Latest Back Pain Treatments in India

Minimally Invasive Lumbar Discectomy (MILD) for Back Pain

One of the safe procedures to cure Lumbar Spinal Stenosis is called MILD. If you have pain or numbness in your lower back when you are standing upright or tingling when you walk, you might be having Lumbar Spinal Stenosis. MILD is an effective treatment option which can deliver significant pain relief for patients with Lumbar Spinal Stenosis.

Lumbar Spinal Stenosis is a condition, where the spinal canal narrows and compresses the spinal cord nerves in the lower back. It may occur as a result of natural wear and tear due to ageing. Other factors that cause narrowing of the spinal canal are:

• Formation of excess bone
• Compression or bulging of discs
• Thickening of ligament tissue etc.
  
  

Pain and numbness are the main symptoms of Lumbar Spinal Stenosis. As the disease progresses, the symptoms also will increase. When other medications and therapies fail to cure the disease, the doctor will suggest for MILD procedure.

MILD is a short outpatient procedure done using a small incision. The procedure does not require anesthesia, implants or stitches. The doctor will use an imaging machine and specialized tools for the procedure. During the procedure, the doctor will remove excess ligament tissue and small pieces of bone through the small incision in the back. This will help to restore the space in the spinal canal and decreases the nerve compression. So that, the patient will get relief from pain and can restore mobility.

The patient will be able to go home on the same day of surgery itself. The doctor may suggest you to avoid strenuous physical activities. Reliable surveys have found the fact that, MILD has given significant results to about 79% of patients. MILD has proven to be a very low risk procedure. But, it can be complicated for people who have other health issues. All the people may not be apt for the procedure. Talk to your doctor in order to confirm how far the procedure is suitable for you.

Some of the other latest back pain treatments are :

• Endoscope Assisted Discectomy
• Ozone Arthroplasty

Endoscope Assisted Discectomy

Discectomy is the surgical procedure employed to remove herniated discs from the spinal canal. Endoscope assisted disectomy is a minimally invasive method which makes use of endoscope and small surgical tools. Herniated disc will cause compression of nerve roots and spinal cord. Fragment of the spinal disc that is putting pressure on the nerves is so removed.

Discectomy is performed under a light anesthesia. A very small incision is made in the middle of your back neck. A small metal tube is inserted into the herniated disc through this incision using x-ray fluoroscopy. This will help your surgeon to locate the herniated disc using x-rays and camera. The inserted tube acts as a passage for endoscope and surgical instruments. Then surgical tools and an endoscope with small camera will be guided through this passage. After identifying the disc, fragments that put pressure on the nerve is removed using special instruments. Camera attached with the endoscope will visualize live the damaged disc which is to be removed.

After all fragment tissues are removed, your surgeon will withdraw tools from the spine and dress the incision using bandages with utmost care.

ADVANTAGES

• Less tissue injury and scar formation
• No need of large skin incision
• Shorter recovery period
• Very little blood loss

Ozone Arthroplasty

Each bone in the spine is separated by cushion like disc called intervertebal disc which acts as shock-absorbers. Any damages to this disc or its rupturing can cause protrusion of jelly like nucleus of disc outwards. This condition is called disc herniation which causes compression of nerve roots and spinal cord. It ultimately leads to lower back pain or leg pain.

Many people show no symptoms from herniated disc. To relieve symptoms of herniated disc, pain medications and muscle relaxers may be prescribed to patients. If the pain continues or persists, inflammation-suppressing steroid injections would be given.

Physical therapies like heat or ice application or electrical stimulation may be useful.

But sometimes, least number of patients may need surgery to heal their disc hernation. Protruded or bulged portion of disc shrinks over a time within a few weeks after surgery. Herniated disc would be removed during the surgery.Apart from these treatment options, a new method has been innovated called ozone arthroplasty.

