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SPINE SURGERY

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Spine Surgery

SPINE SURGERY

What is Spine Surgery?

  • This refers to any intervention, procedure or operation that is carried out to a part of your spine aiming to resolve issues that are causing problems such as back pain, pinched nerve etc.
  • They constitute a wide range from minor interventions such as injections and nucleoplasty, to common procedures such as discectomies and decompressions and more extensive procedures such as spinal fusion surgery
  • These can be delivered by a variety of techniques such as percutaneous needles to minimally invasive surgical techniques (MIS) to traditional open surgery

Types of Spine Surgery

Keyhole Discectomy

Keyhole Discectomy

  • It is a surgical procedure that is used to treat a slipped disc that is causing leg pain, numbness, weakness etc. that has not resolved with non-operative treatment
  • The aim of the procedure is to relieve the compression of the pinched nerve
  • Only the herniated part of the disc is removed, leaving behind the normal tissue
  • It is also used to treat cauda equina syndrome

Keyhole Spine Surgery

  • This term refers to any surgical technique that involves minimal or no trauma to the muscle in order to achieve the surgical results
  • It utilizes special instruments, retractors and tubes that allow the surgical procedure to be carried out safely through a smaller window
  • It usually, but not always, utilises a smaller skin incision
Keyhole Spinal Fusion Surgery

Keyhole Spinal Fusion Surgery

  • This is a procedure where one or more spinal levels are fixed with screws and rods to permanently stop them from moving
  • It usually requires placing some fresh bone in the disc space and may require the insertion of a plastic or metal ‘cage’ for added stability
  • The bones on either side of the disc space knit together over a period of 6 months to 1 year
  • Here the fresh bone is like a slow setting concrete and the screws and rod are like the scaffolding that holds the concrete

Most Common Spine Surgery

Scoliosis

Scoliosis

With most scoliosis cases, the spine will rotate or twist in addition to curving side to side. This causes the ribs or muscles on one side of the body to stick out farther than those on the other side.
Slipped (Herniated) Disc

Slipped (Herniated) Disc

A slipped disc occurs when the outer ring becomes weak or torn and allows the inner portion to slip out. This can happen with age. Certain motions may also cause a slipped disc. A disc can slip out of place while you are twisting or turning to lift an object. Lifting a very large, heavy object can place great strain on the lower back, resulting in a slipped disc.
Bulging, Herniated Disc and Sciatica

Bulging, Herniated Disc and Sciatica

Disc herniation means that some of the nucleus material that is in the center of the disc has moved out of the disc through a tear or a crack in the outer annulus. Most often the defect in the annulus is at the back of the disc and the nucleus material squirts out into the spinal canal where it can compress or irritate a nerve root resulting in sciatica, which means leg pain. Sciatica is a very severe type of leg pain.
Lower Back Pain (Lumbar Pain)

Lower Back Pain (Lumbar Pain)

lower back pain vary depending on which structures are affected. Some of the more common symptoms of lumbar pain are:
  • Back stiffness and reduced range of movement
  • Muscle weakness in the hip, thigh, leg or foot
  • Pain spreading from the buttock to the foot
  • Pain spreading into the buttocks and thighs
  • Sensory changes (numbness, prickling or tingling) in the leg, foot or toes
Degenerative Disc Disease

Degenerative Disc Disease

Spinal disks are like shock absorbers between the vertebrae, or bones, of your spine. They help your back stay flexible, so you can bend and twist. As you get older, they can show signs of wear and tear. They begin to break down and may not work as well. Nearly everyone’s disks break down over time, but not everyone feels pain. If worn-out spinal disks are the reason you’re hurting, you have degenerative disk disease.
Nerve Root Impingements

Nerve Root Impingements

Pressure on the nerve roots often causes what is known as “radicular pain” – that is, pain that seems to come from some distance away from the site of the original problem. This is because the nerves that emerge from your spine form the link between your brain and you outlying tissues: if they are pinched or damaged, you’ll feel pain in the areas that they supply.
Radiculopathy

Radiculopathy

Radiculopathy can cause pain, numbness and tingling along a pinched nerve in your back. There are three types of radiculopathy — cervical, thoracic and lumbar. Which type you have depends on where in your back your pinched nerve is.
Back Pain

Back Pain

Back pain is a very common complaint. However, there are a lot of situations where back pain cannot be treated at home and needs professional help. In such cases, you should see an orthopaedic physician for treatment. Orthopaedic physicians are medical doctors who specialize in the diagnosis, treatment, and prevention of musculoskeletal system diseases, conditions, and injuries

Dr Aravind Kumar

Adjunct Assistant Professor Dr. Aravind Kumar is a fellowship trained (UK & Australia) Orthopaedic surgeon with more than 20 years of experience practising in Australia, Singapore and the UK with a special interest in managing spinal conditions.
He has extensive experience in conditions such as slipped discs, spinal stenosis, scoliosis, fractures etc. which can lead to back pain, leg or arm pain and deformity. Some of the conditions that he has successfully managed include

Need Help?

FAQs

If I see an orthopaedic surgeon, will he or she recommend surgery generally?

  • Yes, in general, some form of anaesthetic is required for spinal procedures
  • These may be just an injection of local anaesthetic or some sedation or a general anaesthetic
  • The choice of technique will be tailored for the specific procedure that you are undergoing
  • Surgery, in most cases, is not essential
  • Such situations might include cancer, fractures, spinal cord compression or severe nerve compression leading to weakness, pain, urine leak etc
  • Most conditions can be managed non-operatively with a judicious combination of medication, plasters, physiotherapy and lifestyle modifications
  • In some patients, the disease is severe enough that they do not find enough relief and then surgery is a good option

There is usually a gap beneath the inner part of the foot when a person stands, as the arch raises off the ground slightly. In people with flat feet or a very low arch, this gap is diminished or sometimes not present. Other tell-tale signs of flat feet will be noticing the wearing out of the soles of the shoe on the inside aspect. Also footprints in the sand or when out of the shower, may show the presence of an imprint on the inside of the foot. ( In patients with a normal arch, this imprint is not present) Most patients with flat feet do not have symptoms but other conditions can develop together with flat feet such as tight calf muscles and also tendon degeneration on the inside of the foot generally known posterior tibial tendinopathy. It is always wise to have flat feet assessed and to prevent it from getting worse and the development of symptoms.

A sprain is an injury that damages a ligament while a fracture on the other hand is when the bone has broken. Your orthopaedic surgeon will conduct tests such as x-rays and or MRI or CT scans to determine for certain how badly the ligament is injured or to study a fracture more closely. Sprains generally heal with time and rest and a good rehabilitation program, but a fracture will require some type of treatment including splint, cast, crutches, and even surgery.

If you have any foot and ankle injury and pain, it’s important to have them examined to find out the diagnosis of the condition(s) causing pain. Sometimes these issues tend to get worse if left alone without proper treatment. While some conditions can be corrected by foot and ankle strengthening exercises, stretching exercises or changing the kind of shoes that you wear, other issues can be more complex, requiring special knowledge and training to properly treat them.

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