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Spine Surgery
An increase in age, trauma, improper body mechanics, and structural abnormalities may cause back pain, leg pain, or even leg weakness. Most back problems can be treated by using non-surgical methods like physiotherapy and medications. A spine surgery is recommended when the non-surgical treatment methods fail to work.
Purpose: Spine surgery may be considered under the following conditions:
The following symptoms could indicate the need for spine surgery:
- Back pain
- Slipped disk that does not get better on its own
- Numbness or weakness in the arms and legs
- Trouble in walking or using hands
- Loss of bowel or bladder control
- Spinal infection, characterized by high fever with back pain
- Dislocated or broken bone in the back
- Physical examination: The doctor will check the patient physically and also note down the symptoms and medical history of the patient.
- Blood tests: These tests help to rule out any metabolic abnormalities that may be present.
- X-rays: They use electromagnetic energy beams to create images of the bones, tissues, and organs. They help in the diagnosis of bone injuries or tumors.
- Myelogram: It is an imaging test that combines the use of an injected contrast substance along with x-rays or computed tomography (CT scans) to check the abnormalities of the spinal cord, spinal canal, nerve roots, and other tissues.
- Magnetic resonance imaging (MRI) scans: It is an imaging test performed to obtain clear images of the soft tissues within the body.
- Computed tomography (CT) scans: It is an imaging test performed to obtain detailed images of the bones and soft tissues.
- Nerve conduction velocity (NCV): They help in detecting the problems with the nerves and differentiate a nerve disorder from a muscle disorder.
- Electromyography (EMG): It is used to detect diseases that occur due to problems with the muscle itself, and is often used in combination with NCV to differentiate a nerve disorder from a muscle disorder.
Spine surgery can be performed in the following different ways:
1. Open surgery:
The procedure is usually performed using general anesthesia (the patient will be sleeping throughout the procedure).
A large incision is made through the skin, through the back, abdomen, or chest region.
The surgery is performed through the incision made.
The incision is then closed using sutures and covered by a bandage or dressing.
2. Minimally-invasive spine surgery:
The procedure may be performed under regional anesthesia (an area of the spine is numbed) or general anesthesia.
One or more small incisions are made through the skin, either through the back, chest, or abdomen.
A fluoroscope (portable x-ray machine providing real-time images of the spine during the surgery) or an endoscope (a thin tube attached to a video camera on one end) may be used by the surgeon to determine where to make the incisions.
Small surgical instruments will be passed through the endoscope or through the other tiny incisions made through which tubular retractors (thin, hollow tubes) have been placed.
The spinal bone and tissue can be removed during the surgery through the same tubular retractors.
The tubular retractors help in holding the muscles away from the surgical site during the surgery and the muscles return to their original position when the retractors are removed.
After the surgical procedure is completed, the incisions are closed using sutures, glue, or staples, and covered with small bandages or surgical tape.
A minimally-invasive surgery has a quicker recovery, is less painful, and has fewer complications than open surgery.
The complications associated with spine surgery are:
- Allergic reaction to the anesthesia used
- Infection
- Bleeding
- Blood clot formation
- Pneumonia after surgery
- Damage to the surrounding tissues
- Spinal fluid leak
- Pain
- Injury to the nerves or spinal cord
- Paralysis
- Sexual dysfunction
- Loss of bowel or bladder control
- Heart attack
- Stroke
- After a discectomy or foraminotomy it is normal to feel some pain, numbness, or weakness along the path of the nerve that was under pressure. These symptoms should improve within a few weeks.
- Recovery following a laminectomy and fusion surgery may take longer. It may take at least three to four months after surgery for the bones to heal well, and the healing may continue for up to a year.
- In case of a spinal fusion, the patient may need to stay off work for approximately four to six weeks, provided the patient is young and healthy, and the job is not very strenuous.
- It may take approximately four to six months for older people undergoing more extensive surgery to go back to work.
- The doctor may prescribe pain-relieving medications to ease your discomfort.
- The tape or bandages will usually fall off within seven to ten days, or the patient may remove it themselves after the doctor gives permission for the same.
- It is normal for the incision area to have some pain and numbness after the procedure.
- The patient should call the doctor if the incision appears more swollen or red, feels warm, is draining more fluid from the wound, or begins to open up.
