Minimally Invasive Spine Surgery
The latest treatment option, Minimally Invasive Spine Surgery allows for the surgery to be performed through much smaller in+6-cisions and relatively less muscle damage.
Microscopes, and small instruments are used for making a small incision ? 1 to 2 cm long, and the muscles are retracted using tubes rather then cutting them, thus reducing muscle damage. Almost all surgeries, including instrumentation and disc replacement surgeries can be performed by a Minimally Invasive approach.
Very few spine surgeons are trained in the Minimally Invasive Surgery technique.
The Asian Orthopedic Institute is one of the few hospitals in Western India consistently performing this technique with good results.
- Small cuts hence less tissue damage
- Less pain
- Faster recovery ? patient can be discharged within 2 to 3 days
- Better cosmetic outcome ? no ugly scars
- Absorbable sutures used ? no requirement for suture removal
Endoscopic Spine Surgery is advancement over Minimally Invasive Spine Surgery. It is usually done for selected cases like disc prolapse in healthy individuals.
No general anesthesia is given. A small tube is inserted into the disc directly under image guidance, then the disc material or any structure compressing the nerve is removed with the help of specialized instruments. This is especially beneficial for young, active individuals.
Asian Orthopedic Institute is the only hospital in Mumbai, offering this new technique.
In addition to the benefits of Minimally Invasive technique, Endoscopic Surgery has the following benefits
- Surgery is performed under general anesthesia, hence patient fully conscious all through surgery
- Faster recovery ? patient is discharged within 6 to 8 hrs post surgery in contrast to 3 to 5 days in conventional surgery
- Patient goes back to his normal daily routine within two weeks of surgery
Anatomy of Spine
- Bones called vertebrae
- Cushions in between vertebrae called discs
- Ligaments and joints which connect the various bones to each other
- Nerves coming out behind each disc
What are the most Common Spine Disorders?Open or Close
is the degeneration of one or more spinal structures due to stress/age, leading to pressure on the nerves People with spondylosis usually complain of pain, numbness in hands/legs, weakness in fingers/toes and are unable to work for long hours. It is diagnosed after a thorough clinical examination by a qualified spine surgeon and radiological investigations like X-rays, CT scans and MRI scans. Sometimes some special nerve tests may also be required.
The disc is made up of a soft gel-like center, called nucleus, and a tough exterior, called annulus. A Slip Disc is when the annulus gets damaged and gives way, causing the nucleus to come out. The disc after coming out presses on the nerves causing pain, numbness and sometimes weakness. The disc can get damaged due to many reasons ? inadequate exercise, obesity, improper posture, sudden heavy activities and smoking.
Other Disorders of the Spine
Bones get weak due to loss of calcium and phosphorous. It happens in old age and in people with problems like diabetes, renal disorders, etc. People with osteoporosis have frequent complaints of back pain and are more prone to fractures.
Tuberculosis of spine ?
The most common infection affecting the spine in Indian population in all age groups. If not diagnosed early and treated properly with anti-TB medicines, along with surgery sometimes, it can cause permanent weakness and spine deformity.
Deformity of the spine due to an infection or other genetic problems. Usually detected in late childhood or adult age. By then, the person has a severe deformity, not cosmetically appealing and may cause pain and weakness. Surgery is the only option.
What is the diagnostic procedure and treatment for spinal problems?Open or Close
It is important to first get an accurate diagnosis by an expert. Various investigations like X-rays, blood tests and other scans are done to confirm the diagnosis. Several non operative and operative options are available for treatment.
Do all spine problems require surgery?Open or Close
Most patients can be managed by non-operative methods, provided they don't have any other neurological problems. About 80 to 90% of spinal problems can be treated by non-operative methods.
At the Rehabilitation Department, at Asian Orthopedic Institute, more focus is given to other modalities like ergonomics, lifestyle and workplace modifications apart from physiotherapy, to enable the patient to work without any pain.
Other modalities available are IFT, ultrasonic therapy, Lumbar and Cervical traction. These all combined with exercises can help to a great extent in reducing the pain and building the muscle strength.
?Besides physiotherapy, pain can also be reduced to a great extent by injections like Epidural, root blocks and facet blocks and radiofrequency ablation in people whose spinal problem is not severe.
Do medicines help in reducing the pain?Open or Close
Painkillers if taken in large doses or for a longer duration can cause severe side effects like kidney failure, liver problems and gastritis with tendency to develop ulcers. Other ways to treat pain need to be discussed with your Doctor.
How long can we try physiotherapy?Open or Close
If effective, physiotherapy can be continued for a longer duration, under the supervision of a spine surgeon. However, if the patient experiences more pain or develops weakness in the hands or legs while exercising, physiotherapy should be immediately stopped and the spine surgeon should be consulted.
What if medicines or physiotherapy are not helping?Open or Close
If pain persists, even after an extended course of physiotherapy or is aggravated during physiotherapy, it probably means that the spinal condition is more severe. In such a scenario a surgery is necessary.
Is spine surgery dangerous, will I be bedridden after surgery?Open or Close
With the availability of advanced instruments and newer techniques, spine surgery is a very safe option. People who undergo a spine surgery are back on their feet faster and live a better quality of life. They are also capable of doing all their daily and strenuous activities.
Is old age a hindrance to spine surgery?Open or Close
No. In fact, most of the spine problems occur in people after the age of 50, hence age is not a restriction for spine surgery provided the person is medically fit.