Ozone artroplasty is a new practice performed by some physicians to cure herniated discs. In this procedure, ozone gas would be directly injected into the herniated disc. This injected ozone gas will fill the disc and bubbles out through protrusion. The chemical reaction of the gas with the nucleus of the disc causes the shrinking of herniated portion of disc. The pressure on the nerves become relieved. Consequently, symptoms of leg pain and lower back pain start to disappear. Recent studies reveal that it can produce long lasting results with a single ozone injection.

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Minimally Invasive Surgery for Spine Tumors : Vertebral Fracture Treatments , Vertebroplasty and Kyphoplasty (Vertebral Augmentation)

Minimally Invasive Spine Tumor Surgery

Tumor is abnormal mass of rapidly growing cells without any physiological function. That means it does not perform any function for the body but derives its nutrition from the body.  It can occur anywhere in the body. The cause is unknown. Those tumors that are found in and around the spinal cord are known as spinal tumors. They may be primary tumors whose cells of origin is the spinal tissue, or they may be secondary tumors which have spread (metastasize) via blood stream from some other focus in the body.
 

The Spinal cord is covered by a layer of protective tissue called as meninges. The entire spinal cord is encased within the vertebral column.
 

The Spinal tumor are of three types depending on their location:

• Intramedullary – within the substance of the spinal cord.
• Intradural-Extramedullary- within the layers (meninges) covering the spinal cord
• Extradural- between the meninges an the vertebral body. Most of the spinal tumors are extradural.  

Tumors are also classified as benign and malignant. Tumors that are confined to a particular area in the body are known as benign tumors. Those tumors that spread rapidly to various parts of the body are known as malignant tumor. A tumor can initially start as a benign one and can convert to a malignant one in a few cases. The benign tumors are easier to treat as they are localized in their extent and their complete removal is possible. Whereas incase of metastatic or malignant tumor, the earlier they are detected, the better the chances of their removal. But in the malignant tumor the chances of recurrence are also there as they are rapidly growing tumors.
 

What are the Symptoms of Spinal Tumor?

Tumor may cause generalized symptoms in the body (like persistent low energy levels, unexplainable weight loss, lump formation, enlargement of lymph nodes, malaise, irregularities of menstruation in females etc) as well as symptoms pertaining to the affected organ in the body. In case of spinal tumor the patient may present with any of the following:

• Back pain, often radiating to other parts of the body and worse at night
  
• Loss of sensation or muscle weakness, especially in the legs
• Difficulty walking, sometimes leading to falls
• Decreased sensitivity to pain, heat and cold
• Loss of bowel or bladder function
• Paralysis may occur in varying degrees and in different parts of the body, depending on which nerves are compressed.
• Scoliosis or other spinal deformity resulting from a large, but non cancerous tumor
• Erosion and Destruction of vertebral body

Minimally Invasive Surgery for Spine Tumors

Surgery is considered minimally invasive when it involves small incisions (e.g. ½ inch) and minimal tissue disruption. Most minimally invasive procedures are done on an outpatient basis, meaning that the patient can go home the same day, and have relatively short recovery times.

Vertebral Fracture Treatments
Vertebroplasty and Kyphoplasty, also referred to as vertebral augmentation, are typically reliable procedures designed to provide pain relief for patients who have a vertebral fracture associated with a spinal tumor.

Vertebroplasty
This procedure involves inserting a needle through a small incision in the back so that a medical-grade bone cement can be inserted into a fractured vertebra to fill in the empty spaces and act as an internal cast to stabilize the bone. The treatment is designed to reduce pain, prevent further collapse of the vertebra, and restore the patient's mobility.

Kyphoplasty (Vertebral Augmentation)
Kyphoplasty also involves injecting bone cement into a vertebra, and involves the additional step of first inserting a balloon into the bone and inflating the balloon to create a cavity. This treatment is designed to stop the pain caused by a spinal fracture, and to stabilize the bone via an internal cast.