- The incision area should be kept dry for at least five to seven days after the surgery. It can be covered by plastic wrap while showering.
- Avoid smoking after the surgery to help in quicker healing.
- Do not sit for more than 20 to 30 minutes in one place.
- Ask your surgeon when you can resume sexual activity.
- A back brace or corset may be worn to support your back when you are walking or sitting.
- Avoid bending at the waist region. Instead, bend from your knees to squat down if you need to pick up something.
- Avoid heavy lifting and strenuous activities during the recovery period.
- Avoid long drives for the first two weeks after the surgery.
- Short walks can be taken for the first two weeks after the surgery.
- Physiotherapy sessions are recommended to resume your daily activities quickly.
Home remedies:
The following home remedies help in quicker recovery after spine surgery:
- Drink lots of fluids and eat a healthy, high-fiber, well-balanced diet
- Heating pads and ice pack application may help in relieving pain
- A walker, cane, or crutches may help in walking for the first few weeks after the surgery
- Wear loose, comfortable clothing
- Start taking short walks and gradually increase the speed and intensity of your walks
Cost of Spine Surgery in India-
The cost of spine surgery in Mumbai is between INR 1,50,000 to INR 5,50,000.
The cost of spine surgery in Delhi is between INR 1,40,000 to INR 5,25,000.
The cost of spine surgery in Bangalore is between INR 1,40,000 to INR 5,25,000.
The cost of spine surgery in Chennai is between INR 1,25,000 to INR 5,00,000.
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Spine Surgery
An increase in age, trauma, improper body mechanics, and structural abnormalities may cause back pain, leg pain, or even leg weakness. Most back problems can be treated by using non-surgical methods like physiotherapy and medications. A spine surgery is recommended when the non-surgical treatment methods fail to work.
Purpose: Spine surgery may be considered under the following conditions:
- Herniated (ruptured) disks, in which one or more disks cushioning the spine bones are damaged
- Spinal stenosis, in which the spinal column narrows to put pressure on the spinal cord and nerves
- Vertebral fractures due to an injury to the spinal bones or osteoporosis (a condition in which the bones become brittle and weak)
- Spondylolisthesis, in which one or more spinal bones slip out of their place
- Degenerative disk disease or damage to the spinal disks due to an increase in age
- Cauda equina syndrome, in which back pain is caused due to a tumor, infection, or nerve root problem
The different types of spine surgeries include:
- Vertebroplasty and kyphoplasty: These procedures help in repairing the compression fractures of the vertebrae caused by osteoporosis. A glue-like cement is injected in both procedures to harden and strengthen the bone.
- Spinal laminectomy or spinal decompression: This procedure is performed in cases of spinal stenosis that causes pain, numbness, or weakness. The surgeon will remove the bony walls of the vertebrae, along with any bone spurs that may be present, in order to open up the spinal column and remove any pressure on the nerves.
- Discectomy: It is performed to remove a disk when it has herniated and pressed on the spinal cord or nerve root. Discectomy is usually performed along with laminectomy.
- Foraminotomy: It involves the enlargement of the bony hole from where a nerve root will exit the spinal canal to prevent the joints that are thickened with age or the bulging disks from pressing on the nerve.
- Nucleoplasty or plasma disk decompression: This is a type of laser surgery that uses radiofrequency energy for treating people with low back pain that is associated with a mildly herniated disk.
- Spinal fusion: This procedure involves the removal of the spinal disk between two or more vertebrae and then fusing the adjacent vertebrae using metal devices secured by screws or bone grafts.
- Artificial disk replacement: This is an alternative form of treatment to spinal fusion used to treat people having severely damaged disks. It involves the removal and replacement of the disk with a synthetic disk that will help in restoring the height and movement between the vertebrae.
Symptoms
The following symptoms could indicate the need for spine surgery:
- Back pain
- Slipped disk that does not get better on its own
- Numbness or weakness in the arms and legs
- Trouble in walking or using hands
- Loss of bowel or bladder control
- Spinal infection, characterized by high fever with back pain
- Dislocated or broken bone in the back
Diagnosis
- Physical examination: The doctor will check the patient physically and also note down the symptoms and medical history of the patient.
- Blood tests: These tests help to rule out any metabolic abnormalities that may be present.
- X-rays: They use electromagnetic energy beams to create images of the bones, tissues, and organs. They help in the diagnosis of bone injuries or tumors.
