful for diagnosis of pain but generally not definitive and must be considered together with history and physical examinations. Cervical spondylosis treatment Treatment for cervical spondylosis depends on the severity of signs of sickness. The goal of treatment relieves pain, help you maintain your normal activities as much as possible, and prevent permanent injury to the nerves and spinal cord. Physical therapy management There have been several trials and systematic reviews into the use of physical therapy program for treatment of cervical spondylosis and its consequences. There are several types of manipulations and exercises your physiotherapist can utilize to relieve stiffness, strengthen the area, and restore the function of the neck. Treatments such as cold or heat application, deep tissue massage, neck stretching, ultrasound and electrical stimulation may be used prior to exercise. During physiotherapy, you practice a range of exercises to stretch and strengthen the muscles that support the neck. You also learn how to improve your posture and range of movement exercises. You have to learn correct postures, the physiotherapist stand in front of a mirror while exercising, so you can see your mistakes and correct them. one technique sometimes to provide pain relief and improve movement by cervical traction. Traction gently extends the neck opening the spaces between the cervical vertebrae and temporarily relieve pressure on the affected discs. Neck traction either done continuously or intermittently (short periods of pulling and resting). It s also possible at home to do cervical traction. There are pulley system devices that enable you to perform cervical traction in lying down. It s important if you do cervical traction at home to see your physiotherapist first to make sure that you buy the right things and learn how to correctly set up. cervical pillows (neck pillows) are designed to stabilize the neck while you sleep. A cervical collar may also help you stabilize and realign your spine and relieve pain. Medications If over-the-counter pain medication doesn't help, your doctor might prescribe: Non-steroidal anti-inflammatory drugs- prescribe-strength ibuprofen or naproxen sodium might be needed to relieve pain and inflammation. Muscle relaxants- certain drugs, such as cyclobenzaprine and methocarbamol can help relieve muscle spasms in the neck. Antidepressants- antidepressant medications have also been found to help ease neck pain from cervical spondylosis. Surgery Cervical spondylosis tends to be a chronic pain condition, but in most cases, it s not progressive. Only rare cases surgery is required.
2 people found this helpful

Spondylosis - Is Ayurveda The Best Form Of Treatment?

Dr. Sandip Patel 84% (182 ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda, Ph.d Arthritic Disorder
Ayurveda, Surat
Spondylosis - Is Ayurveda The Best Form Of Treatment?
Spondylosis is a disease of the bone which involves wear and tear of the discs. The latter is the cushion between the joints of the neck and the neck bone. While it is mostly observed in aged people, it is not too uncommon among the youth as well. It can present with symptoms such as numbness, neck pain, headache, stiffness near the shoulder area etc. Ayurvedic treatment has been extremely promising in treating both cervical and lumbar spondylosis. The food connection: Ayurveda states that there is a close connection between Spondylosis and food. In Ayurvedic terms, an increase of Vata Dosha can lead to the problem of Spondylosis. For instance, consumption of frozen or processed food, sodas, junk food, low consumption of water, excess consumption of curried food heighten the chances of Spondylosis. Habits matter: As per the books of the Ayurveda, a reckless lifestyle increases the chances of Spondylosis. Habits such as day sleep, regular walking for a long distance, urging the suppression, rigorous exercise daily, work that involves bearing of weight on the neck, head and shoulder, night awakening etc. can wreak havoc and result in Spondylosis. On the other hand, healthy lifestyle changes can help a person refrain from this condition. Psychological Factors: Ayurveda states that even psychological factors can go a long way in making a person suffer from Spondylosis. Certain factors such as excess stress, loss of interest in day to day work, fear of failure, feeling of frustration, too much anger, grief resulting from personal loss etc. play a major role in Spondylosis. Visible Symptoms of Spondylosis: Some medical symptoms that can be easily identified as the signs of Spondylosis include fatigue, pain in the arm, shoulder, and forearm, difficulty in functions pertaining to neck rotation, extension, joint stiffness, muscular spasm, headache, weakness in the arm, difficulty in movement, difficulty in muscle coordination etc. Some ayurvedic treatments to deal with Spondylosis Treatment: Home Remedies For Cervical Spondylosis: Use Cow's ghee in your food. It is a best natural "Vata" reliever and gives nourishment to the nerves and other body parts. 1 tablespoonful of Turmeric should be consumed once every day, after boiling it in milk for half an hour. It is a very useful herbal treatment for cervical Spondylosis. Constipation must be avoided at all costs. Constipation may increase pain in Cervical Spondylosis. Herbs have divine healing powers and they have the ability to cure any type of disease from the root. They were gifted to us by God when he created life. So believe in God if you want to get rid of your problems! Ayurvedic herbs are unique natural remedies for Cervical Spondylosis. Ayurvedic principles are different in many ways from modern medicine for example - Drinking water from a copper pan after keeping it overnight is also very useful in Rheumatoid arthritis and Cervical Spondylosis. Consuming castor oil at night with milk or alone is a very useful herbal remedy for arthritis, especially rheumatoid arthritis and Cervical Spondylosis. Improve your nutrition as the first step.It plays an important role to fight diseases. When nothing works, nutrition does! Use herbal juices like Aloe vera juice (Kumari Saar) and Amla Juice (Amla Saar) in routine. Amla is the richest source of natural Vitamin C. Vitamin C improves the natural immunity of the body. 100 gm of Amla juice contains 30 times more vitamin C than 100 gm of oranges. Greeva Basti- A compound created with Bala Ashwagandhadi oil, Medicated oil and black gram paste is applied on the affected area. Regular application of this can regenerate the muscle bone and reverse Spondylosis to a considerable extent. Ayurvedic Herbs For Spondylosis Some ayurvedic herbs are known to be extremely beneficial for treating Spondylosis. When these are consumed or applied on the affected area, they can fetch surprising result for a Spondylosis patient. Some of these herbs include Prishniparni (Uraria picta), Ashwagandha (Withania somnifera), Guggulu (Commiphora mukul), Shunthi (Ginger), Bala (Sida cardifolia), Amalaki (Emblica officinalis), Gambhari (Gmelina arborea), Shallaki (Boswelia serrata), Rasna (Pluchea lanceolata), Castor root (Ricinus communis) etc.
5207 people found this helpful