Transarterial Chemoembolization
This procedure involves a small incision in the thigh for access to the femoral artery. A catheter guided by a wire is directed through the vascular system to the tumor with the aid of imaging. Once the tumor is located, a chemotherapeutic agent is injected directly into the tumor to shrink or destroy the tumor to remove pressure on individual nerve roots or the spinal cord.

Recovery

Recovery after tumor surgery is a relatively slow process as the patient is weakened by the tumor and all the medications, chemotherapy and radiotherapy, he has been subjected to. Regular follow ups are required to detect any recurrence of tumor. Positive mindset combined with a strong support system can work wonders for the patient’s recovery. The patient should take nutritious diet to replenish his body reserves. 

Tumor or cancer as it is referred to in common man’s language, is a much feared disease. Many of those who are affected feel their world go crumbling around them with the mere mention of such a diagnosis. They go through a variety of emotional phases from denial to acceptance to defeat against the killer. Not only the patient but also the caretaker or the family member is totally drained out while attending to the patient. The picture may seem very dismal, but tumor patients still have a hope to live a normal life, provided the condition is detected early and the remedial measures are begun in time. We provide these patients with a world class diagnostic setup to detect tumors as early as possible and also advanced surgical techniques to treat them. We provide a multidisciplinary approach towards handling of such patients as they require medical, surgical, emotional and psychological support. We make the stay of the patient as well as that of the caretaker as comfortable as possible and try our best to allay their fears and anxieties. All this is offered at our hospitals at very affordable costs.

Most Advanced Laser Spine Surgery in India : Best Spine Hospitals in India

Laser therapy is the use of monochromatic light emission from a low intensity laser diode (250 milliwatts or less) or an array of high intensity super luminous diodes (providing total optical power in the 1000-2000 milliwatt range). Conditions treated include musculoskeletal injuries, chronic and degenerative conditions and wounds. The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This also enhances the body's natural healing processes. The following chart outlines some of the specific effects of Low Intensity Laser Therapy. 

The underlying science behind cold laser therapy is sound. Studies have shown that light of certain wavelengths can reduce pain and inflammation. Lasers can offer very focused beams of light which can be used to target specific areas, which means that in theoretical use, a low intensity laser calibrated to emit light of a specific wavele ngth could potentially be used very effectively to treat areas of inflammation on the body. However, like all medical devices, cold lasers need to be carefully evaluated for safety and efficacy.

Doctors generally recommend cold laser therapy as part of an overall pain management program. For people dealing with chronic pain, cold laser therapy is an option which could be used to reduce the pain, while people with persistent inflammations may also benefit. However, this therapy should not be undertaken without medical supervision, and it is generally not recommended as a replacement for other forms of medical treatment, such as the use of physical therapy to manage chronic pain.

Some practitioners of acupuncture have suggested that cold laser therapy could be used much like acupuncture and acupressure, with the beams of the laser targeting specific points on the body. These practitioners of alternative medicine rely on their training and experience to support their beliefs about the use of cold laser therapy. Stimulation of pressure points can be used to treat a number of conditions treatable with acupuncture. 

A number of terms are used to refer to cold laser therapy, including low power laser therapy (LPLT), low level laser therapy (LLLT), biostimulation, soft laser, and laser acupuncture. In all cases, the technique involves exposing the skin to targeted laser beams for set periods of time and at set intervals. The light in the laser is supposed to stimulate damaged cells to promote healing and a reduction in inflammation and pain. The "cold" refers not the temperature of the laser, but to the fact that the laser is of low intensity, rather than high intensity lasers, which can burn the skin. 

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.

For more information visit:          http://www.medworldindia.com    
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com

Most Advanced Back Surgery in India - World Best Spine Surgery Hospitals in India

There are three basic types of back surgery

1. A laminectomy – removing the back part of the bone (called the lamina) over the spinal column. A laminectomy is performed to relieve nerve root compression (pinched nerve) on one or more nerve roots in the spinal column. The compressed nerve root often causes back and leg pain. A segment of the entire lamina can be removed to relieve pressure on a nerve..

