When Do We Need Spine Surgery?

Hi,

I am Dr. Rajesh Verma, Orthopedist, Narayana Super speciality Hospital, Osteon- Narayana Joints & Spine, Gurgaon. Jaise ki pehle bhaag mein humnein dekha ki spine kya hota hai, disc ka structure kya hota hai, aur kya karan hote hain kamar dard ke, unko kaise thik kiya ja sakta hai, kya galat dharnayein hain rest aur surgery ke baare mein. Ab hum baat karenge ki aisi konsi situatiion hai spine ki jismein humein spine surgery karni padti hai. Disc ki vajaha se spine move karta hai. Kuch cases mein spine abnormal movement karne lagta hai. Aage, piche ya side mein jhuk jata hai. Piche ke facet joints arthritis ho jaate hain aur unstable ho jaate hain. Kuch aur situations bhi hoti hain jaise spine mein tumor ho jaaye, spine mein chot lagne se koi fracture ho jaaye ya fir TB jo kafi common hai. In cases mein jab spine ka structure stable nahi hota hai toh humein surgery karni padti hai.

Durbin ya disc ki surgery karne se spine thik nahi hota hai. Sabse common surgery hai spine fusion surgery. Ismein hum 2-20 screw tak fix karte hain. Jab normal disc kharab ho jata hai jiski vajaha se disc spacers hote hain, jismien hum bone graft kar ke cages ko laga dete hain aur piche se titanium rod fit kar dete hain. Isko spine fusion surgery kaha jata hai. Is surgery ke 1-2 days mein hi hum patient ko khada kar sakte hain. Achi baat ye hai ki ab bade chire ki jarurat bhi nahi padti. Minimally invasive surgery se ise thik kiya ja sakta hai. Spine fusion surgery spine ko itna movement nahi de paati hai. Spine fix ho jaat hai. Patient ka pairon ka dard thik ho jaata hai. Kuch saalon ke baad patient ko lagta hai ki patient ka spine stiff ho gaya hai. Spine mein utna movement and mobility nahi hai. Toh spine ko mobility dene ke liya jise hum kehte hain dynamic spine surgery aur motion preservation surgery jismein hum spine ki stability ko khatam karne ke liya, usko stiff toh kar dete hain but bilkul fuse nahi karte hain. Thoda spine ka movement continue rehta hai. Mene pichle 5 saalon mein dynamic spine surgery kafi jyada sucessfully kiya hain.

Spine ke excessive movement ko kam karne ke liya hum ek spacer lagate hain. Is se spine ka movement kam ho jaata hai but bilkul khatam nahi hota. Patient aage jhukega toh thoda movement kar sakta hai. Dusri ek dynasys surgery hoti hain jismein titanium rod ki jagaha hum silicon ki flexible rod lagate hain. Ek surgery hai jo durbin se ki jaati hai use transforaminal endoscopic spine surgery, us case mein bhi hum normal structure ko kharab nahi karte hain. Ye surgery local anasthesia mein ki jaati hai aur patient aagle din hi chal fir sakta hai. Tubes ke through bhi hum surgery karte hain. Chita cut deke like 1-1.5 cm, badi disc ko bhi hum nikal sakte hain. 3rd surgery hai disc replacement. Is se sari movements patient kar sakta hai aur patient bilkul thik ho jata hai. Ab question ye haii ki jitni bhi surgeries hain kya inhein avoid kiya jaa sakta hai?

In selected group of patients by giving laser injections, facet blocks, radiofrequency injections, pain management ke injections hote hain jo OPD mein kiya jaata hai aur jin patients mein surgery avoid ki jaa sakti hai th hum kar sakte hain. Dusra needle procedure hai kyphoplasty jismein jab haddiyan tut jaati hain, bone fracture ho jaati hai aur atient chall fir nahi pata, us case mein hum needle ke through cement ka injection laga dete hain aur patient ko 3-4 months tak intezaar nahi karna padta haddi judne ka balki vo turant thik hoke chal fir sakta hai. Spine surgery ke baad rehabilitation ka procedure kya hai? Pehle ke operations mein bed rest karna padta tha. But ab patient 2 days ke andar hi walk start kar sakta hai. 3-6 weeks mein hi 90% activities start ho jaati hai. Sports mein hum 3-6 months tak body conditioning karte hain, muscles ki exercise karte hain aur jo pain free hota hai vo ye kam kar sakta hai. Aaj humnein jana ki kis tarah ki spine surgeries hoti hain aur kaise spine fusion surgery se hum apne aap ko bacha sakte hain. Sabse jyada jaruri hai weight kam karna Spine surgery ka sabse common karan hai vajan jyada hona, kam exercise karna, bad posture, bed lifestyle hona, smoking. Agar aap in baaton ka dhayan rakhein toh spine surgery se bacha jaa sakta hai. 

Thanks!