Herniated Disk - Spinal Disk Problems Treatment in India

What Are Spinal Disk Problems?

Only a person who has experienced a damaged spinal disk understands the agony and helplessness it brings. The pain can be excruciating. Every movement seems to make it worse.

This pain is a warning signal that you should heed. If you take appropriate action, the discomfort usually stops, and the problem can be corrected.

Spinal disks are rubbery pads between the vertebrae, the specialized bones that make up the spinal column. Doctors call them intervertebral disks. Each disk is a flat, circular capsule about an inch in diameter and one-quarter inch thick. They have a tough, fibrous, outer membrane (the annulus fibrosus), and an elastic core (the nucleus pulposus).

The disks are firmly embedded between the vertebrae and are held in place by the ligaments connecting the spinal bones and the surrounding sheaths of muscle. There is really little, if any, room for disks to slip or move. The points on which the vertebrae turn and move are called facet joints, which stick out like arched wings on either side of the rear part of the vertebrae. These facet joints are separate from the discs and keep the vertebrae from bending or twisting excessively, which could damage the spinal cord and the vital network of nerves that runs through the center of the spinal canal formed by the stack of vertebra.

The disk is sometimes described as a shock absorber for the spine, which makes it sound more flexible or pliable than it really is. While the disks do separate the vertebrae and keep them from rubbing together, they are far from spring-like. In children, they are gel- or fluid-filled sacs, but they begin to solidify as part of the normal aging process. By early adulthood, the blood supply to the disk has stopped, the soft inner material has begun to harden, and the disk is less elastic. By middle age, the disks are tough and quite unyielding, with the consistency of a piece of hard rubber. These changes related to aging make the outer protect

Understanding Spinal Disk Problems --Herniated Disk

Under stress, a disk's inner material may swell, pushing through its tough outer membrane. The entire disk can  become distorted or bulge in spots. With an injury, all or part of the core material may protrude through the outer casing at a weak spot, pressing against surrounding nerves. If further activity or injury causes the membrane to rupture or tear, the disk material may further extrude, causing pressure on the spinal cord or the nerves that radiate from it. This may result in extreme pain. In the beginning, there may be spasms in the back or neck which will greatly limit your movement. If nerves are affected, you may develop pain that moves into a leg or an arm.

Disk herniation is most often the result of a gradual, aging-related wear and tear called disk degeneration. As you age, your spinal disks lose some of their water content. That makes them less flexible and more prone to tearing or rupturing with even a minor strain or twist.

Most people can't pinpoint the exact cause of their herniated disk. Sometimes, using your back muscles instead of your leg and thigh muscles to lift large, heavy objects can lead to a herniated disk, as can twisting and turning while lifting. Rarely, a traumatic event such as a fall or a blow to the back can cause a herniated disk.

Minimally Invasive Spine Laminotomy Surgery in India 

The laminotomy procedure is a minimally invasive endoscopic surgery carried out on an out patient basis.Laminotomy is a surgical procedure that helps to decompress the spinal cord or the spinal nerves that emerge from the vertebral column. It is done with aim of removing any structure that narrows the spinal canal and free the entrapped nerves.

In this procedure a small incision is made in the lamina as opposed to laminectomy where the entire lamina is removed. As a result laminotomy procedure decompresses the spinal cord without compromising with the spinal stability.

When is  Laminectomy recommended ?

Laminectomy is recommended when one or more of the following symptoms and disorders that affect the lower back are seen in the body:

• ·         Ankylosing spondylitis
• ·         Degenerative disc disease
• ·         Herniated disc
• ·         Sciatica
• ·         Spinal stenosis
• ·         Spondylosis (also known as spinal osteoarthritis)

How does the procedure work?

Laminectomy is performed under general anesthesia, in this the patient is usually positioned lying on the side or stomach. Then a small straight incision is made over the damaged vertebra. And then a retractor is used to spread apart the muscles and the fatty tissues covering the spine. When the laminae have been reached, the bony arch is cut in order to get to the ligamentum flavum (which is a band of yellow tissue attached to the vertebra that helps to support the spinal column). Thereby an opening is made in the ligamentum flavum to reach the spinal canal and then to the compressed nerve. At this point the cause of compression will be visible (that may be a herniated disk, tumour, fragmented disk etc) which is then rectified. This Surgery is completed in one to three hours.

