Spine
Introduction
spine, stacked one on top of another. Together, this stack forms the vertebral column. The topmost section of the vertebral column, the section in the neck, is called the cervical spine. The next section, located in the upper and mid-back, is called the thoracic spine. Below the thoracic spine is the lumbar spine, in the lower back. Finally, the sacral spine (or sacrum) is located below the small of the back, between the hips. Sturdy intervertebral discs connect the vertebrae. The intervertebral discs act as cushions and shock absorbers between the vertebrae. Each disc is composed of a jelly-like core surrounded by a fibrous outer ring.
The vertebral arch is connected to the vertebral body by two small columns of bone called the pedicles. Sections of bone called the laminae form the “roof” of the arch. A hollow space like the center of a ring is enclosed by the vertebral body, the pedicles, and the laminae. Stacked on top of one another in the spinal column, the rings align to form a long, well-protected channel known as the spinal canal.
Inside the well-protected spinal canal is the spinal cord, the delicate bundle of nerves and other tissue that connects brain and body. Membranes called the meninges cover the spinal cord. The meninges hold in a fluid called cerebrospinal fluid (CSF) that bathes and cushions the spinal cord.
Types of spine surgery
Spinal Decompression. Procedures may include a laminectomy to remove a portion of the vertebral bone (a common surgery for spinal stenosis treatment), a discectomy to remove all or portions of a disc, and a foraminotomy, a surgery to widen the opening in the back where nerve roots leave the spinal canal.
Spinal Fusion. a spine surgery in which the discs between two or more vertebra are removed and the adjacent vertebra are fused together to limit back pain and provide stability to the spine. Spinal fusion is often used to treat degenerative disc disease and spondylolisthesis.
Minimally Invasive Spine Surgery to treat a variety of conditions. Minimally invasive surgery provides significant benefits to the patient – it requires a smaller incision, preserves normal muscular structure, reduces infections and blood loss, minimizes post-operative pain and speeds recovery time.
Arthroplasty/Motion Preserving Surgery, a spine surgery to replace cervical and/or lumbar discs with artificial material to prevent the need for spinal fusion surgery and enable more normal spinal movement after surgery.
Complex Spinal Reconstruction, for patients with severe curvature of the spine due to scoliosis or other spinal deformities.
Multidisciplinary Spinal Tumor Surgery and Care, to remove tumors of the spinal cord and nerve sheath. This surgery requires a delicate handling to prevent injury to normal spinal cord tissue, and is usually performed under a special microscope that neurosurgeons can use to constantly monitor the function of the spinal cord during surgery.
Risk Factors
Risk factors include:
- Blood that is moving is less likely to clot. Getting of moving so that your blood is circulating is perhaps the most effective treatment against developing DVT. While you are in bed, other things can be done to increase the circulation of blood from the legs back to the heart. Simply pumping your feet up and down (like pushing on the gas pedal) contracts the muscles of the calf, squeezes the veins in the calf, and pushes the blood back to the heart. You cannot do this too much.
- Any time you operate on the spine, there is some risk of injuring the spinal cord. This can lead to serious injuries to the nerves or the covering of the spinal cord - the dura. The spinal cord is a column of nerves that connects your brain with the rest of your body, allowing you to control your movements. The nerve fibers in your spinal cord branch off to form pairs of nerve roots that travel through the small openings (foramina) between your vertebrae. The nerves in each area of the spinal cord connect to specific parts of your body. Damage to the spinal cord can cause paralysis in certain areas and not others, depending on which spinal nerves are affected
- Some spinal operations are simply unsuccessful. One of the most common complications of spinal surgery is that it does not get rid of all of your pain. In some cases, it may be possible to actually increase your pain. Be aware of this risk before surgery and discuss it at length with your surgeon. He or she will be able to give you some idea of the chance that you will not get the relief that you expect.
- The spinal cord and spinal nerves carry the nerve signals that allow the rest of your body to function, feel sensation - and even have sex. Damage to the spinal cord and the nerves around the spinal cord can cause many problems. If a nerve is damaged that connects to the pelvic region, it could cause sexual dysfunction.