- Myelogram: It is an imaging test that combines the use of an injected contrast substance along with x-rays or computed tomography (CT scans) to check the abnormalities of the spinal cord, spinal canal, nerve roots, and other tissues.
- Magnetic resonance imaging (MRI) scans: It is an imaging test performed to obtain clear images of the soft tissues within the body.
- Computed tomography (CT) scans: It is an imaging test performed to obtain detailed images of the bones and soft tissues.
- Nerve conduction velocity (NCV): They help in detecting the problems with the nerves and differentiate a nerve disorder from a muscle disorder.
- Electromyography (EMG): It is used to detect diseases that occur due to problems with the muscle itself, and is often used in combination with NCV to differentiate a nerve disorder from a muscle disorder.
Treatment
Spine surgery can be performed in the following different ways:
1. Open surgery:
The procedure is usually performed using general anesthesia (the patient will be sleeping throughout the procedure).
A large incision is made through the skin, through the back, abdomen, or chest region.
The surgery is performed through the incision made.
The incision is then closed using sutures and covered by a bandage or dressing.
2. Minimally-invasive spine surgery:
The procedure may be performed under regional anesthesia (an area of the spine is numbed) or general anesthesia.
One or more small incisions are made through the skin, either through the back, chest, or abdomen.
A fluoroscope (portable x-ray machine providing real-time images of the spine during the surgery) or an endoscope (a thin tube attached to a video camera on one end) may be used by the surgeon to determine where to make the incisions.
Small surgical instruments will be passed through the endoscope or through the other tiny incisions made through which tubular retractors (thin, hollow tubes) have been placed.
The spinal bone and tissue can be removed during the surgery through the same tubular retractors.
The tubular retractors help in holding the muscles away from the surgical site during the surgery and the muscles return to their original position when the retractors are removed.
After the surgical procedure is completed, the incisions are closed using sutures, glue, or staples, and covered with small bandages or surgical tape.
A minimally-invasive surgery has a quicker recovery, is less painful, and has fewer complications than open surgery.
Risks
The complications associated with spine surgery are:
- Allergic reaction to the anesthesia used
- Infection
- Bleeding
- Blood clot formation
- Pneumonia after surgery
- Damage to the surrounding tissues
- Spinal fluid leak
- Pain
- Injury to the nerves or spinal cord
- Paralysis
- Sexual dysfunction
- Loss of bowel or bladder control
- Heart attack
- Stroke
After Procedure
- After a discectomy or foraminotomy it is normal to feel some pain, numbness, or weakness along the path of the nerve that was under pressure. These symptoms should improve within a few weeks.
- Recovery following a laminectomy and fusion surgery may take longer. It may take at least three to four months after surgery for the bones to heal well, and the healing may continue for up to a year.
- In case of a spinal fusion, the patient may need to stay off work for approximately four to six weeks, provided the patient is young and healthy, and the job is not very strenuous.
- It may take approximately four to six months for older people undergoing more extensive surgery to go back to work.
- The doctor may prescribe pain-relieving medications to ease your discomfort.
- The tape or bandages will usually fall off within seven to ten days, or the patient may remove it themselves after the doctor gives permission for the same.
- It is normal for the incision area to have some pain and numbness after the procedure.
- The patient should call the doctor if the incision appears more swollen or red, feels warm, is draining more fluid from the wound, or begins to open up.
- The incision area should be kept dry for at least five to seven days after the surgery. It can be covered by plastic wrap while showering.
- Avoid smoking after the surgery to help in quicker healing.
- Do not sit for more than 20 to 30 minutes in one place.
- Ask your surgeon when you can resume sexual activity.
- A back brace or corset may be worn to support your back when you are walking or sitting.
- Avoid bending at the waist region. Instead, bend from your knees to squat down if you need to pick up something.
- Avoid heavy lifting and strenuous activities during the recovery period.
- Avoid long drives for the first two weeks after the surgery.
- Short walks can be taken for the first two weeks after the surgery.
- Physiotherapy sessions are recommended to resume your daily activities quickly.
