Spine Related Problem

Hi,

I am Dr. Rajesh Verma, Orthopedist. Today I will talk about spine. Aaj hum apna discussion 2 bhagon mein rakhenge. First part is how our spine works, uske kya components hote hain aur kya kya dharnayein and myths hain like spine surgery, rest karna chahiyai ya nahi karna chahiyai aur kya aisi technique hai jo without surgery spine ko thik kiya ja sakta hai. Toh pehle samjhate hain ki kamar mein kya kya hota hai. Spine mein 2 bones hoti hain and bich meien ek disc hota hai. Disc 2 parts ka bana hot hai. outer structure and bich mein jelly structure hota hai. Jelly shock absorber ka kam karti hai. Jab bhi disc prolapse hota hai jisko commonly slip disc kaha jaata hai, agar ye bahar aa jata hai toh ye nerves ko press karta hai jis se pairon mein taklif hoti hai, jhanjhnahat, sunapan, glut region mein pain, pairon mein weakness and chalne mein kafi dikkat aati hai.

Aisi talklif mein patient ko bed rest karna padta hai. Bed rest ke liya bhi myths hai ki besd rest hi best treatment hai? But mai aap ko btana chaunga ki bed rest worst treatment bhi nahi hai aur na hi acha treatment hai. Iske kayi karan hain. Agar hum aaj se 10-20 years pehle ki baat karein toh bed rest ko ek acha ilaj mante the. Agar hum 3-4 weeks se jyada bed rest karte hain toh usmein pneumonia, muscles weakness bhi aa jata hai. Humari abdominal muscles and back muscles integral part hai spine stability ka . Ye humein sidha khade rehne, aage jhukne and mudne mein help karti hain. Is se patient ka dard jaldi thik nahi hota hai. Toh bed rest unhi cases mein karna chahiyai jismien spine fracture ho jaye, ya koi spine mein infection hai, ya fir tumor se instability ho jaati hai toh un cases mein bed rest acha hota hai.

Otherwise, 1-3 days se jyada bed rest spine and disc problem ke liya thik nahi hai. 2nd question hai ki sare disc problem mein kya surgery ki requirement hoti hai? Ye bhi bilkul thik nahi hai. Mai ye manta hun and research bhi manti hai ki 90% patients kamar dard ke rest, physiotherapy, exercises and with time bhi apne aap thik ho jaate hain and disc mein jo water hota hai vo bhi improve ho jaata hai. 90% patients surgery ke bina thik ho sakte hain. Fir sabse badi dharna hai ki agar spine surgery karni padti hai toh uske baad patient nomal nahi ho pata aur apna time thik se spend nahi kar sakta. Aisa bhi bilkul thik nahi hai. 98% tak success rate hai aaj kal ki modern techniques hain spine surgery ka.

Bus aap ko surgery ka indication thik se choose karna chahiyai. Aise cases mein surgery ke 98% ache results hain. Uske baad pucha jaata hai ki spine surgery ke baad kya bed ridden ho jaate hain. Nahi, ye ek myth hai. Only 1% cases mein aisi taklif ho sakti hai. Vo bhi tab jab spine mein instability hai ya tumors ki surgery hai ya revision cases mein spine surgery ke results itne ache nahi hain jitne ki primary cases mein hain. Fir sabse pehle kaha jata hai ki dharna galat hai. Spine surgery mein bahut bada cut lagta hai, bahut sari muscles damage ho jaati hai. Patient vo activity kabhi bhi nahi kar pata jo normally karta hai. Ye bhi galat hai. Aaj kal ki spine surgery usmein hum 5mm ka cut dete hain durbin se aur 1 inch tak ka cut deke hum spine surgery karte hain. Humare paas computer navigation hai, latest techniques hain and chote chote durbin ke through jaise laparoscopic colectomy, usi tarah hum spine surgery ke liya chote se durbin se jaate hain aur disc ke tukade ko nikal dete hain.

Ismein bich ki bone ko koi bhi destruction nahi hota hai. So, without destroying the normal structure hum spine ki surgery karte hain. Local anesthesia mein hi hum patient ko walk kara sakte hain. Th ye kehena bilkul sahi nahi hai ki patient apni normal activity nahi kar sakta hai surgery ke baad. Ye baat sahi hai ki kuch spine surgery is type ki hoti hain jismein humein spine ko fuse karna padta hai. Humein screw laga kar spine ko fuse karna padta hai. Uske baad patient apna normal activity kar sakta hai. Dusre bhaag mein hum baat karenge ki spine surgery kyun jaruri hai? Kab jaruri hai, uske kya indications hain, iske kya nuksan ho sakte hain and kaise bacha jaa sakta hai?

Thank You!