- One of the interesting things about how the spine works is that it behaves like a chain of repeating segments. When the entire spine is healthy, each segment works together to share the load throughout the spinal column. Each segment works with its neighboring segment to share the stresses imposed by movements and forces acting on the spine. However, when one or two segments are not working properly, the neighboring segments have to take on more of the load. It is the segment closest to the non-working segment that gets most of the extra stress. This means that if one or more levels are fused anywhere in the spine, the spinal segment next to where the surgery was performed begins to take on more stress. Over time, this can lead to increased wear and tear to this segment, eventually causing pain from the damaged segment. This is called a transitional syndrome because it occurs where the transition from a normal area of the spine to the abnormal area that has been fused.
Procedure
Procedure include:
- Spinal fusion involves techniques designed to mimic the normal healing process of broken bones. During spinal fusion, your surgeon places bone or a bonelike material within the space between two spinal vertebrae. Metal plates, screws and rods may be used to hold the vertebrae together, so they can heal into one solid unit.
- Deformities of the spine. Spinal fusion can help correct spinal deformities, such as a sideways curvature of the spine (scoliosis).
- Spinal weakness or instability. spine may become unstable if there's abnormal or excessive motion between two vertebrae. This is a common side effect of severe arthritis in the spine. Spinal fusion can be used to restore spinal stability in such cases.
- Surgeons perform spinal fusion while you're under general anesthesia so you're unconscious during the procedure. Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused, the reason for the spinal fusion, and in some instances, your general health and body shape.
- Surgeons perform spinal fusion while you're under general anesthesia so you're unconscious during the procedure. Surgeons have developed a variety of techniques for performing spinal fusion surgery. The technique your surgeon uses depends on the location of the vertebrae to be fused, the reason for the spinal fusion, and in some instances, your general health and body shape.
- Incision. To gain access to the vertebrae being fused, the surgeon makes an incision in one of three locations: in your neck or back directly over your spine, on either side of your spine, or in your abdomen or throat so that your surgeon can access the spine from the front.
- Bone graft preparation. The bone grafts that actually fuse two vertebrae together may come from a bone bank or from your own body, usually from your pelvis. If your own bone is used, the surgeon makes an incision above your pelvic bone, removes a small portion of it and then closes the incision.
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Fusion. To fuse the vertebrae together permanently, the surgeon places the bone graft material between the vertebrae. Metal plates, screws or rods may be used to help hold the vertebrae together while the bone graft heals.
Spinal fusion is typically an effective treatment for fractures, deformities or instability in the spine. But study results are more mixed when the cause of the back or neck pain is unclear. In many cases, spinal fusion is no more effective than nonsurgical treatments for nonspecific back pain.
Range of Treatment Cost
| Procedure | Duration In Hospital | Min Cost ₹(INR) | Max Cost ₹(INR) |
|---|---|---|---|
| Spinal Fusion- 1 level | 7 | 450000₹ | 750000₹ |
| Spinal Fusion - 2 Level | 7 | 480000₹ | 750000₹ |
| Disc Repalcement - 1 Level | 3 | 470000₹ | 800000₹ |
| Disc Replacement- 2 Level | 3 | 600000₹ | 800000₹ |
| Kyphoplasty | 2 | 520000₹ | 700000₹ |
| Laminectomy | 5 | 200000₹ | 450000₹ |
| Discectomy | 3 | 250000₹ | 500000₹ |
| Deep Brain Stimulation | 7 | 1200000₹ | 1600000₹ |
| Anterior cervical discectomy and fusion | 4-7 days | 360000₹ | 660000₹ |
| Spinal fusion surgery | 4-7 days | 360000₹ | 760000₹ |
| Cervical spine surgery | 4-7 days | 400000₹ | 750000₹ |
| Lumbar Spine Surgery | 4-7 days | 400000₹ | 750000₹ |
| Spinal Decompression | Depends upon the treatment | 360000₹ | 1590000₹ |
| Cervical Disc Replacment Surgery | 7 | 750000₹ | 1000000₹ |
| Disc Nucleoplasty | 4 | 350000₹ | 450000₹ |
| Laminoplasty | 4 | 504000₹ | 705000₹ |
| Percutaneous Endoscopic lumbar Discectomy | 5 | 360000₹ | 560000₹ |
| Posterior Lumbar Interbody Spinal Fusion | 5 | 450000₹ | 480000₹ |
| Brain Tumor Treatment | 2- 5 days | 390000&₹ | 550000₹ |
| Brain Cancer Surgery - Craniotomy | Depends upon the treatment | 540000₹ | 750000₹ |
| Brain Cancer Surgery - Micro Surgery | Depends upon the treatment | 750000₹ | 1150000₹ |