2. A discectomy – removing a portion of a disc to relieve pressure on a nerve.

3. A spinal fusion – this involves the permanent fusion of two or more vertebrae for more stability, to correct a deformity or to relieve pain. The surgeon will harvest small pieces of bone from your hip or pelvic bone and place them between the vertebrae. In many cases they will use wires, rods, screws, metal cages or plates to provide immediate stability.

Laminectomy

How is a laminectomy performed?

Step 1: A laminectomy is performed with the patient lying on his stomach or side and under general anaesthesia. The surgeon (an orthopaedic or neurosurgeon) reaches the spinal column through a small incision in the back.
Step 2: He will use a retractor to spread the muscles of the back apart in order to expose the bony lamina.
Step 3: He cuts away part of the lamina to uncover the ligamentum flavum – a ligament supporting the spinal column.
Step 4: In the next step he will cut an opening in the ligamentum flavum to reach the delicate spinal canal containing the compressed nerve.
Step 5: The compressed nerve can now be seen as well as the bundle of nerve fibres (known as the cauda equina) to which it is attached. It is now possible to identify the cause of compression: a bulging, ruptured or herniated disc, or perhaps a bone spur.
Step 6: The source of the pressure can now be removed. This may involve removing the bulging portion of the disc or the bony spurs and scar tissue. The herniated disc is removed after the compressed nerve has been gently retracted to one side. The surgeon will remove as much of the disc as is necessary to take pressure off the nerve. Sometimes a fragment of disc has moved and presses on the nerve root as it leaves the spinal canal. This will often cause more severe symptoms.
Step 7: With the cause of compression removed, the nerve can now begin to heal. The space created by removal of the disc will gradually fill with connective tissue. The incision is closed in several layers, from the inside outwards.
Step 8: The skin layer will be closed with steri-strips, sutures or skin clips. A dressing will be placed over the incision to protect the wound.

This operation is normally performed within one or two hours, depending on the number of levels that are decompressed.

After surgery
A plastic drain will run from inside the wound to remove any accumulating blood. In most cases, the drain can be removed on the second day after surgery.

An intravenous line to administer medication may remain connected through a vein in your hand or arm for two to three days.

Pain can and should be well controlled. Usually the acute pain subsides after a day or two. Pain may be most severe in the lower back. Leg pain may be caused by swelling of the previously compressed nerve and the trauma of the surgery. Muscle spasms across the back and down the legs are not uncommon and this can be relieved by muscle relaxants.

A physiotherapist will help you to begin standing and walking again, and show you how to get in and out of bed and how to sit, stand, and sleep.

 What about new and less invasive procedures?
The era of less invasive surgery has dawned – also in back surgery. Smaller keyhole incisions are replacing large surgical cuts. These less invasive techniques include:

• Endoscopic discectomy – this technique employs a disposable scope that the surgeon inserts through a small incision. The protruded disc that is compressing the nerve is then removed using specially designed instruments.
• Vertebroplasty – the injection of bone cement into a fractured vertebrae. The hardened cement will seal and stabilise the fracture and relieve pain. People suffering from severe pain because of a compression fracture will be considered for this procedure, especially if they have difficulty standing and walking.
• Kyphoplasty – the insertion of a “balloon” to expand a compressed vertebra and the injection of bone cement
  
  
  

Treatment and Surgery for Back Pain in India

There are many ways to prevent low back pain problems from developing. Commonly people have created problems in their back themselves. What that means is that problems are self-inflicted, such as poor posture or poor moving and handling techniques.

Poor posture usually involves excessive flattening of the low back (slouching), and is associated with a forward slippage of the head resulting in a flattening of the neck curves. This puts extra stress on the muscles and ligaments in the neck and shoulders. Commonly this causes tension in the muscles which is felt as pain, and an increased likelihood of trapping nerves in the neck. Slouching in the low back results in the neck ligaments taking more strain on a daily basis. This results in the extra strain ultimately causing an misalignment of the spine and resultant nerve entrapment. Effects of this include low back pain pins and needles, sciatica, referred leg pains, and low back spasms and aches.

