Who can benefit from Microsurgical Discectomy ? : Most Advanced Minimally Invasive Spine Surgery in India

A microsurgical discectomy, microdiscectomy or micro decompression spine surgery involves removal of a small portion of the bone/disc over or under nerve root to relieve nerve pinching and provide more room for the nerve to heal.

A microsurgical discectomy is typically performed for a herniated lumbar disc or spinal stenosis and is actually more effective for treating leg pain (commonly known as radiculopathy) than lower back pain.

Pressure on the nerve root (Neural impingement) can cause substantial leg pain. While it may months for the nerve root to heal completely and any numbness or weakness to get better, patients normally feel relief from leg pain almost immediately after a microdiscectomy lumbar spine surgery.

Microsurgical Discectomy is considered to be more reliable compared to the closed procedures like percutaneous procedures. Here the surgeon can directly view the disc fragments. After moving the muscles of the back and excising a bit of bone tissue, the surgeon can directly look into the spinal canal. The microsurgical discectomy involves the use of an operating microscope which allows magnification of the spinal disc material and further allows greater maneuverability to the operating surgeon. This allows quicker post operative healing of the wound and hastens recovery.

Who can benefit from Microsurgical Discectomy?

A microsurgical discectomy is typically recommended for patients who have:

•     Experienced leg pain for at least six weeks
•     Not found sufficient pain relief with conservative treatment (such as oral steroids, NSAID’s, and physical therapy).
•     In cases of severe disc herniation, causing weakness, pain, numbness and in cases of loss of control of bowel/bladder (Clauda Equina Syndrome) or worsening neurological symptoms. It is recommended to conduct the surgery immediately as conservative care is not expected to provide relief.

Prior to deciding the surgical intervention on the patient, it is crucial that conservative treatment is tried. Conservative care includes NSAIDS, physical therapy with exercises for pelvic stabilization. Occasionally traction may be required

Some patients may benefit from epidural steroid injections, directly into the spinal canal, to alleviate the irritation caused due to inflamed nerve roots.

Usually the conservative treatment is tried for about 2 months before considering surgery.

The Microsurgical Discectomy Surgery:

Before the disc material is removed, a small piece of bone (the lamina) from the affected vertebra may be removed. This is called a Laminotomy or Laminectomy It allows the surgeon to better see the herniated disc.

Microdiscectomy uses a special surgical microscope to view the disc and nerves. This surgical microscope is mounted on a flexible stand and lets the surgeon to view with both eyes. This larger well lit view allows the surgeon great flexibility and to operate using a smaller incision. Usually the incision is less than 2 inches. This causes less damage to surrounding tissue. Upon the initial incision the back muscles are stretched out rather than being cut to allow the surgery. This step aids greatly in post surgical recovery.

The surgeon then uses a special high speed surgical drill to remove a small portion of facet joint. The nerve is very carefully moved to the side. Then the surgeon removes the part of the disc that is herniated and is pushing into the spinal canal. Any loose fragments of disc are also removed. The nerve is then moved back and the incision is closed with sutures or surgical tape. This surgery is carried out under general anesthesia and in some cases might involve overnight stay in the hospital.

Minimal Invasive Spine surgery comes with more benefice than invasive spine surgery.

• Less scar tissue is created thereby not leaving the patient to recover with huge and ugly scar marks.
• Pain associated with this procedure is effectively less severe as small incisions are made. Also less soft tissues are damaged.
• Less blood is lost and therefore the patients don’t have to be at a medication for long periods of time
• Procedure is more accurate and leaves the patient with better results.
• The cost for such a surgery is quite lesser as compared to an Invasive Spinal surgery.

The Post Surgical care after Micro Surgical Discectomy:

The patient will be given antibiotics to prevent infection and pain relievers to help with post operative pain.

The patient will be mobilized within 24 hours. Some studies noted no extra risk of re herniation in the patients who resumed normal activities sooner.  Everyday activities can be resumed within few days while high intensity activities should wait 2-3 months.

The patient will receive physical therapy to regain the spine strength and encouraged to walk on a regular scheduled regimen. The brisk walking is shown to improve the post surgical outcome and lower back stabilization.

Most Advanced Minimally Invasive Spine Surgery in India

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       
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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.

