Minimally Invasive Spinal Fusion Surgery at India

What is Spinal Fusion?

The operation of spinal fusion is performed to correct issues related to the little bones of the spine. The fusion is primarily in deep trouble eliminating the pain that has been caused by abnormal motion of the vertebrae. spine 1spinal fusion is essentially performed within the body part region of the spine and is additionally wont to treat pectoral and cervical issues. fusion relieves symptoms of many back issues that includes –
• Infection
• Degenerative disk disease
• Tumor
• Spondylolisthesis
• Fracture
• Scoliosis
• Spinal stenosis

The basic role of spinal fusion with Instrumentation & Stabilization is to produce further spinal stability whereas setting-up associate surroundings for fusion. numerous types of medical instrumentation devices are developed to assist successful spinal fusion as bones tend to fuse effectively during a stabilised atmosphere with very little motion. Instrumentation may be a style of ingrained medical device that helps fusion set-up by limiting motion at the united phase. Sometimes manufactured from titanium or stainless steel, instrumentation devices usually are available in several shapes & sizes to suit specific set-ups.

Types of Spinal Fusion Surgery:-

Lumbar spinal fusion can be divided into two categories.

Posterolateral Fusion : In the back of the spine, the bone graft is placed in amid the transverse processes. With the help of wires and screws, the vertebrae is carefully fixed throughout the particles of every vertebrae. A rod is made up of metal which is attached on the side of vertebrae.

Interbody Fusion : In this, the graft of the bone is placed in between the vertebrae and the area is generally engaged by the intervertebral disc. The disc is entirely removed in preparing for the spinal fusion. In order to maintain the disc height and spine alignment, a device can be placed in between the vertebrae. This device (intervertebral device) can either be prepared from titanium or plastic.

Then the fusion starts in between the vertebrae’s endplates. Interbody fusion is of 3 types-

o Posterior Lumbar Interbody Fusion (PLIF)

o Transforaminal Lumbar Interbody Fusion (TLIF)

o Anterior Lumbar Interbody Fusion (ALIF)

o Transpsoas Interbody Fusion (XLIF or DLIF)

Posterior Lumbar Interbody Fusion (PLIF)

In Posterior lumbar interbody fusion, the spinal fusion is achieved through a surgical incision made on the posterior (back) aspect of spine. It aims at fusion of two adjacent vertebrae in cases of spinal instability and associated back pain. It is a popular procedure as it gives excellent results. The procedure provides almost complete relief of symptoms in 90-95% of the cases and the patients are able to return to their daily activities within a few weeks. The patients can also return to most of their recreational activities.

Who can perform my spinal surgery?
Both neurosurgeons and orthopedists are trained in spinal surgery and that they each perform the surgery. it’s vital that your doctor has experience in performing arts this sort of surgery.

Procedure for Posterior Lumbar Interbody Fusion (PLIF)

PLIF surgery aims at achieving spinal stability through bony fusion.

The Open PLIF is the traditional technique which is performed using general anesthesia. The patient is made to lie down on his front side on the table with the low back exposed. A 3-6 inch long incision is made on the skin overlying the affected vertebrae. The skin and the fascia are cut open. The underlying muscles are retracted and the affected vertebrae are identified. Fluoroscopic X-ray is used to confirm the exact location of the affected vertebrae. Then a complete laminectomy (removal of the lamina of the vertebrae) followed by bilateral foraminotomy (enlargement of the foramen by removing the bony spurs) and/or discectomy (removal of offending disc) are performed.

This relieves the compression off the spinal nerves, allowing them to come to their normal size and shape. The area is checked for any remaining bony outgrowth or disc fragments that may compress the nerves. Autogenic bone grafts or Metal or plastic implants are fitted in the empty disc space for initiating bone growth.

What should I do when the surgery?
Resume our low-impact activities as shortly as possible, beginning with walking. Walk a trifle farther daily. spinalcordfunctioningOnce your staples are removed, you’ll swim, that is a wonderful variety of exercise for patients with back issues.

 

Could I be paralyzed? 

The probabilities of such injury are terribly low and also the chance of fatal injuries like paralysis, impotence or loss of bladder management is very unlikely.

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Minimally Invasive Spinal Fusion Surgery at India

Scoliosis Surgery in India

What is Scoliosis Surgery?

Our spine is an engineering marvel that supports our weight and ties our body along. The spinal column consists of a stack of little bones that aim size from 2-3 inches to 5-6 inches in diameter. once viewed from the front, the spine seems to be straight, however once checked out from the facet, the normal spine has two mild S-curves.