Ayurveda For Cervical Spondylosis!

Dr. Riju Lohan 88% (29 ratings)
B.A.M.S.
Ayurveda, Dehradun
Ayurveda For Cervical Spondylosis!
In Ayurveda Cervical spondylosis is discussed as GRIVA SANDHIGATA VATA . Cervcical spondylosis the most common disorder of the cervical spine. INTRODUCTION Cervical spondylosis is a term used for age related wear and tear affecting the bones (vertebrae),joints and discs of the neck (cervical spine),usually occurs in men and women older than 40 and progresses with age,men usually develop it in earlier age than women.With the increase of age discs gradually breakdown and become stiffer as a result of which body reacts and develops bony growths (osteophytes) these osteophytes put pressure on the on the spinal nerve roots or spinal cord resulting in pain. CERVICAL SPONDYLOSIS-AYURVEDIC CONCEPT According to Ayurveda the Vata, the principle of movement is the predominant function with the skeleto-muscular system and the nervous system. Problems relating to these systems are predominantly caused by vitiated Vata. The vitiation of vata is caused by two mechanisms. One of them is obstruction to vata due to malfunctioning of kapha and pitta. The other one is increase of vata independently (the degenerative problems). The sacrum is situated in the Vata area of the body and this disease is caused by aggravated Vata and ama (toxins), which cause stiffness and reduce mobility in this area. Treatment involves detoxification and elimination of ama and also a Vata pacifying diet, lifestyle and herbal preparations. CAUSES 1.Basic cause of cervical spondylosis is age related wear and tear. 2.Most of the people show age related wear and tear in the age of thirty as evidenced by x-rays but symptoms does not appear until later ages of life. 3.Drying and loss of elasticity in the spinal and cervical disks 4.Bulging and sometimes herniation of disks so that disk material protrudes from between two vertebrae 5.Stiffening of the ligaments connecting neck bones and muscles Cervical spondylosis is caused by chronic degeneration of the cervical spine, the cushions between the neck vertebrae, and joints between the bones of the cervical spine. A previous neck injury can predispose to a person to cervical spondylosis. SYMPTOMS The signs and symptoms of cervical spondylosis are: A stiff, painful neck Shoulder, arm or chest pain Tingling and pinprick sensations in the arms, hands, legs or feet Numbness and weakness in the arms, hands, legs or feet Lack of coordination Difficulty walking Abnormal reflexes Loss of bladder or bowel control, or urinary or bowel retention INVESTIGATION AND DIAGNOSIS Your symptoms and history, along with an examination, may suggest that you have cervical spondylosis. You may also have imaging tests. The workup may include: Neck flexibility assessment. . Cervical spondylosis limits the range of motion in your neck. To observe this effect, your doctor may have you tilt your head toward each of your shoulders and rotate your neck from side to side. Neurological exam. To find out if there s pressure on your spinal nerves or spinal cord, your doctor will test your reflexes and make sure you have sensation all along your arms and legs. He or she may watch you walk to see if spinal compression is affecting your gait. Neck or spinal X-ray. An X-ray may show abnormalities, such as bone spurs, that indicate cervical spondylosis. Computerized tomography (CT) scan or magnetic resonance imaging (MRI). These tests may help your doctor determine the extent of damage to your cervical spine. Home Remedies For Cervical Spondylitis Use Cow s ghee in your food. It is a best natural Vata reliever and gives nourishment to the nerves and other body parts. 1 tablespoonful of Turmeric should be consumed once every day, after boiling it in milk for half an hour. It is a very useful herbal treatment for cervical spondylitis. Constipation must be avoided at all costs. Constipation may increase pain in Cervical Spondylitis. Herbs have divine healing powers and they have the ability to cure any disease from the root. They were gifted to us by God when he created life. So believe in God if you want to get rid of your problems! Ayurvedic herbs are unique natural remedies for Cervical Spondylitis. Ayurvedic principles are different in many ways from modern medicine for example - Drinking water from a copper pan after keeping it overnight is also very useful in Rheumatoid arthritis and Cervical Spondylitis. Consuming castor oil at night with milk or alone is a very useful herbal remedy for arthritis, especially rheumatoid arthritis and Cervical Spondylitis. Improve your nutrition as the first step.It plays an important role to fight diseases. When nothing works, nutrition works a lot! Use herbal juices like Aloe vera juice (Kumari Saar) and Amla Juice ( Amla Saar) in routine. Amla is the richest source of natural Vitamin C. Vitamin C improves the natural immunity of the body. 100 gm of Amla juice contains 30 times more vitamin C than 100 gm of oranges. DIET AND LIFESTYLE Diet Diet Sour things particularly curd, are strictly prohibited. Fried things, pulses and various preparations of pulses are also contra- indicated in this condition. Bitter vegetables like bitter variety of drumstick, neem flowers, and bitter gourd are very useful. Wheat is better than rice for the patient. Lifestyle Exposure to cold , cold bath and any violent exercise of the neck muscles, including pressure, are very bad for the patients. Under the impression that this pain is being caused by some defects in the muscles, people undertake different types of neck exercises. While reading and writing, one should maintain a comfortable posture. Morning walk gives some relief to the patient, but if it is cold outside the patient should always use a woollen scarf around his neck while going out of the house. USEFUL HERBS 1.Nirgundi 2.Shallaki 3.Guggul 4.Sonth 5.Giloy 6.Ashwagandha SELF CARE TIPS For mild neck pain or stiffness: Take a long, hot shower every day Wear a cervical collar (which you can buy in a drugstore) during the day
1 person found this helpful

