Why Endovascular NeuroSurgery at Best Hospital in India

Conditionsin which Endovascular Neurosurgery is performed

Cerebral or Spinal Angiography
DSA (Digital Subtraction Angiography) is considered as the 'gold standard' investigation to diagnose diseases of blood vessels and is performed when a vascular disease is suspected.

Intracranial Aneurysms
Aneurysms are focal swelling of blood vessels, which can burst and cause bleeding in the brain. Endovascular coiling can treat these aneurysms, thus avoiding open surgery. Studies have shown that coiling treatment leads to better outcomes as compared to open surgical clipping.

Angioplasty or Stent Placement
This procedure is done to treat stenosis in arteries of brain (including carotid, vertebral, intracranial arteries). Many cases of stroke occur due to stenosis in arteries leading to brain. They can be treated non-invasively by endovascular route with an angioplasty or stenting procedure. Many of these procedures are performed under local anesthesia with reduced morbidity.

Stroke or Brain attack, including Intra-ArterialThrombolysis
Acute stroke or brain attack usually occurs due to blockage of arteries of the brain. Appropriate patients can be treated by placing a micro-catheter at the site of blockage followed by administration of thrombolytic drugs, which dissolve the blocking material. Mechanical clot removal can be done in patients even who come many after the stroke.

Arteriovenous Malformation
Arteriovenous Malformation (AVMs) of brain are malformed swollen blood vessels, which can cause bleeding in brain, seizures and headache. AVMs can be treated by injecting "glue" or "onyx" through a microcatheter placed precisely into these abnormal blood vessels.

Tumour Embolisation
One of the major problems in surgical removal of intracranial tumour is bleeding during the surgery. Interventional Neuroradiologist can help the surgeon by preoperative endovascular occlusion of the blood vessels supplying the tumour. This will reduce the bleeding and facilitate the surgery.

Vertebroplasty and Kyphoplasty
With age, bones become weak and collapse of bones (vertebrae) in the spine is one of the major causes of severe back pain in the elderly. Vertebroplasty is a revolutionary treatment in which "bone cement" is injected through a needle placed into the broken bone so as to stabilize the vertebra and to reduce the pain.

Percutaneous Sclerotherapy
Many superficial vascular malformations such as Haemangioma (malformation of the blood vessels) or Lymphangiomas (malformation of lymphs) can be treated by puncturing through a needle, followed by injection of 'Sclerosant Material' which causes obliteration of the malformation.

Advantages of Endovascular Neurosurgery/ Interventional Neuroradiology

1) The endovascular approach ensures minimal injury to normal brain.

2) It has fewer complications, better outcome and ensures shorter hospital stay.

3) Enables treatment of diseases, which could be treated in the past.

4) Acute stroke patients can be treated even many hours after the stroke.

Why Endovascular NeuroSurgery at World Best Hospital in India

• Use of Bi-plane technology - visualization in 2 planes simultaneously and 3D imaging of blood vessels
• Advanced Dyna CT capability enhances the ability of Endovascular surgeon to perform most accurately in delicate vascular areas like brain
• Minimal incision similar to cardiac treatment, such as angioplasty or stent placement
• Very thin catheters or wires placed through groin are navigated in to the blood vessels of the brain
• Diagnostic (Cerebral or Spinal Angiography) or Therapeutic procedures for Intracranial Aneurysms, Arterial Stenosis, Stroke (Brain attack), Arteriovenous Malformations, Vertebroplasty and Percutaneous Sclerotherapy
• Tumour Embolisation is done to reduce bleeding during surgery

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Kyphoplasty at Best Spine Surgery Hospitals in India

If you have been diagnosed with a spinal fracture caused by osteoporosis, cancer or benign tumors, balloon kyphoplasty is a treatment option you may want to consider. Balloon kyphoplasty is a minimally invasive procedure that can significantly reduce back pain and repair the broken bone of a spinal fracture. The procedure is called balloon kyphoplasty because orthopaedic balloons are used to lift the fractured bone and return it to the correct position. Before the procedure, you will have a medical exam and undergo diagnostic studies such as X-rays, to determine the precise location of the fracture. 

Balloon kyphoplasty can be done under local or general anesthesia—your physician will decide which option is appropriate for you. Balloon kyphoplasty takes about one hour per fracture treated. It can be done on an inpatient or outpatient basis, depending on medical necessity. After the procedure, you will likely be transferred to the Recovery Room for about an hour for observation. The aim of Kyphoplasty is to reduce the pain of fractured vertebra, to reinforce the weakened bone and to restore normal vertebral height.

