Spine Surgery In Max Super Specialist Hospital Shalimar Bagh

Ageing, trauma, improper body mechanics, and structural abnormalities can injure the spine causing back pain and other symptoms. In addition, chronic back pain often requires a team of professionals to diagnose and treat it. It is thus advisable to consult different specialists before opting for spine surgery.

Classically neurosurgeons treat brain & spine problems, and orthopaedic surgeons treat other musculoskeletal problems. Orthopaedic surgeons that specialise in spine surgery are popularly known as spine surgeons. However, neurosurgeons rarely dedicated themselves entirely to spine surgery.

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Types

The different types of spine surgeries include:

• Discectomy: In this procedure, the surgeon removes a herniated disk that presses on a nerve root or spinal cord. Discectomy is often performed in combination with laminectomy.
• Spinal laminectomy/spinal decompression: This procedure is performed when spinal stenosis causes narrowing of the spinal canal, resulting in numbness, pain, or weakness in the body. In this procedure, the surgeon removes some positions of the bony walls of the vertebrae and any bone spurs. Their aim is to open up the spinal column and relieve the pressure on the nerves.
• Foraminotomy: In this procedure, surgeons enlarge the bony hole at the exit of the nerve root from the spinal canal. This prevents the bulging of the disks or joints that may have increased in width due to age and have been pressing on the nerve.
• Spinal fusion: In this procedure, the surgeon removes the spinal disc between two or more vertebrae for this procedure. This is followed by fusing the adjacent vertebrae with bone grafts or metal devices. Screws secure these devices or grafts. Spinal fusion may cause loss of flexibility in the spine in some cases.
• Artificial disc replacement: This procedure is considered an alternative to spinal fusion. It is advised for people with severely damaged discs. The procedure involves removing the disc and replacing it with a synthetic disk. The synthetic disc helps restore the height and movement between the concerned vertebrae.
• Vertebroplasty and kyphoplasty: These procedures help repair compression fractures of the vertebrae caused by osteoporosis. Both procedures include the injection of bone cement that hardens and imparts strength to the bone.
• Nucleoplasty: This procedure is also known as plasma disc decompression. It is a surgery that uses radiofrequency to treat pain in the lower back associated with a herniated disc.

Symptoms

Spine disorders are usually asymptomatic unless they affect activities of daily living. Sometimes, patients may experience dull pain in the affected area that worsens with activity.

Other symptoms related to spine disorders include:

• Heavyness & Numbness
• Stiffness of Limbs
• Pius & needle sensation in limbs
• Radiating pain in limbs
• Loss of movement
• Fractures
• Changes in sexual function and fertility
• Swelling around a bone
• Night sweats
• Fevers
• Difficulty in breathing
• Coughing or clearing secretions from the lungs becomes challenging
• Altered sensations such as lack of the ability to feel the heat, cold and touch
• Exaggerated reflex activities or spasms
• Difficulty in lifting objects
• Pain on bending
• Pain due to damage to the nerve fibres of the spinal cord
• Difficulty in lying down or getting up
• Dull or sharp pain
• Restricted mobility
• Limping
• Fatigue
• Weight loss

The emergency symptoms of a spinal cord injury are:

• Increased back pain or pressure in the head, neck, or back
• Weakness
• Impaired breathing after injury
• Uncoordinated parts of the body or paralysis
• Numbness and tingling in the limbs
• Lack of sensation in the limbs
• Loss of bladder control
• Difficulty with balance and walking
• An oddly positioned neck or back
• Twisted neck or back

Diseases That Spine Surgeons Treat

Spinal surgery was formerly the job of only orthopaedic surgeons. However, in the past few decades, even neurosurgeons have developed an interest in spine surgeries. However, not all procedures can be performed by one doctor alone.

Hence, both the specialities treat their respective conditions such as:

Orthopaedic surgeons

Orthopaedic surgeons diagnose and treat musculoskeletal disorders associated with the joints, bones, and muscles. The diseases they treat include:

• Spinal disorders
• Spinal tumours
• Arthritis
• Sports injuries
• Trauma
• Deformities
• Scoliosis
• Kyphosis
• Degenerative disorders
• Problems associated with a specific area of the cervical spine, lumbar spine, lower back and others.
• Congenital disorders

Neurosurgeons

Neurosurgeons specialise in diagnosing and treating neurological issues associated with the brain and primary spinal cord. These include tumours or syringomyelia. While most neurosurgeons exclusively perform brain surgery, some do spine work. Some disorders they treat include:

• Spinal arthritis
• Degenerative disc disease
• Spondylolisthesis
• Osteoporosis
• Bulging or herniated discs
• Spinal stenosis
• Spinal deformities (scoliosis, kyphosis, lordosis)
• Fractures

When to see a Spine surgeon?

Patients may need to see a spine surgeon if they are experiencing any of the following:

• Herniated or ruptured discs.
• Spinal stenosis is a serious condition in which there is a narrowing of the spinal column, and it applies pressure on the spinal cord and its nerves.
• Spondylolisthesis, a condition in which one or more bones on the spinal vertebra slip out of place.
• Vertebral fractures are caused by injury to the spine’s bones or osteoporosis.
• Degenerative disc disease or damage to spinal disks.

Diagnosis

Doctors first inquire about the symptoms and medical history and then perform a physical exam. Various tests that may be advised are:

• X-rays: Bone disorders can be best detected on X rays. They appear as abnormal outgrowths of irregular shape and size, fracture lines, tumours, bone density and other problems that can be evaluated on a radiograph.
• CT scans: A CT scan gives clear images of the tumours’ size, shape, and position and helps identify the enlarged lymph nodes that may be cancerous.
• MRI scans: MRI scans may help examine bone cancer with a detailed view of the structures and may help determine whether or not cancer has metastasized.
• PET scans: In patients with cancer, PET scans can help assess the location of the tumour to assist with spine surgery. The technician injects radioactive glucose into the vein. A scanner then spots cancer cells, which use more glucose than normal cells.
• Bone scans: A technician injects a different radioactive material into the vein. It collects in the bones, where the scanner can see it.

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