Although back pain is fairly common these days, there are times when the pain becomes unbearable. Here are the top 5 modes of treatment your doctor is likely to prescribe in case of severe back pain. 

Main Modes of Treatment

 Rest: The first step in the treatment of low back pain is to rest the spine. Because most cases of back pain are due to muscle strain, it is important to avoid further irritation to the spine and the muscles that surround the spinal column. Bed rest is fine, so long as this only lasts two to three days. Prolonged bed rest can actually lead to more persistent back pain. Once the acute back pain eases, avoid lifting, twisting, and physical exertion.

Oral Medication: Anti-inflammatory medications (NSAIDs) are helpful in treatment of both back pain and the associated inflammation. There are both over-the-counter and prescription NSAIDs, and both work well in the treatment of back pain. Side-effects of NSAIDs include problems of gastro-intestinal bleeding, and these medications should be avoided in patients with stomach ulcers. Sometimes, muscle relaxing medications are prescribed. They help to relieve muscle spasm, but may also make patients quite drowsy.

Physiotherapy and Exercises: Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine. Other modalities that can be used in the treatment of back pain if the exercises alone do not help include aquatherapy, ultrasound, electrical stimulation, short-wave diathermy and others.

Epidural steroid injections: They are an option for back pain treatment and inflammation around the spinal nerves. An epidural steroid injection is performed using an x-ray to guide the medication to the area adjacent to the inflamed spinal nerve.

Spine Operation: Spine surgery is rarely an initial treatment for back pain; there are a few emergencies, however, that may require surgical treatment. In the vast majority of patients, spine surgery is only considered after a long course of conservative therapy. Back pain often takes quite some time to resolve. Rushing into spine surgery, therefore, may not be the most sensible idea. Most commonly, doctors will advise at least 3 to 6 months of conservative treatment before considering spine surgery.

5 Operations commonly carried out for back pain are:

1. A Discectomy is a procedure to remove a portion of the disc that rests between each two vertebrae. A herniated disc is the most common reason for spine surgery. In this type of spine surgery, the protruding, herniated disc is removed and this relieves the pressure on the nerves.
2. A Foramenotomy is also a procedure used to relieve pressure on a nerve, but in this case, the nerve is being pinched by more than just a protruding disc. The surgery removes a portion of bone and other tissue that may be compressing the nerve as it exits the spinal column.
3. A Laminectomy is performed to relieve pressure on the spinal cord itself.  It is most commonly used to treat conditions such as spinal stenosis and spondylolisthesis, where the spinal column is seen slipping forwards. Depending on the amount of bone removed, this procedure may be done with a spinal fusion to prevent instability.
4. A spine fusion is surgery that is done to eliminate motion between adjacent vertebrae to treat a problem such as spondylolisthesis (an unstable spine), or it may be done because of the extent of other surgeries such as a Laminectomy.
5. Spinal disc replacement is a new surgery that is still quite uncommon. It is done to treat specific types of back pain, while avoiding the problems associated with spine fusion surgery.
   
   
   
   
   
   

Benefits of Spine Laser Treatment in India

Laser therapy is the use of monochromatic light emission from a low intensity laser diode (250 milliwatts or less) or an array of high intensity super luminous diodes (providing total optical power in the 1000-2000 milliwatt range). Conditions treated include musculoskeletal injuries, chronic and degenerative conditions and wounds. The light source is placed in contact with the skin allowing the photon energy to penetrate tissue, where it interacts with various intracellular biomolecules resulting in the restoration of normal cell morphology and function. This also enhances the body's natural healing processes. The following chart outlines some of the specific effects of Low Intensity Laser Therapy. 

