Clinic Intermed

Hi,

I am Dr. Neelabh, Orthopedist. Aaj mai aap ko spine ki problems ke bare mein bataunga. Hum slip disc ya disc prolapse bolte hain. Ismein curvature aage ki tarafa hota hai. Jab ye chhati ki taraf aata hai to ye curvature piche aa jata hai jo niche kama ke hisse mein aa kar vapas piche ki taraf aana shuru ho jata hai. Bone ke bich disc hota hai. Ye sari hadiyan ek ke upar ek hoti hain aur piche se bhi ye covered hota hai. Canal se sari nerves cross karti hain. Ek bayein taraf aur dayein taraf nerves nikalti hain jo sare sharir ko supply karti hain. Hamare sare sharir ka control brain ke niche ki nerves mein hota hai. Ye ek main circuit hai jiske through control hota hai. Inko balance karne mein doo chizen kaam aati hain. Abdominal and chest muscles aage se isse support dete hain. Piche se back muscles support karte hain. Back muscles ka strong hona bohot jaruri hota hai kyuki hum khade hoke chalte hain. Humara sharir sidha hota hai. Islia in muscles ka strong hona bohot jaruri hota hai.

Agar hum exercise nahi kar rhen hain ya fir peat aage nikala hua hai, achanak bhari saman utha lia ya fir aage jhuk ke kam kar rhen hain ya fir chot lag gyi ho, toh is se spine pe pressure aata hai and aage ki taraf ye bend hota hai. Bend hone ki vajaha se disc piche ki taraf pop out kar jata hai. Iska space narrow hota hai. Piche aane ki vajaha se disc compress ho jata hai. Is se us particular area mein pain and swelling aana shuru ho jata hai. Agar hume light aur fan on karna hai to hum switch board se switch on karte hain. Isi tarah humare sharir ke sare switches yahan par hain. Isi tarah jab pairon me dard iski vajaha se aan shuru hota hai to ise sciatica kehte hain. Sciatica koi alag bimari nahi hai. Jab slip disc ya disc prolapse hota hai toh uski vajaha se jo pairon mein dard jata hai use sciatica kehte hain. Is se bachne ke lia kya karna chaiye?

Aap ko regular exercise, walk karana hai. stomach ko aage na aane den, weight control rakhen, back muscles ko strong banayein. Ye problem mainly 45 ke baad hoti hai. Disc mein water kafi jayada hota hai jo age ke sath-sath dehydrate ho jata hai. Dheere-dheere ye hard ho jata hai and iski elasticity khatam ho jati hai. Islia hum suggest karte hain ki 45 ki age ke baad aage jhuk ke kam mat kriye aur weight mat uthaiye. Agar ye sab precaution lene ke baad bhi disc prolapse ho gaya hai to kya karna chaiye? Ismein deciding factor hota hai ki disc apni jagah se kaha nikali hai aur kitna nikala hai?

Agar vo center se nikalta hai to halka sa pressure deta hai. Ismein piche ek strong ligament hoti hai aur agar ye ligament ke andar rehta hai toh usse buldge kehte hain ke disc buldge kar rha hai piche ki taraf. Ye buldges exercises, medicines se thik ho jate hain. Lekin agar ye agle stage me aa gaya hai jahan par disc bahar aa gaya toh usse hum exterior disc kehte hain. Agar ismein nerve press ho jati hai toh kafi severe pain hota hai. Bohot jaldi sonapan aata hai aur kamjori aani shuru ho jati hai. Agar disc buldge kar ke neuro phenomena mein chala jata hai to sirf operation hi ek ilaj bachta hai. Lekin agar ye central canal mein aa jata hai toh iske symptoms hote hain back pain, legs pain and hand pain hota hai. Hum medicines, physiotherapy and exercises batate hain swelling ko kam karne ke lia. Almost 70% patients us se thik ho jate hain. 30% patients ka group hota hai jinko koi aram nahi aata hai. Iske lia hum kamar me injections lagate hain. Ye local injection dia jata hai taki iska effect sare sharir par na aaye. 20% patients ko is se aram aa jata hai. Jiska matlab hai ki 100 mein se 90% patients in sab chizon se thik ho jaate hain. Jo baaki ke 10% patients bachte hain jinhone sare treatments le lia hain but aram nhi aa rha hai fir hum operation ke baare me sochna shuru karte hain. Jaise jaise age hoti hai, vaise ligament dissolve hone shuru ho jaate hain and arthritis develop hone lagta hai. Patient jab 1km chalta hai toh uske pairon mein jhan jhanahat hone lagati hai, bharipan aata hai, dard hota hai aur dard itna hota hai ki aap ko 2 minutes ke lia baitha deta hai.

Dheere dheere distance coverage aap ka kam ho jata hai. Agar lumbar canal stenosis ya fir cervical canal stenosis hai toh iska ilaj kewal operation hota hai. Ismein medicines and exercises ka koi role nahi hota hai. Hume nerve ka pressure release karna padta hai. Agar ye problem niche ke area mein hai to patient ko pairon me sunapan aa jata hai, weakness aa jati hai. Isse cauda equina syndrome (CES) kehte hain. Ye ek emergency hota hai jismein humein patient ka immediately operation karna padta hai. Hume kaise pata chalta hai ki problem kitni badh gyi hai? Humare kuch routine investigation hote hain jaise x-ray, MRI aur ye tests hume guide karte hain ki patient ko humen kaise treat karna hai. Slip disc ke operation kayi tarah ke hote hain. Agar buldge hai toh conservative ya fir injections se thik ho jata hai. Agar disc right or left side aa gaya hai toh hum durbin se operation kar dete hain endoscopically. Is operation se hum disc bahar nikal dete hain. Kuch ghante baad mariz chalna firna shuru kar deta hai.

