What is Spinal Surgery?
Spinal surgery is a medical procedure performed to alleviate pain caused by spinal problems. It aims to stabilize spinal joints and vertebral bones that have been affected by hernIt aims to stabilize herniated spinal joints and affected vertebral bones.
Herniated discs, spinal abnormalities, bone spurs, spinal injuries, or spinal tumors all have the potential to affect spinal joints and vertebral bones, discs, spinal abnormalities, bone spurs, spinal injuries, or spinal tumors. Spinal surgery is also referred to as Endoscopic Spine Surgery (ESS), Minimally Invasive Spine Surgery (MISS), or Arthroscopic Spine Surgery.
These advanced techniques have minimal impact on the surrounding muscles and tissues of the spine, resulting in reduced pain and a shorter recovery period compared to traditional spinal surgery.
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Apollo Gleneagles Hospital
No. 1, Elgin Rd, Sreepally, Ballygunge, Kolkata, West Bengal 700020
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Fortis Memorial Research Institute
Sector - 44, Opposite HUDA City Centre, Gurugram, Haryana 122002
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Manipal Hospital
98, HAL Old Airport Rd, Kodihalli, Bengaluru, Karnataka 560017
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Indraprastha Apollo Hospital, New Delhi
Indraprastha Apollo Hospital, Mathura Rd, New Delhi, Delhi 110076
Open 24 Hours
Types of Spinal Surgery
- Spinal Laminectomy/Spinal Decompression: This procedure is commonly carried out for patients with spinal stenosis. The surgeon removes bony spurs or walls that are compressing the spinal column to relieve pressure on the nerves.
- Vertebroplasty/Kyphoplasty: To treat compression fractures brought on by osteoporosis, vertebroplasty and kyphoplasty are procedures. The surgeon injects a bone cement-like substance that hardens and strengthens the vertebrae.
- Discectomy (or Microdiscectomy): This surgery is conducted to remove a herniated disc that is compressing the nerve root and spinal cord. Laminectomy is frequently combined with it during surgery.
- Foraminotomy: This procedure involves widening the spinal column where the nerve root exits the spinal canal, especially if it has narrowed due to aging.
- Nucleoplasty: Nucleoplasty, also known as plasma disk decompression, is a minimally invasive laser surgery. The surgeon uses a plasma laser device to reduce the size of the herniated disc and treat mild disc herniation.
- Spinal Fusion: In spinal fusion, the surgeon removes the spinal disc and fuses the adjacent vertebrae together using bone grafts or metal implants. This allows for the fusion of vertebrae via the bone grafts, such as ACDF surgery (Anterior Cervical Discectomy and Fusion) or TLIF surgery (Transforaminal Lumbar Interbody Fusion).
- Artificial Disc Replacement: For individuals with severely damaged vertebral discs, the surgeon removes the disc and replaces it with a synthetic implant, restoring vertebral height and movement.
Diagnosis Prior to Spinal Surgery
Before undergoing spinal surgery, a doctor will conduct a physical examination to assess the spinal issues. They may ask questions to gain a better understanding of the condition. Commonly asked questions may include:
Experience pain in your back or neck
Have you suffered from any back injury or undergone any neck or back surgery? Do you feel weakness or experience a loss of balance in your legs?
After the physical examination, various diagnostic tests are recommended to obtain a clear image of the spinal abnormality. The following tests are commonly recommended:
- X-ray: X-rays are used to study the structural anatomy of the hard tissues of the spine, helping diagnose conditions such as spine dislocation, kyphosis, scoliosis, bone spurs, disc space narrowing, vertebral body fracture, spinal collapse, or erosion.
- Magnetic Resonance Imaging (MRI): MRIs help diagnose abnormalities in the soft tissue components of the spine, such as the spinal cord and nerves.
- Computed Tomography (CT) Scan: CT scans provide a detailed view of both the hard and soft tissues of the spine, aiding in the diagnosis of abnormalities in the vertebrae, and other soft and hard tissues, including the spinal cord and nerves.
