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SPINE

Spine

Spine surgery is one of the most complex and complicated surgical procedures performed to treat the wide range of spinal diseases and abnormalities of the spine and spinal cord. Spinal surgery is often performed to reduce deformity, stabilize a painful segment, and decompress the nerves of the spinal cord.

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When is a Spine Surgery Recommended?

An Orthopedic surgeon recommends for Spine Surgery to:

  • Take Pressure Off of Spinal Cord Nerves: Some medical conditions like disc herniation and spinal stenosis compress the nerves in the spinal column that can lead to pain, tingling, numbness, muscle weakness, and other severe symptoms. In this case, spinal surgery is typically required to avoid permanent impairment. This can be accomplished through surgeries like a laminectomy, AnteriorLumbar Interbody Fusion(AILF), or Lateral Lumbar Interbody Fusion(XLIF).
  • Stabilize an Unstable, Painful Spine: An unstable spine is observed during medical conditions including spinal fractures, spondylolisthesis, or an extreme disc injury. Spine surgery is often recommended when symptoms progress to intractable back pain, leg pain, or significant neurologic problems from a pinched nerve. This is best achieved by fusing the unstable spine parts through an ALIF, Posterior Lumbar Interbody Fusion(PLIF), or Lateral Interbody Fusion.
  • Realign a Crooked Spine: Some medical conditions like scoliosis, kyphosis, and flat-back syndrome, affect the natural curvature of the spine resulting in various impairments. In instances when the spinal curvature exceeds a certain degree, surgical intervention is needed to realign the spine. Surgical intervention is also required for flat-back syndrome if symptoms are not relieved through non-operative measures.

Basic Tests Performed Before Spine Surgery

If a specific condition that might be causing the back pain is suspected, then the surgeon may prescribe one or more of the following tests:

  • X-ray: An X-ray is a useful test that helps your doctor understand the cause of chronic back pain or view the effects of injuries, disease, or infection. Your doctor may suggest a lumbar spine X-ray to diagnose birth defects that are affecting the spine, injury/fractures to the lower spine, severe low back pain, osteoarthritis, osteoporosis, abnormal curvature.
  • Magnetic Resonance Imaging(MRI) Scan: The MRI scan is an imaging test that allows physicians to examine a patient’s spinal anatomy and investigate an anatomical cause of the patient’s back pain. The physician then correlates the findings on the MRI scan with the patient’s signs and symptoms of back pain to arrive at a clinical diagnosis.
  • Computerized Tomography(CT) Scan: Your doctor can view a cross-section of the lower back, in case of a lumbar spine CT scan. A CT scan is one of the many imaging tests a doctor may use to evaluate spine problems including pain due to injuries, disease, or infection.
  • Blood Tests: Blood tests are generally not used for examining the cause of back pain. However, in some cases, they are performed if your doctor suspects an infection or inflammatory arthritis.
  • Bone Scan: One of the potential sources of back pain can be the lumbar spine facet joints. A nuclear medicine Bone Scan with SPECT/CT imaging might be helpful if the clinical suspicion is for this area being the problem. A nuclear medicine Bone Scan involves injecting small amounts of a radioactive substance that attaches to the bones.
  • Electromyography(EMG): Electromyography examines the electrical activity of a nerve root and is sometimes recommended for patients with back pain. After three weeks of pressure on a nerve root, the muscle begins to spontaneously contract. Nerve compression slows electrical conduction along that nerve. EMG’s are also used to distinguish nerve degeneration from nerve root compression.

Spinal Surgery Procedures

  • Cervical Spine Surgery: It is a type of neck surgery for removal of the damaged disc to relieve nerve root pressure or spinal cord and alleviate corresponding pain, weakness, numbness, and tingling. The surgery comprises of two parts:
    • Anterior Cervical Discectomy: The surgical procedure is approached through the anterior of the cervical spine(neck). The disc is then removed from between the two vertebral bones.
    • Fusion: Fusion surgery is performed at the same time as the discectomy operation to stabilize the cervical segment. Fusion surgery involves placing a bone graft and/or implants where the disc originally was to provide stability and strength to the area.
  • Lumbar Spine Surgery: This is the most common surgery for lumbar spinal stenosis. In this surgical procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in the back. This would relieve pressure on spinal nerves and ease pain or weakness.
  • Minimally Invasive Spine Surgery(MISS): Minimally Invasive Spine Surgery is a type of surgical procedure performed on the bones of the backbone. This surgery uses smaller incisions than open surgery causing less harm to nearby muscles and other tissues. This leads to less pain and faster recovery after surgery.
  • Scoliosis Surgery: Scoliosis Surgery is a surgical procedure for fixing an abnormal curve of the spine known as scoliosis. This surgery uses smaller incisions than open surgery. The spine has some normal curves backward and forward. However, it should not curve to the side. Rods and screws are attached to the spine to help make it straighter.
  • Slip Disc: Discectomy is the most common surgical procedure used for a herniated disc in the lumbar region. The portion of the disc that is causing the pressure on the nerve root is removed in this surgery. In certain cases, the entire disc is removed. The surgeon will access the disc through an incision in the back(or neck).
  • Spinal Fusion: Spinal fusion is a surgical procedure to correct problems with the small bones in the spine(vertebrae). The main goal is to fuse together two or more vertebrae to heal into a single, solid bone. This is done to restore stability to the spine or to eliminate painful motion.

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