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Spinal Cord Injury Treatment in India - Understanding Spinal Cord Injury

Your spinal cord is a bundle of nerves that runs down the middle of your back. It carries signals back and forth between your body and your brain. A spinal cord injury disrupts the signals. Spinal cord injuries usually begin with a blow that fractures or dislocates your vertebrae, the bone disks that make up your spine. Most injuries don't cut through your spinal cord. Instead, they cause damage when pieces of vertebrae tear into cord tissue or press down on the nerve parts that carry signals.

Spinal cord injuries can be complete or incomplete. With a complete spinal cord injury, the cord can't send signals below the level of the injury. As a result, you are paralyzed below the injury. With an incomplete injury, you have some movement and sensation below the injury.

A spinal cord injury is a medical emergency. Immediate treatment can reduce long-term effects. Treatments may include medicines, braces or traction to stabilize the spine, and surgery. Later treatment usually includes medicines and rehabilitation therapy. Mobility aids and assistive devices may help you to get around and do some daily tasks.

Each patient's injury is unique. Some patients require surgery to stabilise the spine, correct a gross misalignment, or to remove tissue causing cord or nerve compression. Spinal stabilisation often helps to prevent further damage.  Some patients may be placed in traction and the spine allowed to heal naturally.  Every injury is unique as is the course of post injury treatment that follows.

Spinal Cord Shock

When a spinal cord injury is caused due to trauma, the body goes into a state known as spinal shock. While spinal shock begins within a few minutes of the injury, it make take several hours before the full effects occur. During spinal shock the nervous system is unable to transmit signals, some of which may return once spinal shock has subsided, the time spinal shock lasts for is approximately 4-6 weeks following the injury. In some rare cases spinal cord shock can last for several more months.  The loss of these signals will effect the persons movement, sensation and how well the body’s systems function. Often the persons loss of movement and sensation below the level of the spinal cord injury may appear complete soon after the injury. This may mask the real extent of the damage. Usually, over the first few weeks the some of body systems adjust to the effects of the injury and their function improves. Therefore, during this time and the early stage of ANY new injury it is unlikely that an accurate prediction of any recovery or permanent paralysis can be made.


Surgery

Depending on the circumstances, when surgery is required, it may be performed within 8 hours following injury. Surgery may be considered if the spinal cord is compressed and when the spine requires stabilization. The surgeon decides the procedure that will provide the greatest benefit for the patient.

Different tissue and bony structures including vertebrae misaligned from the force of injury, a herniated disc, or a haematoma can cause spinal cord compression. An unstable spine may require spinal instrumentation and fusion to build in support.

Spinal instrumentation and fusion can be used to provide permanent stability to the spinal column. These procedures correct, join, and solidify the level where a spinal element has been damaged or removed .

Instrumentation uses medically designed hardware such as rods, bars, wires and screws. Instrumentation is combined with fusion (bone grafts) to permanently join two or more vertebrae.

Healing Broken Bones Without Surgery

Surgery isn't the only way to repair broken bones in the neck and back a more conservative and less invasive approach is to allow the bones to heal naturally with the help of halo traction where needed.  This approach may mean up to two months complete bed rest.
 

Recovery

Once the patient is stabilised, care and treatment focuses on supportive care and rehabilitation. Family members, nurses, or specially trained carers give supportive care. This care might include helping the patient bathe, dress, change positions to prevent bedsores, and other assistance.

Rehabilitation often includes physical therapy, occupational therapy, and counselling for emotional support. Each program is designed to meet the patient's unique needs. 

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Spine Tumor and Spinal Surgery Specialists in India

What arespinal cord tumors?

A tumor forms when an abnormal cell proliferates to form a mass of abnormal cells. Spinal cord tumors are tumors that form on the spinal cord or in the area around it.

A spinal cord tumor may be cancerous (malignant) or noncancerous (benign). Even if benign, a tumor may cause symptoms including pain, weakness, numbness or tingling because it pushes on the spinal cord or nerves.