When is Kyphoplasty recommended ?

Kyphoplasty is done on patients who experience painful symptoms or spinal deformities due to vertebral compression fractures resulting from osteoporosis. Kyphoplasty is also performed on patients who:

• Are aged or are in poor health to tolerate open spinal surgery.
• Have too frail bones for surgical spinal repair
• Have a vertebral damage due to a cancerous tumor
• Are younger and have osteoporosis caused by a long-term steroid management or a metabolic disorder

Limitations in the traditional treatments of vertebral compression fractures have led to the refinement of such procedures as kyphoplasty. This procedure provide new options for compression fractures and are designed to relieve pain, reduce and stabilize fractures, reduce spinal deformity, and stop the "downward spiral" of untreated osteoporosis.

Additional benefits of kyphoplasty include  :

• Short surgical time
• Only general or local anesthesia required
• Average hospital stay is one day (or less)
• Patients can quickly return to the normal activities of daily living
• No bracing required

Kyphoplasty utilize a cement-like material that is injected directly into the fractured bone. This stabilizes the fracture and provides immediate pain relief, in many cases. Kyphoplasty has the additional advantage of being able to restore height to the spine, thus reducing deformity. After either procedure, most patients quickly return to their normal daily activities.

Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our world best hospitals in India. Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.

Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest technology and infrastructure to offer the most advanced spine surgery at low cost.

Salient features of these hospitals are:

• Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.
• Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Expert evaluation of spinal problems by dedicated team of experienced spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
• Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
• Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.

All about Back Pain Surgery - Spine Treatment in India

Spine surgery is traditionally done as "open surgery," meaning the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.Because minimally invasive spine surgery (MISS), does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.

For herniated discs:

Laminectomy/discectomy: In this operation, part of the lamina, a portion of the bone on the back of the vertebrae, is removed, as well as a portion of a ligament. The herniated disc is then removed through the incision, which may extend two or more inches.

Microdiscectomy: As with traditional discectomy, this procedure involves removing a herniated disc or damaged portion of a disc through an incision in the back. The difference is that the incision is much smaller and the doctor uses a magnifying microscope or lenses to locate the disc through the incision. The smaller incision may reduce pain and the disruption of tissues, and it reduces the size of the surgical scar. It appears to take about the same time to recuperate from a microdiscectomy as from a traditional discectomy.

Laser surgery: Technological advances in recent decades have led to the use of lasers for operating on patients with herniated discs accompanied by lower back and leg pain. During this procedure, the surgeon inserts a needle in the disc that delivers a few bursts of laser energy to vaporize the tissue in the disc. This reduces its size and relieves pressure on the nerves. Although many patients return to daily activities within 3 to 5 days after laser surgery, pain relief may not be apparent until several weeks or even months after the surgery. The usefulness of laser discectomy is still being debated.

For spinal stenosis:

Laminectomy: When narrowing of the spine compresses the nerve roots, causing pain and/or affecting sensation, doctors sometimes open up the spinal column with a procedure called a laminectomy. In a laminectomy, the doctor makes a large incision down the affected area of the spine and removes the lamina and any bone spurs, which are overgrowths of bone that may have formed in the spinal canal as the result of osteoarthritis. The procedure is major surgery that requires a short hospital stay and physical therapy afterwards to help regain strength and mobility.

For spondylolisthesis:

Spinal fusion: When a slipped vertebra leads to the enlargement of adjacent facet joints, surgical treatment generally involves both laminectomy (as described above) and spinal fusion. In spinal fusion, two or more vertebrae are joined together using bone grafts, screws, and rods to stop slippage of the affected vertebrae. Bone used for grafting comes from another area of the body, usually the hip or pelvis. In some cases, donor bone is used.

Although the surgery is generally successful, either type of graft has its drawbacks. Using your own bone means surgery at a second site on your body. With donor bone, there is a slight risk of disease transmission or rejection. In recent years, a new development has eliminated those risks for some people undergoing spinal fusion: proteins called bone morphogenic proteins are being used to stimulate bone generation, eliminating the need for grafts. The proteins are placed in the affected area of the spine, often in collagen putty or sponges.