Operation karane se patient ko dubara problem nahi hoti hai and spine stable ho jata hai. Mai aap ko yhi suggest krunga ki weight apna control me rakhen, regular walk karen and back ki exerccise regular karen. 45 cross karne ke baad weight lift karana and aage jhukna band kar den. Gym jaane par belt pehnen back ko support karne ke lia aur tabhi weight lift karen. Humare paas 14-15 saal ke bache bhi aate hain slip disc ki problem leke jis se unka lifestyle zindagi bhar ke lia change ho jata hai. Islia aap apna khaas khayal rakhen.

Thank You.

Hello Friends,

Dr. Neelabh, Orthopedist. Aaj me total hip replacement ke bare me baat krunga. India me ye last 25-30 years se ki ja rhi hai. Ye kafi safe surgery hai. Ab is surgery ki jrurat kin logon ko pdti hai. Iske cause hain ankylosing spondylitis, rheumatoid arthritis, tuberculosis ho hi ka. Ek condition hai avascular necrosis, isme hip ka femur khrab ho jata hai. Fracture bhi iska ek cause hai. Hip khrab hone ka ek hi option hai iska replacement. Hip ke lia 2 treatments hain. Partial and total hip replacement. Partial me ball change kia jata hai. Total me ball and socket dono change kia jata hai. Total ke types hain cemented and non-cemented. Cemented hum old age ke patient ko dia jata hai. After treatment apko cross legged nhi baithna hai.

Apko niche baithna mana hai. Low sofa or chair pe baithna mana hai. Agar aap precautions nhi lete hain to hip dislocate hone ka risk hota hai. Agar aap sare precautions lete hain to iski life 15-20 years tak hoti hai. Latest treatment ke according iski life 25-30 years increase ho gyi hai. Is se apki movement hone lag jati hai. Bachon me congenital dislocation of hip ka problem hota hai. Isme bachon ko chalne me problem hoi hai. Legs chote ho jate hain. And back bone me problem ho jati hai. Ye operation safe hai islia aap ise kra skte hain. Timely surgery se result normal hote hain. Patient ko kafi relief milta hai. Hip total damage hone se result kafi acha nhi aata hai.

Thank You.

Hi,

I am Dr. Neelabh, Orthopedist. Meri speciality joint replacement means knee, hip replacement and spinal surgery me hai. Aaj me apko knee replacement or osteoarthritis ke bare me btaunga. Knee joint pe pure body ka weight aata hai. Problem arises when the articular cartilage starts to wear out in the knee. Isme cracks ate hain and ye tutna shuru ho jata hai or baad me khtm ho jata hai. Meniscus bhi khrab hona shuru ho jata hai. Hadiyon me ragdna shuru hone se pain start ho jata hai. Iske causes hain hereditary or genetic, obesity, knee fracture, hemophilia, knee infection. Knee ki alignment khrab hone se isme arthritis hona shuru ho jata hai. Rheumatoid arthritis me bhi knee khrab ho jate hain. Arthritis ke kayi grades hain. Symptoms hain pain while climbing stairs, walking and standing. Patient ko kuch time baad road pe walk krne se bhi pain shuru ho jata hai.

Ye pain aise stage pe aa jata hai ki pain killer liye bina thik nhi hota hai. Ek time aata hai jab patient so nhi pata hai. Investigation me common test hain x-ray of knee (grade 1, 2, 3 & 4). Hum blood test krate hain dekhne ke lia ki patient ko diabetes, lack of calcium or vitamin D ka problem to nhi hai. Grade 1 & 2 treatable hai. Grade 3 & 4 me operation hi reh jata hai. Grade 1 & 2 me exercise, physiotherapy and medicines di jati hai. Patient ko suggest kia jata hai ki palti maar ke na baithe and zameen pe na baithen. Weight control karen. Patient ko anti-inflammatory drugs dia jate hain. Medicines grade 1 & 2 tak hi successful hoti hain. Knee me injections bhi dia jate hain fluid ko increase krne ke lia.

Grade 3 & 4 me knee replacement ka hi option rehta hai. Ye operation bhut simple hai and uske baad patient ko pain bhi nhi rehta hai. Patient ko operation ka darr bhut hota hai. Agar patient ko chalne me problem aa rhi hai to patient ko jldi se jldi operation kra lena chaiye. WHO ka slogan hai life is moment and moment is life. Iska success rate bhi 90-98% hai. Operation ke darr se agar hum chalna chor denge to hmari body bhi khrab ho jayegi. Hume heart problem hoti hai, lung shrink ho jata hai, overweight ho jata hai patient. Patient ka moment hona jruri hai, chalna jruri hai. Delay krne se patient ko 100% result dene me hume problem aati hai. Hmesha chalte rhen, healthy rhen or agar knee khrab ho rha hai to operation krayein. Aaj ki date me 2 lakhs se jyada operations per day ho rhen hain.

Dhanywad!