Non-surgical Treatment for Cervical Spondylosis - Tips!

Dr. Neeraj Jain 83% (10 ratings)
MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Non-surgical Treatment for Cervical Spondylosis - Tips!
Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows- Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots. Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include: Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits Opiates, for example, hydrocodone, for pain relief Epileptic medications, for example, gabapentin, to ease pain created by nerve damage Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it: Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve. Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles. Exercise routinely to help you recover quickly. Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief. Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain. Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs). Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles. Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age. ONCE THE CONSERVATIVE TREATMENT FAILS: Early aggressive treatment plan of back & leg pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total LBP patients would need surgery & approx 20% of discal rupture or herniation with Neurologically impending damage like cauda equina syndrome would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then. Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon patient`s pathology & response to treatment. Using precision diagnostic & therapeutic blocks in chronic LBP , isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5-S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed. NEED FOR NON-SURGICAL OPTIONS: Outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. In case of surgery, the chance of recurrence of pain is nearly 15%. In FBSS or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are: Dural fibrosis Arachnoidal adhesions Muscles and fascial fibrosis Mechanical instability resulting from the partial removal of bony & ligamentous structures required for surgical exposure & decompression Presence of Neuropathy. Multifactorial aetiologies of back & leg pain, some left unaddressed surgically. EPIDURAL ADENOLYSIS OR PERCUTANEOUS DECOMPRESSIVE NEUROPLASTY is done for epidural fibrosis or adhesions in failed back surgery syndromes (FBSS). A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with EPIDUROSCOPE Sciatica gets complicated by PIVD with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe & effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location & type of PIVD causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or LA was injected. A flexible guide wire is passed at selected location & direction on which the inflatable balloon is threaded to the area of interest. Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time & location. We inflated the balloon with contrast agent to have visualization of adhesiolysis & opening up of adhesions or root route. Here the balloon pressure & time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure & patient`s response. Once dilatation is done the drug mixture of steroid with LA & or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our Balloon Neuroplasty & foraminoplasty as it is safe & targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via S1 foramen. Now we are employing this technique for fresh cases coupling with Intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The IDD is done by Coblation/ Laser/ DeKompressor or RF Biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding Balloon Neuroplasty to the armamentarium of the interventional pain management many patients can be benefited & relieved of previously interventionally unmanageable disco-radicular pain including FBSS sufferers. INTRADISCAL PROCEDURES: PROVOCATIVE DISCOGRAPHY: coupled with CT A diagnostic procedure & prognostic indicator for surgical outcome is necessary in the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines. PERCUTANEOUS DISC DECOMPRESSION (PDD): After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed. OZONE-CHEMONEUCLEOPLASTY: Ozone Discectomy a least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at 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. If despite the ozone therapy the symptoms persist, Percutaneous intradiscal decompression can be done via Transforaminal route with Drill Discectomy/ Laser or Coblation Nucleoplasty/ Biacuplasty/ Disc-FX / Endoscopic Discectomy are good alternatives before opting for open surgerical Discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In Biacuplasty radiofrequency energy is used in bipolar manner heating & shrinking the disc & making it harder as well for weight bearing. It also