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Unmatched Benefits of Minimally Invasive Spine Surgery

The trend in spine surgery has moved toward minimally invasive procedures.  Minimally invasive spine surgery (MIS) involves surgical treatment of the spine through small incisions with minimal disruption of the surrounding muscle tissue.  The benefits of minimally invasive spine surgery include decreased pain, shorter hospital stays, and quicker recovery.

Open Surgery and Minimally InvasiveSurgery

Surgical procedures of the spine are often referred to as an “open” procedure or minimally invasive.  An open procedure involves making a skin incision and retracting (moving aside) any tissues overlying the anatomy that is to be worked on so that the surgeon can directly view the desired anatomy. The surgeon will view the anatomy either with the naked eye, magnifying telescopic eyeglasses called loupes, or a magnifying microscope. Traditionally, open procedures have required larger incisions and more muscle tissue distraction than minimally invasive surgery. 

Minimally invasive surgical techniques utilize specialized retractors which allow a surgical procedure to be done through smaller incisions with much less tissue disruption. One of these specialized retractors is called a tubular retractor, which is a series of gradually expanding tubes that gently and progressively dilate and separate muscles and soft tissues to expose the operative field.  Using specialized instruments, surgery is performed through the tube.

Laser Spine Surgery

 Lasers are one of many specialized tools that can be used during minimally invasive spine surgery.  There is a common misconception that if a laser is used during surgery, no incisions need to be made.  Unfortunately, this is not the case.  A laser is like any other surgical tool.  In order for it to be used, it has to be placed into the appropriate area of the body through an inicision.

A second misconception is that lasers can be used to remove arthritis.  Spinal arthritis is a condition in which the facet joints degenerate and become inflamed.  Unfortunately, there is no cure for arthritis and it cannot be "lasered away".

 Finally, many people think that laser surgery is always better than surgery without a laser.  Although the laser is helpful for certain procedures, not all spinal conditions can be safely or appropriately treated with a laser, and using a laser does not always provide advantages over other techniques.

Endoscopic ("Arthroscopic") Spine Surgery

 An endoscope is a very thin fiber-optic video camera which can be used to visualize internal portions of the body.  The endoscope is made with built-in magnification and a light source, and the camera sends the images to a video screen similar to a television.

Transforaminal endoscopic discectomy is a technique that is being performed by some fo the surgeons at Resurgens Spine Center to treat herniated discs in the lumbar spine.  Transforaminal literally means "through the foramen".  The foramen is the "window" or "tunnel" through which the nerve exits from the spinal canal at each disc level.  The foramen are located on the sides of the spinal canal, and provide a natural window through which the spinal canal can be accessed without having to remove any bone or ligament tissue.

           

Summary

Minimally invasive surgery is emerging as an alternative, reliable method of treatmetn for a variety of spinal disorders.  Like "building a ship in a bottle", there is a steep learning curve for surgeons learning to do these procedures.  Although the recovery is often faster, the complication rate during surgery can be greater and the results not as predictable when the surgery is performed by surgeons who have not become totally skilled in these newer techniques.  Minimally invasive surgery is certainly "the wave of the future" for many spinal procedures and will continue to develop as new techniques continue to evolve.  Not every patient, however, is a candidate for minimally invasive spinal surgery

MinimallyInvasive Spine Procedures in India 

There is a rapid increase in technology that allows the MIS physician to treat patients with minimally invasive spine surgery procedures. Some of these techniques are now well established, while others remain new and continue to evolve. The best MIS (Minimally Invasive Spine Surgery) technique will depend on the specific character of the problem. While the list of MIS (Minimally Invasive Spine Surgery) techniques continues to expand, the most commonly employed today include:

• Minimally Invasive Tubular Microdiscetomy
• Minimally Invasive Lumbar Laminectomy
• Cervical laminoforaminotomy
• Endoscopic Discectomy
• Minimally Invasive Transforaminal Interbody Lumbar Fusion (TILF)
• Minimally Invasive Transforaminal Interbody Lumbar Fusion (TILF)
• Minimally Invasive eXtreme Lateral Interbody Fusion (XLIF)
• Minimally Invasive eXtreme Lateral Interbody Fusion (XLIF)
• Microsurgical Discectomy
• Posterior Lumbar Interbody Fusion (PLIF)
• Kyphoplasty
• Nucleoplasty or Percutaneous Discectomy

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