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Affordable Cost 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

All About Percutaneous Endoscopic Lumbar Discectomy Surgery

Percutaneous Endoscopic Lumbar Discectomy Surgery at Best Spine Surgery Hospitals in India

Percutaneous Endoscopic Lumbar Discectomy (PELD).

PELD or Percutaneous Endoscopic Lumbar Discectomy is an advanced minimally invasive spine surgery done for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. PELD is also a good treatment option in management of spinal tumors and structural deformities also in patients whose pain threshold is low or who are not responding well to conservative treatments like pain killers, anti inflammatory drugs and rehabilitation.

Percutaneous Endoscopic Lumbar Discectomy (PELD) is not the Conventional excision but a treatment which in between the conservative and open surgery. Therefore, it does not disrupt the normal soft tissue or the vertebral structures. After inserting a thin wire into the skin, the surgeons treat the herniated disc with laser and radio-frequency thermal effect under endoscopic guidance.

What is Percutaneous Endoscopic Lumbar Discectomy (PELD)?

Percutaneous Endoscopic Lumbar Discectomy (PELD) is a unique approach for the treatment of non-sequestrated disc herniation (disc prolapse). An advanced minimal invasive technique, PELD is performed for the decompression of the lumbar disc space and removal of nucleus pulposus via a posterolateral approach. In addition to decompression surgery, the technique has been found effective in management of spinal tumors and structural deformities.

What does the procedure involve?

Percutaneous Endoscopic Lumbar Discectomy is a minimal invasive spine surgery. It is an endoscopic surgical procedure which is conducted under local anaesthesia with mild sedation. The patient is made to lie on his/her front and the exact entry point is mapped on patient’s body using image intensifier X-ray system. A small incision of about 8-10 cm is made from the midline on the posterior part of the body. There are two different ways in which the inter-vertebral disc material can be removed:

• Manual procedure also known as Automated Percutaneous Discectomy involves insertion of a long spinal needle from the side of the back, directly into the disc, by-passing other bone and ligaments. Through this needle, guide wire is passed and after making a 5 mm incision, a dilator and working cannula are passed, through which an endoscope is inserted. The prolapsed part of disc is removed with the guidance of the camera and monitor attached to the endoscope.
  
• The laser surgery, referred to as Percutaneous Laser Discectomy (PLD), uses an external imager called the fluoroscope to direct the probe. The probe delivers laser energy which vaporizes a part of the inter-vertebral disc material and decompresses the nerve root. The most frequently used laser for treatment is Holmium Yttrium-Aluminum-Garnet (YAG) laser.
  

Advantaages of PELD (Percutaneous Endoscopic Lumbar Discectomy)

• Surgery done under local anesthesia with conscious sedation
• Very good technique for old and medically compromised patients.
• No muscle, ligament or normal tissue damage
• It saves the time and the costs. 75% of the patients discharged on the same.
• Due to rapid recovery, comparing to open surgeries, it is recommendable for the workers or students with the desire of early return-to-work.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed.
• Very good technique for old and medically compromised patients.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed.
  
  
  
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Spinal Tumor Removal Surgery :Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India

A spinal tumor is a cancerous (malignant) or noncancerous (benign) growth that develops within or near your spinal cord or within the bones of your spine. Although back pain is the most common symptom of a spinal tumor, it's also an extremely common problem in people who don't have spinal tumors. In fact, most back pain isn't caused by a tumor.

A spinal tumor or a growth of any kind can affect nerves in the area of the tumor, leading to pain, neurological problems and sometimes paralysis. Whether cancerous or not, a spinal tumor can threaten life and cause permanent disability.

Treatment for a spinal tumor may include surgery, radiation therapy, chemotherapy or other medications.

Frequently Asked Questions About Spine Tumors

Q. What is the central nervous system?

A. The brain and the spinal cord form the central nervous system. It controls walking, talking, breathing and digesting food. It is also involved with our senses – seeing, hearing, touching, tasting and smelling – as well as our emotions, thoughts and memory.

Q. What are spine tumors?

A. Spine tumors are abnormal growths of tissue found in and around the spine. Tumors in the spine may be primary (begin in the spine) or secondary (metastatic – move to the spine from other locations). The most common cancers that move to the spine are breast, lung, renal and prostate.