The underlying science behind cold laser therapy is sound. Studies have shown that light of certain wavelengths can reduce pain and inflammation. Lasers can offer very focused beams of light which can be used to target specific areas, which means that in theoretical use, a low intensity laser calibrated to emit light of a specific wavele ngth could potentially be used very effectively to treat areas of inflammation on the body. However, like all medical devices, cold lasers need to be carefully evaluated for safety and efficacy.

Doctors generally recommend cold laser therapy as part of an overall pain management program. For people dealing with chronic pain, cold laser therapy is an option which could be used to reduce the pain, while people with persistent inflammations may also benefit. However, this therapy should not be undertaken without medical supervision, and it is generally not recommended as a replacement for other forms of medical treatment, such as the use of physical therapy to manage chronic pain.

Some practitioners of acupuncture have suggested that cold laser therapy could be used much like acupuncture and acupressure, with the beams of the laser targeting specific points on the body. These practitioners of alternative medicine rely on their training and experience to support their beliefs about the use of cold laser therapy. Stimulation of pressure points can be used to treat a number of conditions treatable with acupuncture. 

A number of terms are used to refer to cold laser therapy, including low power laser therapy (LPLT), low level laser therapy (LLLT), biostimulation, soft laser, and laser acupuncture. In all cases, the technique involves exposing the skin to targeted laser beams for set periods of time and at set intervals. The light in the laser is supposed to stimulate damaged cells to promote healing and a reduction in inflammation and pain. The "cold" refers not the temperature of the laser, but to the fact that the laser is of low intensity, rather than high intensity lasers, which can burn the skin.

Common Spinal Conditions

Facet joint osteoarthritis is a gradual process that breaks down cartilage between joints. The loss of cartilage causes more friction between the joints, resulting in pain and stiffness. This disorder can also result in compression of nerves, which causes pain as well.

Spinal stenosis is a narrowing of the spinal canal or neural passageways (foramina) that can place pressure on nerves in the spinal cord. Stenosis is a gradual result of aging, and wear and tear on the spine.

Degenerative disc disease is a gradual process that affects the structural integrity of discs. As people age, disc moisture decreases, resulting in discs that may shrink, wrinkle and even crack. These disc changes allow vertebral structures to compress, resulting in less space for nerves to exit the spinal column. The compressed nerves may swell and cause pain.

Spondylolisthesis is a condition where one vertebra slips over another, causing spine misalignment and instability. It may be present at birth and develop over time, or be the result of physical activity or deteriorating spinal parts, such as discs.

Disc herniation is a rupture of the disc where the inner core of the disc bulges out through the outer layer. If the bulging disc presses on a spinal nerve, the pressure can cause pain. A common symptom of a herniated disc is sciatica, the term used to describe pain that travels downward along the sciatic nerve from the buttock to the thigh and leg. Herniated discs are also known as “slipped” or “ruptured” discs.

Osteoporosis is a disorder caused by bone mineral loss that results in fragile bones. This disorder can cause vertebral compression fractures or a humped back.

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.

For more information visit:          http://www.medworldindia.com       
                    https://www.facebook.com/medworld.india

Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

Call Us : +91-9811058159

Mail Us : care@medworldindia.com

Benefits of Arthroscopic techniques in minimally invasive spine surgery

This type of minimally invasive surgery is performed on an outpatient basis using a local anesthetic. Since general anesthesia is not used, surgical risks are less. Arthroscopic surgery and use of endoscopic tubes minimizes muscle and other soft tissue damage. Patient benefits include less bleeding during surgery, reduced postoperative discomfort, fewer and smaller incisions, minimal scar tissue formation, and a speedier recovery. In addition, patients can avoid hospitalization and spinal fusion.

Arthroscopic Spine Procedures

Depending on the patient's diagnosis and surgical needs, sometimes more than one procedure is performed during a single surgery.

There are 4 primary arthroscopic spine procedures : -

1. Foraminotomy : - A foraminotomy helps to relieve symptoms caused by nerve root compression. The foramen are passageways between the vertebrae through which nerve roots exit the spinal canal. A foraminotomy may be performed to treat foraminal stenosis, bulging or herniated discs, pinched nerves, scar tissue formation, bone spurs (osteophytes), spinal arthritis, or sciatica.
   
