I am Dr Siddharth Verma and welcome to this educational video. The topic of this educational video is, how to avoid a spine surgery. So you have been suffering from some kind of back pain or you have got some injury or maybe you have a mixture of both maybe you didn't have anything but you still are undergoing a spine surgery or you are posted or your thinking or somebody has advised you for a spine surgery and you have seen your friends or relatives suffer because of this spine surgery or maybe the surgery was not successful and you are very afraid now what to do. So don't worry, we are here to help you and an interventional pain physician or spine and pain specialist can definitely help you in this case. And what you need to do is just go to him and tell him that what disease you are suffering from and he will help you. Now, what is the logical approach in how to avoid a back surgery as the title of the video says, first of all, prevention is better than cure so you must stay fit and stay lumber, by saying lumber I mean your back should be flexible. Most of the back injuries, strains, sprains they occur because the person is not very flexible and if you are not very flexible and you have to do even a trivial work like maybe getting a file from a cabinet, lifting a 10 kg load, maybe some gunny bag or small bucket full of vegetables or something like that. This trivial work can lead to a strain, repetitive strain can lead to various issues with your back which can be as trivial as a myofascial syndrome, in which your muscles are affected or as severe as a disc herniation. So in my other video, you can see how I have described various pain generators in the back which you will find on this website or you can visit my website www.pain.org.in ok. But for this video, we will concentrate on how to avoid this. So the first step is prevention, if you can prevent by staying fit, by controlling your weight, by physical activity, by following the correct technique of lifting weights then, of course, this is the first step. Now supposing that you are suffering from a backache, now the second step is early treatment, so if you know that you have been suffering from a backache. I'm not talking about a backache which happens once in a while, but if the back pain is persisting one week has passed 2 weeks have passed and you still having back pain, then don't ignore, then don't think that this will pass or I will get better by the day let us do some work and something like that. Immediately go and seek treatment you visit a spine and pain specialist and talk to him about your problem and I am sure he will be able to sort it out. Now the next step supposing you didn't pay heed to what your doctor said you continue to gain, weight you continue to be lumber, the non-flexible and still you had this kind of pain, of course, you will have this kind of pain and now the problem has increased and magnified and you go to a surgeon one fine day and he suggest an MRI and there is a big bulging disc and it is compressing on your nerves and now your doctor says you need a surgery. So can you avoid the surgery, in many cases, yes you can and in many cases, you cannot? So when you can and when you cannot, it depends on the opinion of your treating surgeon and your spine and pain specialist. So in the cases where your spine is unstable means, there is a bony instability, then definitely you need to have affixation done or in some way, the bony instability needs to be fixed. By bony instability, I mean that your small bone which makes up the spine is not in a straight line. There is some movement which is happening while you flex or extend your back, ok. So if this is not there then in most cases you can avoid an open surgery and how it can be done, it can be done with as trivial a procedure and as transforaminal neuroplasty procedure. Where you just need to come, lie down on your back under an x-ray, the spine and pain specialist will simply give you a drug which will reach your nerve and cause subsiding of the inflammation which is there due to the compression and your pain will be relieved. Number 2 nowadays we have a very nice procedure which is known as endoscopic foraminoscopy or foraminoplasty or endoscopic discectomy. This is a very noble procedure which is done by the spine and pain specialist and in this procedure, what we actually do is we just give a small neck of the size of maybe smaller than a centimetre also. Then we reached this foramen from where this nerve comes out and we actually put in a camera through this small hollow tube, which is of the size of this pen, which is very hollow. The patient stays awake is under local anaesthesia doesn't feel any pain till the point, this hollow canal touches his nerves on his sensitive nerve fibre, he says feels a slide pain and then we put our camera inside the foramen and we see the nerves, we see the disc and we take this material which is compressing on these nerves, we clean it, we wash it. We see very small tissue, this small tissue we see under a big T.V. ok. So we can very accurately take out the tissues which are causing this compression and help you get relief from your pain. So need not go for any open surgery in these cases because in these cases we can help you by avoiding the surgery and going in for this percutaneous procedure which is way less invasive than a surgery. The main difference is being that you don't get any general anaesthesia, you can walk on the same day of the procedure, you can go to the washroom come back stay in a hospital for a couple of days, get a discharge and you can resume your active life then maybe 4, 5 days or so you will be given some precautions but more or less, your mobile, you don't have any loss of work hours and you can be very productive. This is one of the very latest techniques which are the practice nowadays, by the spine and pain specialist. Now another reason why people come to us is not to avoid the first surgery but how to avoid this second surgery because many of the patients have already undergone under 1 surgery and this still have this kind of pain which is left and the treating doctor has suggested them another surgery. Now they don't want to undergo a second surgery, in those cases, many of them provide there is no instability of these bony spines. We can help them by these procedures there is variety of other procedure for more details you can always visit my website and this can be avoided. If you want to know more on how you can avoid your spine surgery or back surgery, then please do visit my website on www.pain.org.in or visit my clinic website on painreliefcentr.in or you can also visit me on my Lybrate website which is www.lybrate.com/doctor/siddharthverma.
Thank you for watching, have a good day.