seals the annular defect & ablates annular nerves relieving back pain. In Laser or Coblation Nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises. DEKOMPRESSOR: A mechanical percutaneous nucleotome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression. A mechanical device cuts & drills out the disc material debulking the disc reducing nerve compression curing Sciatica & Brachialgia. It comes in needle size of 17G for lumbar discs & 19 G for cervical discs. In lumbar region postero-lateral approach is used & in cervical discs anterolateral approach is used. DISC-FX & ENDOSCOPIC DISCECTOMY: In this novel technique A wide bore needle is inserted & placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful & sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent & decrease recurrences. Next Higher procedure, Endoscopic Discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion & extrusions causing spinal canal stenosis with root or cord compression with leg pain. LASER DISCECTOMY done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers. SELD: Epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This Procedure is done under vision via an epiduroscope inserted via Caudal canal or Transforaminally employing front or side firing Laser fibers &/or fine instruments.
3719 people found this helpful

Cervical Spondylosis (Arthritis of the Neck) - Know Its Treatment!!

Dr. Navneet Sahay 88% (50 ratings)
BPTh/BPT, MPT - Orthopedic Physiotherapy
Physiotherapist, Gurgaon
Cervical Spondylosis (Arthritis of the Neck) - Know Its Treatment!!
Cervical spondylosis is fast becoming the bane of modern life. An age-related wear and tear problem affecting the spinal discs in your neck, cervical spondylosis is increasingly affecting the young because of the use of cell phones, laptops and the like. Cervical spondylosis is a general term used to define shrinkage of discs in between vertebrae in the neck region. Along with disc degeneration, bony projections also form in the area and are called bone spurs. Other causes of cervical spondylosis are dehydrated discs. Discs are thick, pad-like cushions in between vertebrae that act as shock absorbers. They are made of a gel- like material that can dry over time. This causes the spinal vertebrae to rub together causing pain. The discs also crack which allows the internal gel-like material to spill out and impinge on spinal nerves causing symptoms. There is a narrowing of the space required by the spinal cord and nerves that emanate in the upper spine to go to various parts of the body. Pinching of these nerves can cause alarming symptoms like: Numbness and weakness in your arms, hands, legs and feet Lack of coordination and difficulty in walking Loss of bladder or bowel movement Stiffness and pain in neck Treatment and management Usually, cervical spondylosis doesn t cause any symptoms. But when you start experiencing pain, stiffness and weakness of muscles, it s best to go to a doctor who will diagnose the problem and then treat it. Treatment for cervical spondylosis depends on the severity of your symptoms. Its goal is to get rid of pain, allow you to carry on your daily activities and prevent any permanent damage to your spinal cord and nerves. Medicines Anti-inflammatory drugs are prescribed to reduce pain and inflammation. Example Ibuprofen. Corticosteroids are oral medications to get rid of the severe pain. If these don t work, your doctor can suggest steroid injections. Muscle relaxants medicines relax the muscles in the upper part of the spine and help in curing neck pain and stiffness Anti-seizure medications are also prescribed to dull the pain of damaged nerves in the spine. These include epilepsy medications, such as gabapentin and pregabalin. Physiotherapy Non surgical treatments are usually very effective in treating cervical spondylosis and surgery is usually not required. Physiotherapy is a bulwark for patients as it helps manage the condition very well. Neck exercises that help stretch and strengthen muscles in your neck and shoulders can help manage debilitating symptoms of cervical spondylosis. Few patients also benefit from traction, which can help provide more space for nerve roots within the spine. Surgery Surgery is the last resort for treating cervical spondylosis. It is suggested when non-surgical treatments fail and the pain and neurological signs such as weakness in your arms or legs get worse. It is done to create more room for your spinal cord and nerve roots. Cervical spondylosis surgery typically involves removing: Herniated disk Bone spurs Part of a vertebra
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Popular Questions & Answers

I am having lumbar & cervical spondylosis. Under what situation it is advised to go for operation?

