Srikara Advanced Spine Institute
On the edge of excellence in Spine surgery………….!
Spinal problems can be most disabling musculoskeletal conditions, impairing quality of life significantly. The causes for these problems can be varied and the diverse possibilities being-
- Age related degeneration in spinal column leading to Disc prolapse, arthritis of spine, Instability of Spinal column, and deformity of spinal column.
- Trauma or Injuries of spinal column
- Tumors and Infection of Spinal column
- Deformities like Scoliosis, Kyphosis and other congenital abnormalities of spinal column.
- Inflammatory conditions of bone and joints like Rheumatoid arthritis and Ankylosing spondylitis affecting spinal column.
Each of these problems has potential to cause unrelenting pain, weakness in limbs and sometimes pose threat to life. Hence these complex problems require expert care of Spine Surgeons.
Spine surgeons are specialists who complete additional years of medical training after post graduation, in treating these challenging problems of spinal column. In present era of sophisticated technological advancements in medical field, patients must choose Spine surgeon who devote 100% of their practice in treating Spinal conditions. This means they will be more up-to-date on newer techniques and technologies.
For conditions and diseases affecting the spine, experts at the Srikara Spine Institute deliver leading edge value based care, ensuring best chance of patient recovery. We offer state-of-the-art diagnostic studies, as well as medical, interventional, and surgical services for a wide range of Spine disorders.
Srikara hospital's dedicated Spine unit offers state of art operating facilities that includes-
- I suite operating theatres – Operating rooms are designed to create the optimal operating environment for the surgeon, staff and patient as it makes a positive impact on efficiencies and ergonomics as well as enhanced patient care.
- OPMI VARIO 700 CARL ZIESS Operating microscope – We always strive to perform spine surgeries in Minimal invasive way. Operating Microscope is the only tool to obtain good three dimensional visualization of fine structures with simultaneous illumination and magnification of operating field thus improving saftey of spine surgery manifolds.
- Spinal Cord Neuromonitoring system: Neuromonitoring is most exciting innovations to come into spine surgery. Think of it, what surgeon would dare operate without blood gas monitoring? Or blood pressure monitoring? So why operate without nerve monitoring? It's an important technological advancement to safe guard spinalcord functions during critical spine surgeries like scoliosis and kyphosis corrections.
Spine Surgery is highly skill based specialty, with rapid advances and cutting edge possibilities. Our Team boasts of some of unique surgical procedures which have brought accolades from colleagues across the country and abroad.
Wide range of Spinal conditions treated by are :
- Back pain, Neck pain and Sciatica caused Degenerative Spinal Disorders
- Scoliosis (Curved back), Kyphosis(Hunch back) and other Congenital Spine Deformities
- Complex Spinal Reconstruction for High grade Spondylosthesis.
- Traumatic Spine Fractures and Spinal cord injuries
- Infections of Spinal Column
- Failed back surgeries
- Primary and Metastatic Spine and Spinal Cord Tumors
- Occipito Cervical junction spinal disorders
- Vascular Spinal Disorders
- Elderly Patients with Spinal Problems.
In recognition of our success in dealing with most challenging spine problems, Srikara Hospital has been considered a tertiary referral center for patients from all over the world.
What is Ankylosing Spondylitis?
SAnkylosing spondylitis (AS) is one of the many types of arthritis. "Ankylosing" means joining together or stiffening; "spondylitis" means inflammation of the vertebral bones of the spine. Inflammation of the bones in AS can lead to degeneration, pain, and loss of joint motion. AS typically affects the spine but can been seen in other areas, especially the hips. Ankylosing spondylitis can range from a mild to more severe disease in patients.
Ankylosing spondylitis is approximately three times more common in males than females. It is usually diagnosed in young adults, with a peak onset between 20 and 30 years of age. Children may also be affected by a form of AS termed “juvenile ankylosing spondylitis”,seen in children younger than 16 years of age.
There is evidence suggesting a strong genetic component in the development of the disease. Those with a family history of AS involving a first degree relative (i.e. mother, father, siblings) will be 5 to 16 times more likely to develop AS.
What Is Sciatica?
Sciatica is a painful condition that affects the lower back and the leg. When thesciatic nerve becomes irritated, sciatica leads to pain that is typically felt on just one side of the body. Sciatica is also known to cause numbness in the affected regions of the body, as well as trouble with controlling the leg.
When a person has sciatica, pain radiates from the lower back down to the thigh, extending downward to the back of the calf. In some cases, pain from sciatica flows upward as well, affecting the hip, and back down toward the foot. For many affected individuals, pain from sciatica is enough to impair the performance of everyday tasks.
Anatomy Of Sciatica
As the largest nerve in the human body, the sciatic nerve has great range, extending from the lumbar spinal cord down through the leg. The sciatic nerve is formed from the L5 and S1 nerve roots in the spinal canal and the union of these nerves becomes the sciatic nerve in the pelvis. The sciatic nerve continues through the pelvis into the buttock and back of the upper thigh to the back of the knee where it splits into nerves coursing into the calf.
Causes Of Sciatica
One of the main causes of sciatica inflammation then is herniated discs in the lumber or sacral regions which put pressure on the sciatic nerve and result in causing pain and discomfort.
Signs And Symptoms Of Sciatica
- Mild to intense pain in the buttock, thigh, calf or foot, or in all these areas is experienced.
- If the pressure is more on the nerve, numbness will also be felt.
- The numbness, however, is not always accompanied by back pain and this can lead to sciatica being mistaken for a pulled muscle.
