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Spine Surgery is categorically divided into Open Spine Surgery or Minimally Invasive Spine Surgery (MISS), also known as Endoscopic Spine Surgery (ESS), or Arthroscopic Spine surgery. It is a surgical procedure that is performed to relieve a person of pain due to spine injuries.
In the conventional approach of spine surgeries, the spine doctor makes a single long incision, spreads, or pulls a relatively large amount of muscle or tissues to fix the spine. Endoscopic spine surgery, on the other, is a state-of-the-art form of minimally invasive spine surgery that incurs less pain and provides quick relief to the patient. ESS, as the name suggests, is performed using a micro-sized incision with the help of an endoscope to visualize the surgical site.
The MISS is generally performed to stabilize spinal joints and vertebral bones caused due to herniated discs, bone spurs, instability of the spines, or spinal tumors.
Aching back? You are not alone. If you are suffering from back pain, chances are, you can ease your pain without undergoing surgery. In many cases, back pain can be treated with conventional methods of pain management such as hot compressions, ice packing, spinal injections, physiotherapy, and non-steroidal anti-inflammatory drugs. But, if the back pain does not get resolved and the pain continues to affect your daily routine, surgery might be a good option for you.
Spine surgery might be a good treatment option for you if conservative treatments show no effective results and the pain continues to be disabling. Spine surgery not only relieves a patient of chronic back pain but also treats associated numbness that spreads to the shoulder or goes down to the legs.
Endoscopic Spine Surgery
Vertebroplasty
Vertebroplasty
Kyphoplasty
Spinal abnormalities mostly involve abnormal interactions between the soft and hard tissue components of the spine. A spine doctor may be able to rule out a spine injury by physical examination, by asking some questions about the accident that has caused the injury, or by testing for your sensory function and movement.
In addition to these tests, the doctor may ask you a few questions to understand the condition better, some of which might be:
If the above procedures don’t suffice in giving out a clear indication of the condition, the spine doctor will conduct a more comprehensive and detailed exam to diagnose the level of injury and determine the best treatment.
But if the responses of the patient are not enough for the orthopedic doctors to determine the best treatment, or if the person shows signs of neurological injury, the doctor might need to run the following diagnostic tests:
CT Scan – A CT Scan provides a clear image of the injury in both soft and hard spinal tissues. The diagnostic test can also detect abnormalities of the vertebrae, spinal cord, and spinal nerves.
About 3 percent of people suffering a spine injury may develop syringomyelia – a condition in which syrinx or fluid-filled cysts form within the spinal cord. Syringomyelia may sometimes cause pain and discomfort, and at other times, cause no symptoms at all.
Long-term muscle contraction due to injury to the spine may cause stiffness and rigidity in the muscles. Spasticity can make movement, including walking and running, difficult for a person. About 70-78 percent of people with spine cord injury suffer from spasticity.
Neuropathic joint arthropathy is a common complication of spinal cord injury. Neuropathic joint arthropathy is a slow destruction of the joint. The condition may develop even 10-15 years after the spine injury. Conservative monitoring, medications, and spinal fusion surgery can treat the condition of Neuropathic joint arthropathy.
Autonomic Dysreflexia is a serious systematic complication of spine injury that hampers proper communications between the brain and the body. Autonomic Dysreflexia causes unregulated breathing, heart rate, and blood pressure.
The temporary loss of neurological activities including the sensory and motor reflux below the spinal cord lesion is known as a spinal shock The complication can occur immediately after an acute spinal injury. While the reflexes above the spinal cord remain unaffected in the condition, the reflexes below the level either become absent (the condition is known as areflexia) or depressed (the condition is known as Hyporefexia). The extent of reflex disruption can vary from one patient to another.
Neurogenic shock can result due to severe damage to the central nervous system. The condition is also known as Vasogenic Shock. Consequences of neurogenic shock include loss of autonomic control and loss of stimulation to the blood vessels.
Like any other surgery, there are certain risks associated with endoscopic spine surgery or MISS, such as:
To cut down these risks, it is important that you consult a trained and experienced spine doctor. Before the surgery, discuss all the questions and concerns, weigh the benefits and the risks and then undergo the surgery.
It is generally performed for spinal stenosis patients. The surgeon removes bony spurs or walls compressing the spinal column to relieve the nerve pressure.
Vertebroplasty and kyphoplasty are performed to fix compression fractures due to osteoporosis. The surgeon injects a glue-like bone cement that hardens and strengthens the vertebrae.
It is a slipped disc surgery that is performed to remove a herniated disc compressing the nerve root and spinal cord. It is often performed in conjunction with laminectomy.
This is performed to widen the spinal column where the nerve root exits the spinal canal in case it has narrowed due to aging.
Nucleoplasty, also called plasma disk decompression is a minimally invasive laser surgery in which the surgeon uses a plasma laser device to reduce the disk size and treat mild disk hernia.