A spinal cord tumor may be called “primary,” which means the cancer started in the spinal cord, or “secondary,” which means the cancer started somewhere else in body and spread to the spinal cord. Most of the time, spinal cord tumors are secondary tumors. A spinal cord tumor is often a cancer of the breast, thyroid, lung, prostate, or another cancer that has extended throughout the body to reach the spine.

Spinal cord tumors are sometimes caused by a genetic disorder, like neurofibromatosis. Some people get spinal cord tumors because they were exposed to toxic chemicals that can cause cancer or have been exposed to radiation.

Types of spinaltumors

Spinal tumors are classified according to their location in the spine.

·         Extradural (vertebral) tumors. Most tumors that affect the vertebrae have spread (metastasized) to the spine from another site in the body — often the prostate, breast, lung or kidney. Although the original (primary) cancer is usually diagnosed before back problems develop, back pain may be the first symptom of disease in people with metastatic spinal tumors.

Cancerous tumors that begin in the bones of the spine are far less common. Among these are osteosarcomas (osteogenic sarcomas) and Ewing's sarcoma, a particularly aggressive tumor that affects young adults. Multiple myeloma is a cancerous disease of the bone marrow — the spongy inner part of the bone that makes blood cells. Noncancerous tumors, such as osteoid osteomas, osteoblastomas and hemangiomas, also can develop in the bones of the spine.

·         Intradural-extramedullary tumors. These tumors develop in the spinal cord's arachnoid membrane (meningiomas) and in the nerve roots that extend out from the spinal cord (schwannomas and neurofibromas). These tumors may be cancerous or noncancerous.

·         Intramedullary tumors. These tumors begin in the supporting cells within the spinal cord. Most are either astrocytomas or ependymomas. Intramedullary tumors can be either noncancerous or cancerous. In rare cases, tumors from other parts of the body can metastasize to the spinal cord itself.

Advanced Surgical Techniques for spinal tumors

If you have a metastatic spine tumor (a tumor in the spine that began elsewhere in your body), some surgical procedures can help stabilize your spine, reduce pain, prevent paralysis, and increase mobility. These procedures are not curative, but can provide local control of the cancer while allowing you to return to other treatments such as chemotherapy or radiation therapy. Commonly used palliative surgical techniques include spinal cord decompression and spinal instrumentation.

Spinal Cord Decompression

This technique, also called posterolateral laminectomy, involves removing the bony roof of the spinal canal (lamina) to relieve pressure on the spinal cord and nerve roots. Decompression also creates enough space so that high-dose radiation can be given without risking spinal cord injury.

Spinal Instrumentation

Pedicle screws and rods are surgically attached to the spine to redistribute stress on the bones and keep them aligned. This technique is usually used when a patient has significant spinal cord compression, a collapsed vertebra, or a burst fracture that cannot be repaired with kyphoplasty. When possible, our surgeons use specially designed screws to attach the rods in a less invasive technique than with open surgery.

Recovery

The typical hospital stay after surgery to remove a spinal tumor is about 5-10 days, depending on the patient's case. A required period of post-surgery physical rehabilitation may involve a stay in a physical rehabilitation hospital for a period of time.   In other cases, physical therapy may take place at an outpatient facility or at the patient's home. The total recovery time after surgery may be as short as three months or as long as one year, depending on the complexity of the surgery and the patient's overall health.

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Laminoplasty Spine Surgery in India - Best Spine Surgery Hospital in India

Laminoplasty is a surgical procedure carried out usually in the vertebrae of the neck region to decompress the spinal cord in case of narrowing of the spinal canal in this region. The procedure is usually performed in the neck region but can also be performed in the thoracic (mid back region) or the lumbar region(low back region).It is also called “Open Door Laminoplasty” as the back of the vertebrae is made to swing open like a door (hinged at one end and open at the other end). Laminoplasty aims at decompressing the spinal cord and the spinal nerves, by hinging open the vertebrae posteriorly. The lamina (flat arch on the backside of the vertebral body) is cut open on one side and grooved on the other side to keep it hinged to the main body of the vertebra. This creates more room for the spinal cord and nerves. Any compressing structure like a herniated or fragmented disc, or bony spurs, thickened ligament etc are also removed in this procedure. The advantage of this procedure is that the stability of the spine is maintained as the amount of bone and muscle tissue that is removed is very less, and any fusion surgery of the spine is avoided.

