Spine Surgeries

Spine Surgeries

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Overview

Spine (vertebral column) is the central structure of our body that helps in keeping us upright. It consists of bony vertebrae, which are separated by cartilaginous intervertebral discs. There are 33 vertebrae divided into 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae. The vertebral column houses an enclosed cavity known as the spinal canal. The spinal cord is an elongated tubular bundle of spinal nerves that runs from C1 vertebra to L1 vertebra within the spinal canal. It originates from the base of brain and ends in the form of a horsetail (cauda equina). There are 31 pairs of spinal nerves that emerge from the spinal cord in between the vertebrae. The entire vertebral column is supported by various ligaments, tendons and muscles. All these soft tissue structures protect the delicate spinal cord and provide flexibility to your spine.

What are symptoms of spinal injury?

  • Consistent back pain for at least 3 weeks
  • Pain that began after an accident or fall.
  • Pain that gets worse at night.
  • Pain radiating to legs
  • Pain associated with tingling and numbness
  • Pain that is accompanied by fever.
  • Associated bladder or bowel problems

What are the causes of spinal injury?

There are several reasons that may lead to back pain or injury to the spine. Some of the most common reasons include-

  • Herniated disc or bulging of the disc
  • Degenerative disc
  • Osteoarthritis
  • Compression fracture of the vertebra
  • Spinal stenosis (narrowing of the spinal canal)
  • Spinal tumours
  • Spinal infections
  • Spinal deformities e.g., scoliosis
  • Sports injuries
  • Motor vehicle accidents
  • Fall

How are spinal injuries treated?

First line of management for spinal disorders/injuries is conservative treatment. Your doctor will prescribe pain relieving medication, anti-inflammatory medications (reduce swelling), corticosteroids injections, physical therapy and spinal brace/immobilizer. If the treatment fails and there is no improvement in symptoms even after 6 to 12 weeks, then surgery is the treatment of choice.

What are the most common spine surgeries?

Here’s the list of the most common spine surgeries

  • Spinal Fusion: This procedure involves the fusion of 2 or more vertebrae in order to correct the deformity or to improve stability. It eliminates the movement between the vertebrae and prevents stretching of nerves and surrounding muscles and ligaments.
  • Laminectomy: This procedure involves the removal of lamina (bone at the back of the vertebrae), bone spurs, or ligaments of the back. This helps in relieving the compression over the spinal nerves. Sometimes, laminectomy can make the spine less stable. Discuss with your doctor about this before going with this procedure.
  • Discectomy: It is a procedure of removal of complete or part of the cushion (disc) to relieve the pressure that herniated disc causes on spinal nerves. Most patients have pain relief after the surgery and they can move better.
  • Artificial disc replacement: This procedure involves the removal and replacement of worn or damaged discs with an artificial disc. This surgery aims to alleviate back pain while allowing more motion in comparison to other surgeries like spinal fusion.
  • Foraminotomy: This procedure helps in widening the passage where spinal nerves exit the spinal canal. It takes off the pressure of the nerve coming out from the spinal canal and thus reducing the pain.
  • Interlaminar implant: In this procedure, a U-shaped device is implanted between 2 vertebrae. This helps in maintaining the gap between them and relieves pressure on spinal nerves. This is a great alternative to more invasive techniques like laminectomy or laminectomy along with fusion surgery. These implants provide more stability.
  • Vertebroplasty and kyphoplasty: These surgeries are used to treat compression fractures. Vertebroplasty uses a percutaneous injection of bone cement into the cancellous bone of a vertebral body. This aims to alleviate pain and prevent loss of height of the vertebral body. In Kyphoplasty, an inflatable balloon is used to create a cavity for the cement aiming to restore the height and reduce kyphosis.
  • Minimally invasive spinal surgeries (MISS): Most spinal surgeries these days are performed in a minimally invasive fashion due to the added advantages that they offer over conventional open surgery. The surgery is performed by making small incisions (size of a keyhole) through which small operating tools are inserted into the spine. The surgery is performed under X ray guidance which improves the accuracy of the procedure. Other advantages of a minimally invasive surgery are-
    • Minimal scarring
    • Less post-operative pain and stiffness
    • Less blood loss
    • Less risk of infection
    • Shorter recovery time
    • Shorter hospital stay

Tips for prevention

  • Avoid lifting heavy objects. In case you need to lift, bend your knee to reach out to the object rather than bending your back. Stand close to the objects you are lifting.
  • Avoid prolonged standing.
  • Avoid wearing high heels. Wear shoes with well cushioned soles.
  • Always sit with your back fully supported. While working on computers, ensure keeping a stool under your feet.
  • Avoid smoking.
  • Maintain ideal body weight.

Tips for healthy spine

  • Improve your posture: Consult your therapist to know about the techniques and precautions that you need to take while sitting and lying.
  • Strengthen your back and abdomen: Exercising regularly and under the guidance of your physical therapist is very important. Exercising not only improves your posture but also improves flexibility which in turn reduces the chances of injury.
  • Eat healthy food and lose weight: Eating a balanced diet not only helps you to achieve a healthy lifestyle but it also reduces the risk of various lifestyle diseases. Keeping yourself active and keeping a calorie count will certainly help you to achieve ideal weight.

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