Home remedies:
The following home remedies help in quicker recovery after spine surgery:
- Drink lots of fluids and eat a healthy, high-fiber, well-balanced diet
- Heating pads and ice pack application may help in relieving pain
- A walker, cane, or crutches may help in walking for the first few weeks after the surgery
- Wear loose, comfortable clothing
- Start taking short walks and gradually increase the speed and intensity of your walks
Cost of Spine Surgery in India-
The cost of spine surgery in Mumbai is between INR 1,50,000 to INR 5,50,000.
The cost of spine surgery in Delhi is between INR 1,40,000 to INR 5,25,000.
The cost of spine surgery in Bangalore is between INR 1,40,000 to INR 5,25,000.
The cost of spine surgery in Chennai is between INR 1,25,000 to INR 5,00,000.
FAQ Section
A. Spine surgery is a surgical procedure done for treating certain spinal deformities and conditions.
A. Spine surgery is performed by an orthopedic surgeon.
A. Common types of spine disorders include:
- Herniated (ruptured) disks (one or more disks cushioning the spinal bones are damaged)
- Spinal stenosis (the spinal column narrows to put pressure on the spinal cord and nerves)
- Vertebral fractures due to an injury to the spinal bones or osteoporosis (the bones become brittle and weak in this condition)
- Spondylolisthesis (one or more spinal bones slip out of their place)
- Degenerative disk disease or damage to the spinal disks due to an increase in age
- Cauda equina syndrome (back pain caused due to a tumor, infection, or nerve root problem)
A. You need to consider undergoing spine surgery in the following cases:
- Immobility due to severe back pain
- Slip disk does not improve with physiotherapy
- Presence of arthritic bone spurs in the spine that compresses the spinal cord
- Numbness in the limbs due to spinal cord or nerve compression
- Bowel or bladder incontinence due to spinal nerve compression
- Presence of spinal tumor
- Dislocated or broken bone in the back
A. The different types of spine surgeries are:
- Spinal laminectomy or spinal decompression: It involves the removal of the bony spurs or walls that compress the spinal column to relieve the pressure on the nerve. The procedure is generally performed for spinal stenosis patients.
- Vertebroplasty and kyphoplasty: These procedures are performed to treat compression fractures due to osteoporosis. A glue-like cement is injected to harden and strengthen the vertebrae.
- Discectomy or microdiscectomy: It is a type of slipped disc surgery performed for removing a herniated disc that compresses the nerve root and spinal cord. It is usually performed in conjunction with laminectomy.
- Foraminotomy: It is done to widen the spinal column where the nerve root exits the spinal canal if it has narrowed due to aging.
- Nucleoplasty or plasma disk decompression: It is a type of minimally-invasive laser surgery in which a plasma laser device is used to reduce the size of the disk and treat mild disk hernia.
- Spinal fusion: The spinal disc is removed and the adjacent vertebrae are fused together using metal implants or bone grafts.
- Artificial disk replacement: A severely damaged disk is removed and replaced with a synthetic implant to help in the restoration of the vertebral height and movement.
A. You can usually resume your normal daily activities, which include lifting, bending, and twisting movements, within six to eight weeks of having spine surgery. However, certain spine surgeries such as spine fusion procedures may take a longer time for recovery.
A. Although rare, children can also develop spine disorders. Spinal disorders could be either prenatal or postnatal. Certain spine problems could be present at birth, but as the baby will grow, the spine problems become more apparent, such as congenital scoliosis. Certain spine problems can be detected in a prenatal ultrasound itself, such as osteoporosis.
A. How long you need to wear a back brace will depend on the nature of the surgery performed and the condition of the patient. For discectomy and laminectomy procedures, you can usually stop wearing a brace two weeks after the surgery, while you may need to wear a brace for up to three months after fusion surgery.
A. Physiotherapy and rehabilitation will begin immediately after you are discharged from the hospital after spine surgery. The rehabilitation period could last for four to six weeks or even longer, depending on the type of surgery performed and the severity of the condition.
A. The cost of spine surgery will vary depending on the type of surgery performed, the technique used for performing the surgery, and the overall health status of the patient.
The cost of spine surgery will vary among different orthopedic surgeons in different hospitals. On average, the cost of spine surgery in India is between INR 1,25,000 to INR 5,50,000.
| CITY | COST |
| Mumbai | INR 200000- INR 500000 |
| Bangalore | INR 175000- INR 475000 |
| Delhi | INR 175000- INR 475000 |
| Chennai | INR 150000- INR 450000 |