   During a foraminotomy, the surgeon arthroscopically removes bone and tissue compressing the spinal nerve root. The endoscope is slowly removed to allow muscles and other soft tissues to move back into place. Occasionally, a stitch or two is needed to close the small incision.

2. Laminotomy : - A laminotomy is performed to increase the space around nerve roots and the spinal cord. The procedure helps to remove (decompress) pressure from these neural tissues. The lamina is the bony plate covering each vertebra's posterior arch, or entryway to the spinal canal and nerve structures.
   
   A laminotomy may also be performed to remove the ligamentum flavum. This is the spine's largest ligament. Sometimes the ligamentum flavum becomes thick and compresses the spinal cord contributing to spinal stenosis. When the surgeon removes part of the lamina, he can access the ligamentum flavum for removal.
   
   A laminectomy is similar to a laminotomy. The difference between the procedures is a laminectomy is usually performed during a traditional open back surgery to remove the entire lamina. A laminotomy does not remove the entire lamina, but only a portion of the bony plate
   
   A laminotomy is performed to treat bone spurs (osteophytes), bulging and herniated discs, pinched nerves, scar tissue, spinal arthritis, and spinal stenosis.

3. Percutaneous Arthroscopic Discectomy : - Percutaneous means through the skin. A percutaneous arthroscopic discectomy is the surgical removal of bulging or herniated disc material. Bulging and herniated discs are a common cause of nerve root and spinal cord compression.
   
   During this minimally invasive procedure, the surgeon uses a laser to vaporize disc material to reduce pressure on the spinal cord and nerve roots. When the procedure is completed, the endoscopic tube is slowly removed to allow muscles and soft tissues to move back into place. A percutaneous arthroscopic discectomy is a short procedure only taking 30 to 45 minutes.

4. Facet Thermal Ablation : - A facet thermal ablation is performed to treat facet disease, facet joint syndrome, facet hypertrophy (enlargement), facet arthritis, or facet joints affected by degeneration. The facet joints are the spine's joints. Found at the back of the spine, 2 vertebrae share 1 facet joint.
   
   Thermal ablation refers to disabling or destroying a nerve using a laser. During the procedure, the surgeon uses a laser to clean the facet joint and deaden the nerve that innervates the joint and causes pain.
   
   After a local anesthetic is administered, a small incision is made and the endoscope is inserted. The endoscope (about the size of a straw) helps protect surrounding anatomical structures from damage during thermal ablation. The procedure only takes about 40-minutes.

Laser Spine Surgery : -

The most commonly performed spinal operation in the United States is the lumbar discectomy. Lumbar discectomy is the cornerstone of surgical treatment of disc herniations. A disc herniation is a protrusion of the inner core of disc material beyond the confines of the disc space to compress on the lumbar nerve root(s). This nerve root compression causes a variety of symptoms, but most notable is that of sciatica. Sciatica is a radiating pain from the low back around the hip joint into the leg and down the leg to the foot. Fortunately, 80% of symptomatic disc herniations respond to non-surgical treatment. For the remaining 20%, lumbar discectomy is the treatment of choice 

How long does surgery typically last?

The average spine procedure lasts about an hour. When the procedure is complete, the surgeon removes the tube to let the tissue and muscle go back to their natural position. The last tube is gently removed and absorbable sutures are used to close the incision. The patient is wheeled into the post-anesthesia care area where their vital signs are monitored, medications are given as needed and some light refreshments can be enjoyed. That same day, patients are encouraged to walk around. Soon after, they are discharged home or to their hotel.

What's the recovery process like?