Q. What are metastatic spine tumors?

Metastatic is a term that describes cancer that has spread from its primary site to other places in the body. Metastatic spine tumors are abnormal growths of tissue that are found in and around the spine, but that began in another location in the body. The skeletal system is the third most common site of metastases.

Most often cancer that moves to the spine is not fatal, although it can cause pain and compress nerves. Nerves that are compressed can cause weakness or paralysis of the arms or legs. Treatment of spine tumors is focused on maintaining quality of life.  

Q. Where are spine tumors located?

A. The majority of spine tumors are located in the center of the back. But they also occur in the lower back or neck region.  The location of the tumor determines the symptoms experienced.

Q. What are the symptoms of spine tumors?

A. Some patients have no symptoms. The most common symptom, however, is pain. Patients may experience persistent back or neck pain. Other complaints may include numbness, tingling or weakness in the arms or legs, problems walking and maintaining balance or problems with bowel and bladder function. 

Q. How is a spine tumor diagnosed?

A. The most common test is a magnetic resonance imaging (MRI) of the spine, which will show the soft tissues and nerves of the spinal column. Plain X-rays will show vertebral fractures, common when the tumor invades the spinal bones. A computerized tomography (CT) scan shows the bones more clearly and can help to determine the extent of the bony disease. Other tests include CT scans of the chest, abdomen and pelvis or a positron emission tomography (PET) scan to determine where else the cancer may be.

Q. What are the treatments for spine tumors?

A. The type of treatment that is best for you depends on the type of your tumor, the location of the tumor and how much tumor is in the spine. Your options may include:

• No medical treatment
• Managing your pain
• Surgery
• Radiation and/or chemotherapy
• Vertebroplasty (injecting bone cement into spine bones to make them strong)

Q. When is surgery necessary?

A. The role of surgery for metastatic spine tumors is to improve or maintain quality of life. There are a number of reasons why surgery would be a good treatment option for spine tumors:

• Surgical cure, if tumor can be removed
• Control of tumor growth by surgical removal, sometimes accompanied by radiation and/or chemotherapy
• Alleviation of symptoms by reducing pressure on nerves and stabilizing spine to prevent deformities, collapse or paralysis

The goal is usually to reduce the severity of symptoms, including:

• Reduction of pain
• Restoration of spine stability to improve mobility
• Preservation of neurological function
• Alteration or change in prognosis

Q. How do I know if I am a candidate for surgery?

A. The following are factors that determine if you are a candidate for surgery:

• Medically stable
• Expected survival of three months or more
• Extent of systemic disease

Q. What are the surgical options?

A. The type of surgery your doctor recommends will depend on the type of tumor, its location and the symptoms you are experiencing. If you have weakness, numbness or paralysis of arms and legs or a change in bladder or bowel function, an open surgical procedure may be necessary. 

• Closed procedure (vertebroplasty) – Using a needle, the surgeon injects special cement into the vertebral body damaged by the tumor.
• Open procedures – These procedures may be done with a surgical incision on the front or back
  o Decompression:  to remove bone that has the tumor and to increase the space around the spinal cord and nerves
  o Stabilization:  application of screws, rods or cement to stabilize the spinal column
  o Combination: both of the above procedures; may be staged one or more days apart

Q. How long is the recovery period after surgery?

A. Your length of stay in the hospital will vary by the extent and type of surgery. A typical hospital stay after spinal tumor surgery is 5 to 10 days, although each person will respond differently and recover differently. 

Following surgery, you may need help with activities of daily living. This is referred to as rehabilitation. Rehabilitation may be done in an inpatient setting, which means you are admitted to a rehab unit or hospital. It can also be done as an outpatient, which means you could receive therapy in your home or be transported to a rehab facility during the week.

Q. What are the othertreatment options?

A. The non-surgical treatment options for spinal tumors are observation, radiation therapy and chemotherapy.

• Observation – Tumors that cause mild or no symptoms and do not appear to be progressing may be observed and monitored with regular MRIs.
• Radiation therapy – If you are a candidate to receive radiation therapy to the spine, you will be evaluated by a radiation oncologist who specializes in radiation treatments. Radiation therapy, if indicated, may be delayed to allow time for healing after surgery.  This will be determined by your doctors.
• Chemotherapy – Usually, chemotherapy for spinal tumors is not indicated. If you require chemotherapy for systemic cancer, you will be referred back to your original oncologist to make determinations regarding chemotherapy.
  