Preparing for the Surgery
Preparation for spinal surgery involves both physical and psychological aspects. Depending on the injury's condition, the doctor will provide necessary guidance. However, here are a few points that can be helpful for anyone planning to undergo spinal surgery
- Gather comprehensive information about the surgery: It is crucial to be well-informed about the surgery. Engage in discussions with the doctor and medical staff to acquire important information about the procedure, medications, costs, and any other concerns. The more informed you are about the surgery, the better your postoperative experience will be.
- Maintain physical activity: Despite the challenge of living with constant back pain, it is recommended to stay physically active as much as possible. A sedentary lifestyle may lead to complications during surgery. Engaging in physical activity and achieving a healthy weight can accelerate the recovery process and improve blood circulation.
- Discontinue anti-inflammatory drugs: Prior to surgery, it is important to stop taking drugs like ibuprofen, naproxen, and aspirin. These blood thinners can increase the risk of complications during surgery. Any over-the-counter medications you are taking should be disclosed to your doctor.
- Set realistic expectations: It is important to have realistic expectations about the surgery. While it can significantly improve the symptoms of your condition, it may not be a guaranteed cure. The outcome also depends on your dietary and lifestyle habits.
What to Expect During Endoscopic Spine Surgery?
Endoscopic spine surgery is an advanced, minimally invasive procedure designed to provide patients with a faster recovery time and less recurring pain compared to traditional methods of spinal surgery. Most endoscopic spine surgeries are performed under general anesthesia to reduce medical risks, especially in older patients or those with existing medical conditions.
During the procedure, the physician creates a tiny 1/4-inch incision, inserts a spinal needle, and threads a wire through it. A metal dilator and cannula are then inserted into the spinal disc. Once the surgical portal is established, the wire and dilator are removed.
Through the endoscope, the surgeon uses micro-instruments to decompress the affected spinal nerves. Precision is employed to target and remove bone spurs and herniated discs.
After the surgery, the doctor administers a steroid injection at the surgical site to alleviate post-operative pain and discomfort. The cannula and scope are then removed, and the patient is moved to the recovery ward for monitoring.
When is Spinal Surgery Necessary?
Determining the exact reasons for spinal surgery can be challenging, but the most common causes are back and cervical pain resulting from various degenerative bone and muscle conditions. An orthopedic surgeon may recommend spinal surgery for the following reasons:
- Degenerative disk diseases, such as spinal arthritis or spinal stenosis
- Herniated disc with associated complications like sciatica
- Spinal instability
- Bone spurs and tumors
- Scoliosis
Benefits of Minimally Invasive Spine Surgery (MISS)
Advanced and minimally invasive surgery offers a faster and safer surgical approach compared to conventional spinal surgery. This method reduces the extent of trauma to the muscles and soft tissues. The common benefits of minimally invasive spine surgery include:
- Reduced blood loss during surgery
- Enhanced cosmetic results due to reduced skin infections
- Decreased risk of muscle damage as no muscle cutting is involved in the procedure
- Lower risk of infection
- Reduced postoperative pain
- Faster recovery and shorter rehabilitation period
- Decreased reliance on post-surgery medications
Recovery Guidelines after Spinal Surgery
Once you return home from the surgical center, your focus should be on your recovery. Allowing the spine to heal properly, getting ample rest, and maintaining a healthy diet are crucial. It is essential to follow the post-operative instructions provided by the spine surgeon to ensure a speedy and safe recovery.
- Take care of your spine: Start with short walks and gradually increase the distance and duration. Moderate exercise helps tone muscles and build strength. Avoid twisting, lifting, and bending. If you've undergone spinal fusion, refrain from lifting weights.
- Maintain a balanced diet: Consume a well-balanced diet rich in fruits and vegetables. Since you may be less physically active, avoid consuming excessive calories and fatty foods. Healthy eating is essential for a smooth recovery.