After a day of rest and recovery, the patient returns for a postoperative appointment. An epidural injection may be given to reduce swelling and increase range of motion. Physical therapy may be prescribed. Physical therapy consists of a series of stretching exercises, walking, ice or heat, gentle electronic stimulation and a nice relaxing massage. Each patient is given instructions for postoperative activity and limitations. Over the weeks and months to come, gradual and continuous improvement will be seen, as the nerves and tissues heal. With time and exercise, the body can repair any damage, gain strength, and a gradual increase in daily activities can occur.

Most commonly, laminectomy is performed to treat spinal stenosis

Laminectomy or Laminotomy (a partial laminectomy) is sometimes called a decompression procedure and is a spinal procedure to remove a portion of the vertebral bone called the lamina. The lamina is a posterior arch of the vertebral bone lying between the spinous process, which juts out in the midline and the more lateral of each vertebra. The pair of lamina, along with the spinous process, make up the posterior wall of the bony spinal canal.  Although the procedure indicates excision of the lamina, the operation called conventional laminectomy, removes the lamina, spinous process and overlying connective tissues and ligaments, cutting through the muscles that overlie these structures. Minimal surgery laminectomy is a tissue preserving surgery that leaves the muscles intact, spares the spinal process and takes only one or both lamina. Laminotomy is removal of a mid-portion of one lamina and may be done either with a conventional open technique, or in a minimal fashion with the use of tubular retractors and endoscopes.

BRIEF ABOUT THE PROCEDURE

There are many variations of laminectomy, in the most minimal form small skin incisions are made, back muscles are pushed aside rather than cut and the parts of the vertebra adjacent to the lamina are left intact. After an incision is made in the midline of the neck or back, the muscle is moved away to expose the lamina, which are the bony shingles that overlay the neural (nerve) elements. The lamina can be removed in whole or in part to expose a single nerve root or more of the neural elements as needed. In the case of a lumbar disc herniation, a laminotomy, or partial removal of the lamina is usually sufficient to gain access to the affected nerve root.  The nerve root will usually be visible just beneath the lamina, with a disc herniation underneath it. The nerve root is gently held out of the way with a retractor and the disc herniation can be accessed. The traditional form of laminectomy (conventional laminectomy) excises much more than just the lamina, the entire posterior backbone is removed, along with overlying ligaments and muscles. The usual recovery period is very different depending on which type of laminectomy has been performed: days in the minimal procedure and weeks to months with conventional open surgery. A lamina is removal is done to break the continuity of the rigid ring of the spinal canal to allow the soft tissues within the canal to expand or as one step in changing the contour of the vertebral column, or in order to allow the surgeon access to deeper tissues inside the spinal canal. Conventional open laminectomy often involves excision of the posterior spinal ligament and some or all of the spinous process and facet joint. Removal of these structures, in the open technique, requires cutting the many muscles of the back which attach to them. Laminectomy performed as a minimal spinal surgery procedure, however, allows the bellies of muscles to be pushed aside instead of transected and generally involves less bone removal than the open procedure. The recovery period after laminectomy depends on the specific operative technique; minimally invasive procedures having a significantly shorter recovery period than open surgery. Removal of substantial amounts of bone and tissue may require additional procedures to stabilize the spine, such as fusion procedures and spinal fusion generally requires a much longer recovery period than simple laminectomy. Most commonly, laminectomy is performed to treat spinal stenosis. Laminectomy for Spinal Stenosis Spinal stenosis is the single most common diagnosis leading to any type of spine surgery and laminectomy is a basic part of its surgical treatment. The lamina of the vertebra is removed or trimmed to widen the spinal canal and create more space for the spinal nerves and thecal sac. Surgical treatment that includes laminectomy is the most effective remedy for severe spinal stenosis, however most cases of spinal stenosis are not severe and do not require surgery. When the disabling symptoms of spinal stenosis are primarily neurogenic claudication and the laminectomy is done without spinal fusion, there is generally a very rapid recovery with excellent long term relief. However, if the spinal column is unstable and fusion is required, there is a recovery period of months to more than a year and relief of symptoms is less likely.