Dr. Dnyaneshwar Mitke 92% (965 ratings)
BAMS, MD, Panchakrma
Ayurveda, Nashik
Backache /pain has several reasons like muscle spasm, spine issue, injury etc. Condition may get worst if it keep untreated. Ayurveda is one of most popular treatment for joint pain & backache. The selection of remedy is based upon the theory of individualization and symptoms similarity. Ayurvedic treatment not only gives complete relief from pain it also improves bone strength as well calcium absorption which is essential for all 206 bones & joint . You can easily take an online consultation for further treatment guidance and permanent cure without any side effects. in 90 % cases operation does not required ,if u take proper ayurvedic medicines & spine wellness therapy .

I am having lumbar & cervical spondylosis L4_L5 & C5_C6 disk budge. Gabapentin 100 mg, rivotril .5 mg, Neurobiology forte are prescribed by doctor. When we can go for lumbar operation?

Dr. Vishwas Virmani 91% (15609 ratings)
MPT, BPT
Physiotherapist, Noida
• Apply Hot Fomentation twice daily • . Avoid bending in front. • Postural Correction- Sit Tall, Walk Tall. • Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. • Bhujang Asana -- Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. • Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.

I am 37 years old. I have cervical spondylosis since 3 and half month I have pain in neck and right side of hand, shoulder,leg. I have weakness in my right side body. I have little deformity in my right hand and leg since 2 month and weight gain. I’m feeling like my right side abdomen is bending. What should I do.

Dr. (Mrs.) Saroj Das 88% (5551 ratings)
D.A.M.S( A. M.), D.AC/B.E.M.S
Acupressurist, Mumbai
You should take acupressure treatment and take biochemic Nat Mur 200x + kali phos 200x 4 tab each thrice a day with warm water and take it 5 days and inform me private online.
1 person found this helpful

My father mri report says that Cervical spondylosis with disc bulge at c3 / 4 causing left nerve root compression & disc bulge with central protrusion at c4/5 causing compressive myelopathy changes as described So if there is any other way without surgery can it be treated in any branch.

Dr. Julie Mercy J David Raja 92% (2305 ratings)
Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
You have to go for Intermittent Cervical Traction and also you can do Interferential Therapy. Please consult the near by therapist for quick relief. Since you have pain for more than 10 years it is suggestible to go for cervical muscle strengthening exercises and also to use cervical collar to improve the contour of your muscle texture and to improve the cervical angle so that the posture is improved and it also gives you comfort and relieves the pain.

Hi, I am suffering Frozen shoulder, cervical spondylosis, thoracic shoulder blade and lower back l5-s1 and sacroiliac problem. Numbness, pinching, radiating pain weakness in neck shoulders hands elbow to fingers. Lower back to hip to toes radiating pain numbness, some times vertigo feeling. Stiff neck. What are the tests to be done and x-ray to be taken. Medicines and treatment to taken. Exercise r physiotherapy to be taken. I eat lots of spicy food, no proper time maintaining. Sometime skip food, eat heavy food at night. No exercise, late night sleeping getting late in the morning. Daily going outside on bike for long distances to n rough roads. Some times pinching pain left r right side abdomen. And left testicles. Standing/sitting some times for long hours, looking up/down continuously for some time due to job requirements. Please guide what to change myself, what tests and treatment to be taken and which doctor to consult orthopedic r neurologist r ayurvedic massage to be taken. In the meantime kindly suggest some medicine and exercise to be taken. Up to now no medicines r treatment taken. When taking rest and having proper food pain and other problems are vanishing. Now only neck and thoracic pain is there due to poor posture sleeping r sitting and due to poor mattress. Some times I forget completely pain as it goes off and comes back all of the sudden.

Dr. Vishwas Virmani 91% (15609 ratings)
MPT, BPT
Physiotherapist, Noida
Hot Fomentation. Gentle Shoulder Stretching. Core Strengthening Exercises. Gentle Neck Exercises. Avoid sleeping on affected side.. Warm up and cool down is a must.

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