Spine Surgery in Delhi, India

• Discectomy: This procedure involves removing all or part of a herniated disc that is pressing against spinal nerves, relieving pain in the back and leg and restoring nerve function.

• Spinal Fusion: This surgery joins two or more vertebrae together using bone grafts or implants to stabilise the spine, often performed to treat spinal instability, degenerative disc disease, or deformities.

• Laminectomy: It involves removing the back part of a vertebra (lamina) to relieve pressure on the spinal cord and nerves caused by conditions like spinal stenosis, tumours, or discs.

• Artificial Disc Replacement: It involves removing a damaged disc and replacing it with an artificial disc to preserve motion in the spine.

• Vertebroplasty/Kyphoplasty: These minimally invasive procedures involve injecting bone cement into the fractured vertebrae to stabilise the spine and relieve pain caused by compression fractures.

Spine surgery is typically recommended when conservative treatments such as medication, physical therapy, or spinal injections fail to provide adequate relief. It may be necessary in the following cases:

• Spinal cord compression or nerve impingement causing severe pain, weakness, or numbness.

• Spinal deformities like scoliosis or kyphosis cause functional limitations or affect vital organs besides cosmetic disfigurement.

• Spinal tumours or infections requiring surgical intervention to preserve spine stability and remove compression.

• Spinal instability due to trauma or degenerative conditions.

• Severe spinal cord injury resulting in paralysis or loss of motor function, usually due to traumatic Injury.

• Pain relief: spine surgery aims to alleviate chronic pain caused by compressed nerves or damaged spinal structures.

• Improved functionality: By decompressing nerves and stabilising the spine, surgery can restore mobility and enhance overall functionality.

• Enhanced quality of life: Surgery can significantly improve a patient's quality of life by reducing disability, increasing independence, and enabling the resumption of daily activities.

• Prevention of further damage: Surgery can prevent the progression of certain spinal conditions, reducing the risk of long-term complications.

• Correction of spinal deformities: spine surgery can correct deformities such as scoliosis or kyphosis, improving posture and appearance and preserving vital organ function along with preventing neurological deterioration.

The decision to undergo spine surgery is typically made in consultation with a spine specialist or neurosurgeon, or orthopaedic. The following factors are considered when determining the candidacy for spine surgery:

• Conservative treatment failure: Surgery is often recommended when non-surgical treatments have proven ineffective.

• Severity of symptoms: Candidates with severe pain, weakness, or loss of function are more likely to benefit from surgery.

• Diagnostic imaging: MRI, CT scans, or X-rays help assess the extent of spinal cord damage and aid in surgical planning.

• Overall health: Candidates should be in reasonably good health to undergo surgery and tolerate anaesthesia, usually general.

Preparing for spine surgery involves several steps:

• Medical evaluation: Your surgeon will conduct a comprehensive evaluation, including medical history, physical examination, and review of diagnostic tests.

• Pre-operative instructions: You will receive specific instructions regarding fasting, medication management, and discontinuation of blood-thinning drugs prior to surgery.

• Lifestyle adjustments: Your surgeon may recommend lifestyle modifications such as weight loss, smoking cessation, or physical therapy to optimise surgical outcomes.

• Arranging support: Ensure you have a support system in place to assist with post-operative care, transportation, and daily activities during recovery.

The choice of surgery will depend on the underlying condition being treated. spine surgery is typically performed under general anaesthesia and involves the following steps:

• Incision: An appropriate size incision is made over the affected area of the spine, allowing access to the spinal structures. Minimally invasive entails giving small incisions.

• Depending on the procedure, the surgeon may remove herniated discs, stabilise the spine with implants, decompress nerves, or correct deformities.

• Fusion or artificial disc placement: In cases where fusion is necessary, bone grafts along with implants are used to fuse adjacent vertebrae. In artificial disc replacement, a prosthetic disc is inserted after removing the naturally affected disc.

• Closure: The incision is closed using sutures or staples, and a sterile dressing is applied.

• Hospital stay: The duration of the hospital stay varies depending on the procedure performed. It can range from a few days to a week.

• Pain management: You may experience post-operative pain, which can be managed with pain medications prescribed by your surgeon/anaesthetic.

• Limited mobility: Initially, you may experience restricted movement and need to use assistive devices like a walker or cane. Physical therapy will be initiated to gradually regain strength and mobility.

• Follow-up appointments: Regular follow-up visits with your surgeon will be scheduled to monitor your progress, remove sutures/staples, and assess the healing process.

While spine surgery is generally safe, however like any  other surgical procedure, it carries some risks and potential complications, including:

• Infection

• Bleeding

• Nerve and spinal cord damage

• Blood clots

• Implant failure

• non-union (failed fusion)

• Allergic reactions to anaesthesia or medications

Recovery from spine surgery varies depending on the type and complexity of the procedure, as well as individual factors. Generally, the following guidelines apply:

• Physical therapy: Physical therapy plays a crucial role in restoring strength, flexibility, and functionality. Your surgeon may prescribe a tailored rehabilitation program in consultation with a physiotherapist.

• Gradual resumption of activities: You will be advised to gradually increase physical activities and avoid heavy lifting or strenuous exercises during the initial recovery period.

• Pain management: Your surgeon will prescribe pain medications as needed to manage discomfort during the recovery process.

• Follow post-operative instructions: Adhere to the post-operative instructions provided by your surgeon regarding wound care, medication, and activity restrictions.

During the recovery period, it is important to take the following precautions:

• Avoid heavy lifting or strenuous activities until cleared by your surgeon.

• Practice good posture and body mechanics to avoid putting undue stress on the spine.

• Follow a balanced diet and maintain a healthy weight to reduce strain on the spine.

• Quit smoking if you are a smoker, as it hinders the healing process and increases the risk of complications.

The prognosis after spine surgery varies depending on the individual's overall health, the severity of the condition being treated, and the success of the surgery. While surgery can provide significant relief and functional improvement, complete recovery may take several months. It is essential to have realistic expectations and actively participate in the rehabilitation process to achieve the best possible outcome.

After spine surgery, contact your doctor if you experience any of the following symptoms:

• Worsening pain or new onset of severe pain

• Persistent fever

• Increased redness, swelling, or drainage at the surgical site

• Numbness, weakness, or loss of bladder or bowel control

• Difficulty breathing or chest pain

1. How long does it take to recover from spine surgery?

Recovery time varies but can range from several weeks to several months, depending on the procedure and individual factors.

2. Will I be able to resume normal activities after surgery?

With proper rehabilitation and adherence to post-operative instructions, many people are able to resume normal activities and regain functionality.

3. Are there non-surgical alternatives to spine surgery?

In some cases, non-surgical treatments may be effective. However, if conservative approaches fail to provide relief, surgery may be necessary.

4. Can spine surgery be performed minimally invasively?

Yes, many spinal cord surgeries can now be performed using minimally invasive techniques, which offer smaller incisions, reduced blood loss, and faster recovery compared to traditional open surgery.

5. Will I be able to drive after spine surgery?

The ability to drive will depend on your overall recovery, mobility, and clearance from your surgeon. Follow your surgeon's guidelines regarding driving restrictions.

Reviewed by Dr. Abhishek Srivastava, Senior Consultant – Spine Surgery on 07-July-2023.

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