Scoliosis is an abnormal curvature of the spine. In scoliosis, the spine curves to the side once viewed from the front, and every vertebra conjointly twists on subsequent one in a very corkscrew fashion.scoliosis-surgery-india
Scoliosis surgery is one in every of the longest and most complicated orthopedic surgical procedures performed on youngsters or adult. The operation takes close to six hours. Hospitalization will last many days and activities are restricted for many months. scoliosis is best treated once found early and might be detected throughout a routine school screening.

Scoliosis surgery is meant to reduce the patient’s curvature and fuse the spine to prevent any more progression of the deformity. Surgery for adolescents with scoliosis is barely recommended once their curves are larger than forty to forty five degrees and continued to progress, and for many patients with curves that are larger than fifty degrees. Severe curvatures (greater than fifty degrees) are additional probably to progress in adulthood. If a curve is allowed to make seventy – ninety degrees, it’ll not only end in a really disfiguring deformity, however can begin to end in cardiopulmonary compromise. each other, forming a C or S form within the spine.

What are Types of Scoliosis?

There are several types of scoliosis. Each of them are named and defined according to the age, cause of scoliosis and spinal curvature. There are two basic types of scoliosis:

1.  Structural: is caused by neuromuscular diseases, certain infections, birth defects, injury, connective tissue disorders, metabolic diseases, rheumatic diseases, tumors and other unknown factors

2.  Nonstructural: or functional scoliosis is reasoned by underlying conditions such as a difference in leg length, muscle spasms, or inflammatory conditions including appendicitis.

3.   Idiopathic scoliosis: is the most common type of scoliosis based on age. It affects about 4% of the population, commonly females. The reasons may include differences in leg length, hereditary conditions, injury, infections and tumors. It is subdivided into three categories:

1. Infantile scoliosis: extends from birth to age three

2. Juvenile scoliosis: is caused between the ages three and nine

3. Adolescent scoliosis: scoliosis extends from 10 to 18

The Common Procedures for Scoliosis Surgery in India

1.Posterior Approach (Back): The posterior approach has been the gold standard for years to treat scoliosis and continues to be a surgical procedure applicable to most patients. The procedure usually involves implanting two metal rods (stainless steel or titanium) to correct the abnormal curvature. Sometimes more than two rods are needed. A combination of screws, hooks and wire may be used to anchor the rods to the spine. A spinal fusion procedure helps to weld the bone grafts and vertebral of the spinal column into a solid mass. Thoracoplasty involves rib resection (partial or total removal) to decrease the size of the rib hump caused by scoliosis. The rib bone can be used as a source of bone graft used in the fusion procedure. Today, with pedicle screw fixation, Thoracoplasty is less commonly performed than previously. The average hospital stay for most operations ranges from four to seven days.

2.Spinal fusion with instrumentation: Spinal fusion is the most widely performed surgery for scoliosis. In this procedure, bone (either harvested from elsewhere in the body autograft or from a donor allograft) is grafted to the vertebrae so that when it heals they will form one solid bone mass and the vertebral column becomes rigid. This prevents worsening of the curve, at the expense of some spinal movement. This can be performed from the anterior (front) aspect of the spine by entering the thoracic or abdominal cavity or, more commonly, performed from the back (posterior). A combination is used in more severe cases. Originally, spinal fusions were done without metal implants. A cast was applied after the surgery, usually under traction to pull the curve as straight as possible and then hold it there while fusion took place. Unfortunately, there was a relatively high risk of pseudarthrosis (fusion failure) at one or more levels and significant correction could not always be achieved.

3 Thoracoplasty: A complementary surgical procedure a surgeon may recommend is called Thoracoplasty (also called costoplasty). This is a procedure to reduce the rib hump that affects most scoliosis patients with a thoracic curve. A rib hump is evidence that there is some rotational deformity to the spine. Thoracoplasty may also be performed to obtain bone grafts from the ribs instead of the pelvis, regardless of whether a rib hump is present. Thoracoplasty can be performed as part of a spinal fusion or as a separate surgery, entirely. Thoracoplasty is the removal (or resection) of typically four to six segments of adjacent ribs that protrude. Each segment is one to two inches long. The surgeon decides which ribs to resects based on either their prominence or by determining those which are unlikely to be realigned by correction of the curvature alone. The ribs grow back, and will grow back straight.

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Scoliosis Surgery in India

Laminoplasty Spine Surgery in India

Laminoplasty Surgery 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. laminoplasty-surgery-in-india1This 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.

 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 is Laminoplasty done?

A laminoplasty is performed via an incision in the back of the neck which is called a posterior approach. During surgery, the patient lies on the back under anesthesia.

Specialized monitoring devices are used to check the spinal cord during the surgery to ensure that there is no damage to the spinal cord during the surgery. The bone overlying the spinal cord (the “lamina”) is partially cut on both the right and left sides. This creates a hinge on one side of the lamina and a small opening on the other side. The lamina is then moved into the “open” position by elevating the lamina on the open side, which increases the space available for the spinal cord and takes the pressure off of it.