The surgeon removes the spinal disc and fuses the adjacent vertebrae together using bone grafts or metal implants to allow the fusion of vertebrae together via the bone grafts, for example, ACDF surgery (Anterior cervical discectomy and fusion), TLIF surgery (Transforaminal Lumbar Interbody Fusion).
For people with severely damaged vertebral discs, the surgeon removes the disc and replaces it with a synthetic implant to help restore vertebral height and movement.
Spinal laminectomy/ spinal decompression – The cost of spinal laminectomy or spinal decompression may range from INR 1.4 lakh to INR 1.8 lakh in India.
Vertebroplasty/Kyphoplasty – The cost of Vertebroplasty or Kyphoplasty may range from INR 2.3 lakh to INR 3 lakh in India.
Discectomy (or Microdiscectomy) – The average cost of Discectomy may range anywhere between INR 1.4 lakh to INR 1.8 lakh in India.
Foraminotomy – The cost of Foraminotomy may range between INR 1.8 lakh to INR 2.5 lakh in India.
Spinal Fusion – The cost of Spinal Fusion in India can be anywhere between 2.5 lakh to INR 5 lakh.
Artificial Disk Replacement – Artificial disk replacement surgery in India costs between INR 2 lakh to INR 4 lakh in India.
Lumbar Interbody Fusion – The cost of Lumbar Interbody Fusion ranges from INR 2.5 lakh to INR 4 lakh in India.
The above-mentioned costs for different minimally invasive spine surgeries are like to change based on the following factors:
Preparation before a spine surgery includes both physical and psychological aspects. Depending upon the condition of the injury, the doctor is likely to guide the patients with everything necessary. However, here are a few points that may come in handy for anyone planning spine surgery.
Gather all necessary information about spine surgery – The key to preparation for any surgery is being well informed about it. Talk to the doctor, the medical staff, and acquire all important information about the procedure, medicines, the cost, and anything else that comes to your mind. The more well-informed a person is about the surgery, the better he/ she is likely to do postoperatively.
Don’t stop moving – We understand it is tough to live with constant back pain. Even then, it is recommended to be physically active as much as possible. Going stagnant may add to complications during the surgery. Stay physically active, try to achieve a healthy weight. This can speed up the recovery process and enhance blood circulation too.
Don’t take any anti-inflammatory drugs – You should stop taking drugs like ibuprofen, naproxen, and aspirin before the surgery. Blood thinners can increase the risk of complications during the surgery. If you are taking any over-the-counter pills, it is essential that you inform your doctor.
Keep realistic expectations – Don’t expect the surgery to fix everything. The surgery is not a guaranteed cure for the condition. Although it improves the injury symptoms to a great extent, a lot also depends on the person’s dietary and lifestyle habits too.
The famous American actor, George Clooney had suffered a serious neck injury in 2005. The injury had damaged the dura mater – the fluid surrounding the spinal cord – and resulted in chronic pain and prolonged headaches. Reports say that the actor had undergone several spinal surgeries to relieve the pain.
The fastest man on earth had once suffered a spine problem. The Olympic star was diagnosed with curvature in his spine. In 2010, the athlete confirmed his hamstring stretching treatment and his physiotherapy sessions.
The 43rd President of the United States of America had suffered from a persistent disc problem. In 2013, he underwent a spine surgery which was kept low-profile on the internet for a long time.
Mick Mars, the lead guitarist of the band Mötley Crüe, was diagnosed with ankylosing spondylitis at the age of 17. The disorder led to hardening of his spinal cord which resulted in scoliosis, leaving him 3 inches shorter. To treat his condition, he underwent hip replacement surgery in 2004.
The American football player had suffered a herniated disc in his lower back that resulted in a pinched nerve. He suffered prolonged pain from the injury. In 2013, the sportsperson underwent a minimally invasive surgery (microdiscectomy), in which a small part of his herniated disc was removed in order to relieve him of his pressure.
Bollywood actor Boman Irani was diagnosed with a herniated disc at lumbar segments 4 and 5. Although the actor tried physical therapy, the pain stubbornly kept coming back.
Myth 1: Spine surgeries are always major surgeries
Fact: Not all spine surgeries are major. Minimally invasive spine surgeries involve small incisions instead of large cuts and can allow a person to get back to regular life within the shortest possible time. Spine surgery, over the years, has become simpler, faster, and safer. There is not much scarring involved either. In short, nothing much to worry about.
Myth 2: recovery after spine surgery is very painful.
fact: Of course, there is some amount of pain after the surgery, but it is bearable. The pain also gradually starts to decline 2-3 days after the surgery. As time passes, the pain is likely to subside. Mild pain is likely to remain for a month or so.
Myth 3: A spine specialist will always recommend surgery.
Surgery is not for everyone, and your physician knows that. When you consult a spine specialist, surgery is one option they may consider depending upon the severity of the damage. In low-grade traumas, they might consider curing the back pain or instability without surgery using physical therapy or acupuncture.
Myth 4: Recovery from spine surgery takes a very long time.