What type of patients need this surgery?

Any patient with the complaint of pain numbness and tingling in one or both upper extremities, and /or disturbance in walking, or loss of control in bowel and bladder for a considerable period of time despite conventional treatment like rest, physical therapy and medications are recommended for this type of procedure.  

How is the surgery performed?

This surgery is performed by sedating the patient under general anesthesia and making him lie on his stomach. The head is kept slightly bent with the help of Mayfield clamp to straighten the skin folds on the neck.A midline incision is made on the back of the neck corresponding to the affected spinal segment. The skin is cut open and the muscles are separated to view the involved vertebrae. 

The lamina are cut through their thickness longitudinally on one side and grooved on the other side to keep it hinged to the vertebral body. The posterior part of the vertebra is swung open like a door. Small wedges made of bone are placed in the opened space of the door. The door of the vertebrae swings shut, and the wedges stop it from closing all the way. The spinal cord and the nerve roots rest comfortably behind the door. Since this increases the space in the spinal canal, it decompresses the spinal cord with immediate relief of symptoms. Any presence of herniated disc, thickened ligament or facet joint and osteophytes are identified and removed.
Post Operative Recovery an Rehabilitation

The person is usually up and about on the same day after surgery and is discharged in one or two days later. The Physical therapist advises certain exercises of the neck to maintain the flexibility and strength of the neck muscles before the patient is discharged.  Certain ergonomics advice regarding neck movements is also given. The patient is able to return to his daily activities wearing a soft cervical collar within a few days. The collar is discarded after some time.

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.

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Disc Nucleoplasty Surgery in India - Best Spine Hospital in India

Disc Nucleoplasty Surgery

Nucleoplasty is a minimally invasive procedure designed to treat back pain or leg pain caused by contained disc herniations. It works by decompressing the nucleus of the disc. Similar to letting air out of a tire, removing tissue from the center of a disc causes a reduction of pressure within the disc. This in turn leads to a reduction in the pressure that the disc applies to other parts of the body, such as nerve roots or the spinal cord.

During the procedure, an instrument is introduced through a needle and placed into the center of the disc where a series of channels are created to remove tissue from the nucleus. As pressure is relieved, pain is reduced, consistent with the clinical results of earlier percutaneous discectomy procedures. There is little tissue trauma and recovery times may be improved in many patients. A herniated disc may occur suddenly in an event such as a fall or an accident, or may occur gradually with repetitive straining of the spine.

Candidates for Disc Nucleoplasty :-

You are a candidate for disc nucleoplasty if:

• If you are suffering from chronic back pain, back fatigue and rest, medications, medical interventions like steroid injections and physical therapy has not been of help.
• If you suffer from disc herniation
• If you suffer from contained spinal disc herniation, i.e, pain radiating down the leg or arm accompanied by back pain not improving with medication and physical therapy.
• Inflammation and chronic pain, particularly in cases where the nerve roots are pinched or irritated.

                    How does the Disc Nucleoplasty procedure work?

Nucleoplasty requires the patient to lie on his/her stomach for the lumbar procedure or back for the cervical procedure. The procedure is performed under X-ray guidance to accurately place a needle into the disc. Sedation may be administered by your doctor. A small nick is made in the skin near the spine, and a needle is inserted. The decompression device, called a SpineWand, is then inserted through the needle into the disc and activated to remove tissue. The device and the needle are removed and the small nick is covered with a bandage.

Benefits of Disc Nucleoplasty for herniated or slipped disc, chronic lower back pain, Sciatica

• Minimally Invasive, Scarless , Minimal Pain & discomfort to the patient
• Procedure time is less than an hour
• Minimal Tissue trauma and no risk of complications that may result from open surgery
• Minimal pain and discomfort to the patient.
• Quick recovery and Quick relief

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