The spinal cord can move away from whatever was compressing it including disc herniations or bone spurs and the spinal fluid can then flow around the spinal cord more normally. A spacer made out of bone, metal, or plastic, is usually inserted to hold the spinal canal open. The final position resembles an open door being help open with a door stop, and many surgeons refer to this technique as an “open-door” laminoplasty

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Laminoplasty Spine Surgery in India

Spine Tumor Removal Surgery in India

Spine Tumor Removal Surgery

Tumor iimages12s 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.

Following are different types of Spinal tumors based on their cancerous or non-cancerous behavior.

Benign bone tumors are of following types:

  • Giant Cell Tumor: Usually found in the sacrum
  • Hemangioma: Usually found in the thoracic spine
  • Osteoid Osteoma: Usually found to affect the lumbar spine’s posterior spinal column
  • Osteoblastoma: Usually found to affect the spine’s posterior spinal column

Malignant bone tumors are classified as follows:

  • Chordoma: Affects the sacrum and coccyx in the midline
  • Osteosarcoma: affect the anterior vertebral body and it may also invade the Posterior spinal elements.

Malignant cartilage tumor:

  • Chondrosarcoma; Found primarily in the thoracic, lumbar, and sacral spine

Malignant plasma cell tumors:

  • Plasmacytoma is cancer of the white blood cells (plasma cells) which effects the thoracic spine and may also involve the spinal cord ot the nerve roots.
  • Lymphomas are cancer of the body’s lymphatic system that may spread to the spine .Usually the anterior part (front) of the spinal column is affected

Ewing’s Sarcoma: It affects the Sacrum or the nerves.

Symptoms of Spinal Tumour

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.

Why surgery for Spine Tumor Removal?

• When the tumor is removed (partially or completely) pain and neurologic problems may clear up.

• To restore and preserve neurological function and provide spinal stability.

• Spinal Tumor surgery is generally indicated in case there is a localized tumor which can be removed with minimum damage to nerve and spinal cord,

• There is persistent neurological deficit and pain which is unresponsive to non operative treatment

• Surgery may include resection (partial removal) or excision (complete removal) of tumor.

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Spine Tumor Removal Surgery in India

Most Advanced Minimally Invasive Spine Surgery in India | Best Spine Hospital India

Minimally Invasive Spine Surgery in India

Spine surgery is traditionally done as “open surgery,” meaning the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.Because minimally invasive spine surgery (MISS), does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.
Spine surgery is typically recommended only when a period of nonsurgical treatment — such as medications and physical therapy — has not relieved the painful symptoms caused by your back problem. In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis. Minimally invasive techniques are beginning to be used for a wider range of spine procedures, and have been used for common procedures like decompression and spinal fusion since the 1990s. Decompression relieves pressure put on spinal nerves by removing portions of bone or a herniated disk. Spinal fusion corrects problems with the small bones of the spine (vertebrae). The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. This article focuses on decompression and fusion with a minimally invasive technique.
Minimally Invasive Spine Procedures
There is a rapid increase in technology that allows the MIS physician to treat patients with minimally invasive spine surgery procedures. Some of these techniques are now well established, while others remain new and continue to evolve. The best MIS (Minimally Invasive Spine Surgery) technique will depend on the specific character of the problem. While the list of MIS (Minimally Invasive Spine Surgery) techniques continues to expand, the most commonly employed today include:
Comparing Minimal type of Invasive spine surgery to Invasive Spine Surgery:
Minimal Invasive Spine surgery comes with more benefice than invasive spine surgery.

Candidates
People with back pain, numbness or weakness in upper or lower limbs who are not responding to non surgical treatments like pain killers, non steroidal anti inflammatory drugs and physiotherapy can consider surgery. They need further investigations like X-ray/ CT scan/ MRI to confirm bulging or protruding disc which can be corrected by surgery.
Surgery for herniated disc should be considered emergency if there are symptoms of pressure on the spinal cord or on the cauda equine or cases involving serious or increasing paralysis
Expected Results
The results of herniated disc surgery are good. A successful surgery relieves the symptoms of herniated or slipped disc in up to about 90% of the patients.
Recovery
Recovery is different for each patient. However, it is normal to feel pain at the site of surgery for the first few days which can be controlled with medication. You would be advised to start physical therapy after a week of the surgery for rehabilitation. You would be able to return to normal activities in about two weeks while full recovery may take few weeks to months. Your treating surgeon would advise you about the rehabilitation and when to start rigorous activities.
Most Advanced Minimally Invasive Spine Surgery in India | Best Spine Hospital India