It’s true that some back surgeries do take time to heal. But it is important to understand that the recovery time depends on many factors, such as your age, the part of your back being operated on, the specific procedure being performed, or your overall health. Not everybody needs the same amount of time.
Recovery from a discectomy or foraminotomy might take only a couple of weeks. On the other hand, if you have a laminectomy or fusion surgery, it can take at least three or four months after surgery for the bones to heal. In some cases, it may take up to a year for them to heal completely.
Most insurance companies cover the cost of all spine surgeries. But the exact amount of coverage depends on your health insurance policy. To know the details, it is best that you talk to your insurance provider to discuss the insurance coverage of our surgery.
Once you are home from the surgical center, it is time to focus on your recovery. Allowing the spine to heal properly, taking ample rest, and eating healthy foods are the keys. The best advice, however, is to follow the after-care tips by the spine surgeon for a speedy and safe recovery.
Take good care of the spine. Begin with short walks and gradually increase the distance and time. Moderate exercise enhances muscle toning and builds strength. Avoid twisting, lifting, and bending. If you have had a spinal fusion, avoid lifting weights.
Eat a well-balanced diet rich in fruits and vegetables. Since you will be less active physically, do not load the body on high calories and fatty foods. Healthy eating is crucial for smooth recovery.
Follow the advice of the doctor for bathing and incision care. Typically, doctors recommend keeping the surgery site clean and dry for 3-4 days. Avoid getting into the bathtub or the swimming pool until the doctor deems fit.
Take medicines for pain management after the surgery as directed by the doctor and make sure there are no gaps. Do not take any medicine without informing your doctor.
Ask your surgeon what is the best position to sleep in without hurting the back and try to follow it. Ideally, the following tips help relieve the stress from the back and the adjacent body parts.
– Place a pillow under the knees or the back to keep the hips slightly bent.
– Don’t get up suddenly from the bed. Use the ‘log roll method.’
– While getting up, push your arms and legs rather than exert pressure on the waist or back.
Wear a post-operative brace if the surgeon prescribes one. The brace provides support to the neck and back and limits movements of the spinal levels.
Ask your doctor if you may require physical therapy after the surgical treatment. Physiotherapy helps gain and build bone and muscle strength, and increase physical endurance. Ask your doctor if you need to include any form of exercise in the recovery regime.
The post-operative routine you adopt as part of your recovery from spine surgery can help prevent future or additional spine/health-related problems. So, it is important to maintain an active life, practice exercising, eat well, and get plenty of rest to stay on that recovery road for a long time!
Despite many challenges to the validity of clinical trials in orthopedic surgery, it is possible to conduct well-designed trials in this field and produce clinically important findings and reasonably valid conclusions about effectiveness, prognosis, and diagnosis in orthopedic surgery.
New technologies involving hybrid procedures for the treatment of complex spine trauma are now on the horizon. Surgical corridors have been developed utilizing the interspinous space for X-STOP placement to treat lumbar stenosis in a minimally invasive fashion.
Cities Where We Treat Spine-surgery
A spinal cord compression and a nerve compression is medically different from each other. While spinal cord compression may affect the overall functioning of the body, nerve compression may cause pain, sensory loss, and motor impairment.
The duration of a spine surgery depends on the complexity. But for most cases of minimally invasive spine surgery, the duration is approximately 1-2 hours.
In the case of cervical spine surgery, the incision is either made in the posterior cervical (back of the neck) or in the anterior cervical (front side of the neck). The decision entirely depends on the location of the health problem.
If you undergo minimally invasive spine surgery, you can resume your normal activities within 6-8 weeks, including bending, lifting, and twisting movements. However, some spine surgeries like spine fusion procedures may take longer recovery time depending on the location and severity of the condition.
Although it is rare, children can develop spine disorders. Spinal disorders in children can be both prenatal and postnatal. Some spine problems are present at birth, but as the baby grows, they become more apparent, like congenital scoliosis, while some are diagnosed in a prenatal ultrasound itself, like osteoporosis. In severe cases, the baby might even need scoliosis surgery immediately.
To confirm if a person is the right candidate for spine surgery or not, a detailed consultation with a spine surgeon is absolutely necessary. In common scenarios, an individual with the following problems is considered a good candidate for endoscopic spine surgery.
– One who has persistent pain in the back
– One who faces problems in bending, lifting, taking the stairs, or walking for long after a back injury
– One who has been diagnosed with spinal stenosis, a herniated disc, or spondylolisthesis.
Spine surgery is a critical surgery. Hence, it is crucial to find a highly trained and experienced surgeon for the treatment. A good spine surgeon is one who has a steep experience curve in performing successful spinal surgeries and is trained in multiple spine surgical procedures including minimally invasive techniques. The track record of the surgeries that the doctor has performed during their professional career, reviews, and testimonials of his/ her patients can be of help to a great extent.
Medical research shows that minimally invasive spine surgery has a success rate of over 90 percent. But the percentage is not absolute and completely depends on how critical the condition of the spine injury is.
Facts and figures around spine surgery
Understanding medical terms related to spine injury and spine surgery
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