- Follow the doctor's advice for bathing and incision care: Typically, doctors recommend keeping the surgical site clean and dry for 3-4 days. Until your doctor gives the all-clear, avoid taking a bath in a bathtub or swimming pool.
- Pain management: Follow your doctor's instructions when taking any prescribed pain medication and make sure there are no gaps in the schedule. Avoid take any medicine without first speaking with your doctor.
- Use a post-operative brace if prescribed: A brace provides support to the neck and back, limiting movement of the spinal levels.
Consult your surgeon regarding the best sleeping position that won't strain your back, and try to follow their recommendation.
Ideally, following these tips can help alleviate stress from the back and adjacent body parts:
- Place a pillow under your knees or back to keep your hips slightly bent.
- Avoid sudden movements while getting out of bed. Use the "log roll" method.
- Push your arms and legs when getting up, rather than exerting pressure on your waist or back.
- Inquire with your doctor about the need for physical therapy after the surgical treatment.
- Physiotherapy can help regain and build bone and muscle strength, as well as increase physical endurance.
- Additionally, ask your doctor if there are any recommended exercises to include in your recovery regimen.
The post-operative routine you adopt during your recovery from spinal surgery can help prevent future spine-related problems. It is important to maintain an active lifestyle, engage in regular exercise, eat well, and get plenty of rest to support long-term recovery.
Long-Term Complications of Spinal Surgery
While minimally invasive spine surgeries are generally safe, like any major surgery, there can be complications. Spinal fusion surgery and laminectomy are among the most commonly performed minimally invasive surgeries.
The following are some potential complications associated with these surgeries:
- Non-union of fused spinal bones
- Implant failure due to excessive forces on the spine
- Spinal instability and pain resulting from loose implant screws
- Injury and degeneration of facet joints
- Spinal muscle injury
Cost of Spine Surgery in India
In India, the typical cost for spine surgery is between Rs. 1,40,000 to Rs. 3,70,000. The cost can vary based on the type of surgery, ranging from simple laminectomy/discectomy to fusion or disc replacement surgery. Several factors influence the cost of spine surgery, including:
- The general cost of hospitalization
- Cost of diagnostic tests
- Surgeon's fees
- The severity of the condition
- Type of surgery (open vs. minimally invasive)
- Duration and type of rehabilitation and post-surgery care required
- Type of anesthesia
- Patient's age and overall health condition
- Insurance coverage
Frequently Ask Questions?
The most common spinal surgery is a discectomy. It involves the removal of a herniated or damaged disc in the spine to relieve pressure on the nerves and alleviate pain.
There are several types of spine surgeries, including:
- Spinal fusion: Joining two or more vertebrae together to stabilize the spine.
- Spinal decompression: Relieving pressure on spinal nerves by removing bone or tissue.
- Artificial disc replacement: Removing a damaged disc and replacing it with an artificial disc.
- Laminectomy: Removing part of the vertebral bone (lamina) to relieve pressure on the spinal cord or nerves.
Spinal surgery is a complex procedure that carries both benefits and risks. While it can be highly effective in treating spinal conditions and relieving pain, it also carries the potential for complications. The seriousness of the surgery depends on the specific procedure, the patient's overall health, and the expertise of the surgical team.
Yes, spinal surgery is generally considered a major surgery due to its complexity and the potential impact on the spinal column and nerves. It often requires general anesthesia and involves significant incisions and manipulation of delicate spinal structures.
Spinal surgery, like any surgical procedure, carries risks. However, when performed by a skilled and experienced surgeon, the risks are minimized. Preoperative evaluation, careful patient selection, and adherence to proper surgical techniques contribute to the safety of spinal surgery.
The cost of spine surgery in India can vary depending on factors such as the type of surgery, complexity, location of the hospital, and the surgeon's expertise. On average, the cost can range from INR 2,00,000 to INR 10,00,000 or more, depending on the specific case and hospital facilities. It's important to consult with a healthcare provider to get an accurate estimate for your particular situation.