- If one experiences numbness, a feeling of pins and needles and loss of bladder control along with sciatica, it requires immediate medical attention.
Treatment Of Sciatica
Non Surgical Treatment
MEDICATION FOR SCIATICA
If pain is severe, the doctor may prescribe a more potent NSAID. Chronic sciatica may require a muscle relaxant and/or anti-depressant medication. Certain anti-seizure and anti-depressant medications are effective in blocking pain messages sent to the brain. Some of these drugs may enhance the body's production of natural pain killers - endorphins.
EPIDURAL STEROID INJECTION FOR SCIATICA
This type of spinal injection places a steroid (corticosteroid) medication near spinal nerve roots. Steroids reduce inflammation and can help to ease back and leg pain
Surgical Treatment Of Sciatica
If the healthcare professional's diagnosis of your condition is that you have sciatica, they may then, if your condition is severe enough, decide that surgery is appropriate. the common procedures are:
Discectomy: All or part of the problem disc is removed.
Laminectomy / Laminotomy: All or part of the lamina (part of the bony vertebra) is removed to relieve pressure on the sciatic nerve.
Surgery does not necessarily mean being cut open; there are some minimally-invasive procedures becoming available, such as:
Intradiscal Eletrothermoplasty: A heated wire is inserted into the problem disc through a needle and used to destroy the tiny nerve fibres causing the sciatica.
Radiofrequency Discal Nucleoplasty: A radio frequency probe is inserted into the problem disc through a needle and highly-focused radio frequency field is used to vapourise some of the disc, reducing its size and thereby decompressing the disc to reduce the pressure on the sciatic nerve.
What Is Scoliosis?
Some degree of scoliosis may occur in severe osteoarthritis patient. It is a spinal curvature as seen from the front or back of the person who has it. Instead of being straight shape, spine assume an‘s’ or ‘c’ shape. The curves are measured in degrees. Curve which is more than 30 degree need to be carefully watched because they can worsen rapidly. Scoliosis more often then seen with osteoarthritis person as compared to general population.
Anatomy Of Scoliosis
Scoliosis is an abnormal side to side curvature of the spine. A normal spine will have curves that run from front to back. When viewed from the back, a normal spine will appear perfectly straight. When viewed from the back, a spine with scoliosis will appear to curve to one side, or both. This condition can also cause the rotation of individual vertebra in the spine.>Scoliosis is an abnormal side to side curvature of the spine. A normal spine will have curves that run from front to back. When viewed from the back, a normal spine will appear perfectly straight. When viewed from the back, a spine with scoliosis will appear to curve to one side, or both. This condition can also cause the rotation of individual vertebra in the spine.
The curvature of the spine is measured in degrees, just like an angle. A normal spine is straight, or has a curve less than 10 degrees. Mild curvature is from 10 to 20 degrees. Moderate curvature is 20 to 50 degrees. Severe spinal curvature is measured at over 50 degrees.
Causes Of Scoliosis
Nearly 80-85% of scoliosis are Idiopathic, which means the cause cannot be identified. Causes of scoliosis may be structural or functional. There are some few known causes of scoliosis which include birth defects, tumors and injury.
CAUSES OF FUNCTIONAL SCOLIOSIS
When the spine is structuring normal but it appears curved because of another cause is called as functional scoliosis. Such type of scoliosis is often caused by underlying condition such as 1) If there is difference in length of leg 2) Muscle spasms or 3) Inflammatory condition such as appendicitis.
CAUSES OF STRUCTUAL SCOLIOSIS The spine curvature is abnormal in structural scoliosis. It may be due to unknown factors Birth defects, Injury, Certain Infections, Tumors, Rheumatic disease, Neuromuscular disease(such as polio, muscular dystrophy and cerebral palsy) or Connective tissue disorders
Symptoms Of Scoliosis
Scoliosis is usually painless. Scoliosis usually doesn't cause pain or limit a child's movements, so it is easily overlooked. Most children receive a diagnosis during a routine physical. Still, alert parents can often spot early warning signs:
- A tilted head that does not line up over the hips
- A protruding shoulder blade
- One hip or shoulder that is higher than the other, causing an uneven hem or shirt line
- An uneven neckline
- Leaning more to one side than the other 6) In developing girls, breasts appearing to be of unequal size
- One side of the upper back being higher than the other when the child bends over, knees together, with the arms dangling down.
Diagnosis Of Scoliosis
As always, a careful history and physical examination are the first steps in diagnosis of scoliosis. The diagnosis of scoliosis is often made on physical examination.
An X ray of the back will show exactly where and how much the spine is curved. The doctor can make very precise calculations from the X-rayphotograph to determine a measurement known as the Cobb angle. The Cobb angle combines all of the data provided by an X-ray photograph to determine the extent of a person's scoliosis. Occasionally, magnetic resonance imaging (MRI) would be done.
Treatment Of Scoliosis
Non Surgical Treatment Of Scoliosis
The non-operative treatment of scoliosis involves observing the deformity with examinations and repeated x-rays. Under certain Circumstances, when spinal growth remains, a brace may be used in combination with follow-up x-rays. Physical therapy exercises have not been shown to be effective treatment for scoliosis
Surgical Treatment Of Scoliosis
The most common surgical treatment for scoliosis is a Spine Fusion using special stainless steel rods, hooks, and a bone graft. The rods are attached to the spine with hooks and the curved portion of the spine is carefully straightened. Then, small strips of bone graft are placed over the spine to fuse it in a straight position.
As the bone graft heals over the next several months, the spine becomes solid and will not curve again. But the part of the spine that has not been fused will still be flexible, and allow nearly normal overall movement.