  
  
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Scoliosis: What You Need to Know | Low Cost Scoliosis Surgery in India

Surgery for adolescents with scoliosis is only recommended when their curves are greater than 40 to 45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees.

Unlike back braces, which do not correct spinal curves already present, surgery can correct curvature by about 50%. Furthermore, surgery prevents further progression of the curve.

There are several approaches to scoliosis surgery, but all use modern instrumentation systems in which hooks and screws are applied to the spine to anchor long rods. The rods are then used to reduce and hold the spine while bone that is added fuses together with existing bone.

Once the bone fuses, the spine does not move and the curve cannot progress. The rods are used as a temporary splint to hold the spine in place while the bone fuses together, and after the spine is fused, the bone (not the rods) holds the spine in place. However, the rods are generally not removed since this is a large surgery and it is not necessary to remove them. Occasionally a rod can irritate the soft tissue around the spine, and if this happens the rod can be removed.

Two Approaches to Scoliosis Surgery

There are two general approaches to the scoliosis surgery - a posterior approach (from the back of the spine) and an anterior approach (from the front of the spine). Specific surgery is recommended based on the type and location of the curve.

1. ScoliosisSurgery from the Back (Posterior Surgical Approach)

This approach to scoliosis surgery is done through a long incision on the back of the spine (the incision goes the entire length of the thoracic spine).

·         After making the incision, the muscles are stripped off the spine to allow the surgeon access to the bony elements in the spine

·         The spine is then instrumented (screws are inserted) and the rods are used to reduce the amount of the curvature

·         Bone is then added (either the patient's own bone, taken from the patient's hip, or cadaver bone), inciting a reaction in which the bones in the spine begin fusing together

·         The bones continue to fuse after surgery is completed. The fusion process usually takes about 3 to 6 months, and can continue for up to 12 months

For patients who have a severe deformity and/or those who have a very rigid curvature, another procedure may be required prior to this surgery. A surgeon may recommend an anterior release of the disc space (removal of the disc from the front), which involves approaching the front of the spine either through an open incision or with a scope (thoracoscopic technique) and releasing the disc space.

After the discs at the appropriate levels of the spine have been removed, bone (either the patient's own bone and/or cadaver bone) is added to the disc space to allow it to fuse together.

Removing the discs allows for a better reduction of the spine and also results in a better fusion. These two factors are especially important if the patient is a young child (10 to 12 years old) and has a lot of skeletal growth left.

Without the anterior release procedure, the anterior column (the part of the spine facing the front of the body) can continue to grow, eventually twisting around the fused, non-growing posterior spinal column, forming a new scoliosis curve (called "crankshafting"). Fusing the spine anteriorly prevents this process.

2. Scoliosis Surgery from the Front (Anterior Surgical Approach)

For curves that are mainly at the thoracolumbar junction (T12-L1), the scoliosis surgery can be done entirely as an anterior approach.

·         This approach to scoliosis surgery requires an open incision and the removal of a rib (usually on the left side). Through this approach, the diaphragm can be released from the chest wall and spine, and excellent exposure can be obtained for the thoracic and lumbar spinal vertebral bodies.

·         The discs are removed to loosen up the spine.

·         Screws are placed in the vertebral bodies and rods are put in place to reduce the curvature.

·         Bone is added to the disc space (either the patient’s own bone, taken from the patient's hip, or cadaver bone), to allow the spine to begin to fuse together.

·         This fusion process usually takes about 3 to 6 months, and can continue for up to 12 months.

If this surgery is applicable because of the type of curvature, the anterior approach to scoliosis surgery has several advantages over the posterior approach.

·         Not as many lumbar vertebral bodies will need to be fused and some additional motion segments can be preserved

·         Saving motion segments is especially important for lower back curves (lumbar spine), because if the fusion goes below L3 there is a higher risk of later back pain and arthritis

·         Saving lumbar motion segments also helps prevent loading all the stress on just a few motion segments

·         This approach can sometimes allow for a better reduction of the curve and a more favorable cosmetic result.

  MEDWORLD INDIA

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