Lumbar disc herniation with Sciatica
Dr. Hamza Shaikh
Jan 06, 2021
The spine is made of 33 individual vertebral bones stacked one on top of the other, with an intervening intervertebral disc between two individual vertebral bones. This spinal column provides the main support for the body, allowing us to stand upright, bend, and twist while protecting the spinal cord from injury. At the same time strong muscles and bones, flexible tendons and ligaments, and sensitive nerves contribute to a healthy spine.
Manipal hospital is the best spine hospital in Delhi with a vision of developing a dedicated department to cater the need of all spine ailments ranging from simplest spine pathology to the most complex spinal deformity and tumors and trauma surgeries.
Manipal Hospital is well equipped with the latest technology and a team of dedicated spine specialists in Delhi who are ready to provide 24/7 care with the possibility to perform emergency spine surgeries at any time.
Manipal hospital is the best spine hospital in Delhi known for its ethical practice and believes in a multi-disciplinary approach for providing the best possible care to its patients.
Manipal Hospital is the best spine surgery hospital in Delhi having in-house multispecialty support along with world-class operative, post-operative and ICU care. Patient safety is our top priority, we routinely use intraoperative real-time neural monitoring, a cutting edge technology, which helps in preventing paralysis and nerve damage during complex spinal surgery such as deformity correction and tumour excision and reconstruction.
In vertebroplasty, bone cement called polymethylmethacrylate is directly injected into the fractured bone through a hollow needle.
The surgery may be required to remove a benign or malignant tumor, reduce its size, and/or relieve persistent back or neck pain, balance problems, difficulty walking, and bowel or bladder dysfunction.
ACDF has been the gold standard in cervical spine surgery for many years. It is safe, effective, simple to perform. In this procedure first, the damaged or herniated cervical disc is removed entirely (discectomy) to relieve pressure from the nerve. Then a bone graft with or without a cage is placed over the affected vertebra to encourage bone formation…
Posterolateral lumbar fusion is spine surgery that involves placing bone graft between elements in the back, or posterior, of the spine, leaving the disc space intact. The procedure may be performed using minimally invasive surgical techniques.
Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front of the body to remove disc or bone material from in between two adjacent lumbar vertebrae. The procedure may be performed either as an open surgery or using minimally invasive techniques.
A vertebral column resection is a procedure reserved for the most severe spinal deformities and involves removing segments of the spine including the body of the vertebra and the posterior elements, which include the lamina, transverse process, and ribs.
This refers to removing one or more discs to treat herniated discs and degenerative disc disease or it is also used in combination with various spinal fusion procedures.
A spinal osteotomy is a surgical procedure used to correct certain deformities of the adult or pediatric spine. These include the posterior column osteotomy (PCO), the pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR).
Spinal conditions such as scoliosis (curving of the spine), kyphosis (increasing roundback of the spine), spondylolysis (stress fracture of the spine), and spondylolisthesis (movement of one part of the spine on another part) may affect children during their early or late childhood years.
Removal of the thin bony plate on the back of the vertebra called the laminae to increase space within the spinal canal and relieve pressure from the nerves.
A surgical technique used to join two vertebrae. Spinal fusion may include the use of bone graft with or without instrumentation (eg, rods, screws). There are different types of bone graft, such as your own bone (autograft) and donor bone (allograft).
As the name suggests, Spine Stabilization surgery can now be performed using minimally invasive stabilization procedures that offer patients a safe and effective alternative to back fusion with a faster recovery. It is done through a tiny incision without cutting or damaging the surrounding muscles.
A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or spinal column. These cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic…
Cervical disc replacement is also known as total disc arthroplasty or artificial disc replacement. In this procedure, a damaged cervical disc is removed and replaced with a metal or polymer prosthetic. Compared to ACDF, disc replacement spares motion and removes the risk of nonunion complication.
Discectomy is a surgical procedure, which involves decompressing or relieving the pressure of a herniated disc on the spinal cord or the nerve root.
The adult deformity is caused by age-related wear and tear on the back or complications from past surgeries. The moderate deformity occurs when the facet joints and discs deteriorate over time and are no longer able to support the spine's normal posture. Pain results from stressed joints and pinched nerves, not the abnormal curve.
Spinal deformity is an abnormal alignment or curve of the bony vertebral column.
The disc is the soft cushioning structure located between the individual bones of the spine, called vertebra. It is made of cartilage-like tissue. In most cases, the disc is flexible enough to allow the spine to bend. An artificial disc (also called a disc replacement, disc prosthesis or spine arthroplasty device) is a device that is implanted into…
The goals of minimally invasive transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) are to address the cause of your back pain and to keep your spine stable by fusing two or more of your vertebrae together.
A discectomy is a cutting-edge, minimally invasive procedure proven to reduce pain caused by disc herniations (sciatica). Also called microlumbar discectomy (MLD), this is an advanced procedure where the herniated or protruding portion of an intervertebral disc that is compressing the spinal cord and affecting the nerve root is removed, shrinking an…
Dynamic lumbar spine stabilization is a surgical technique that stabilizes the spine with flexible materials to allow for more mobility in the spine than traditional spinal fusion surgery.
Spinal reconstruction surgery may be necessary for patients who have a deformity or misalignment that affects a major portion of the spine.
Cervical laminoplasty is a surgical technique that removes pressure from the spinal cord in the neck. Pressure on the spinal cord can be due to various causes including degenerative changes, arthritis, bone spurs, disc herniations, tumors, or fractures.
Kyphoplasty is a minimally invasive procedure used to treat a spinal compression fracture. It is commonly caused by osteoporosis which leads to vertebral body collapse causing severe pain and loss of mobility.
This procedure is performed to release pressure from the spinal cord, that is mainly caused by spinal stenosis.
This minimally invasive procedure removes a small part of disc material and portion of bone to relieve the compression of nerve roots
We offer a range of surgical and non-surgical treatment of spinal disorders at all levels of the spine. Some commonly used treatments and procedures include:
Discectomy- Microscopic or endoscopic discectomy: Micro endoscopic discectomy is a minimally invasive procedure used to remove a part of or the whole intervertebral disc (discectomy). Tubular retractors (allows direct visualization of the operative field) are used along with a microscope or an endoscope. The advantages of this procedure are less muscular damage, better cosmesis, safe, lesser operative time, faster recovery, etc.
Minimally Invasive Spinal Stabilization: Minimally invasive spine surgery is performed to stabilize the vertebral bones and spinal joints. Conditions such as spinal instability, herniated discs or spinal tumours put undue pressure on the spinal nerves. This procedure helps to relieve the pressure off the spinal nerves. Compared to the open spine surgery, minimally invasive spine surgery is safer, faster, have a smaller incision, less recovery time, less muscle damage, low risk of infection, etc.
Spinal Fusion: Painful vertebrae are fused to form a single, solid bone. The intervertebral disk from the disk space is removed and the bone spacer is implanted. The bone graft material inside this bone spacer promotes bone healing. Types of fusion include:
Posterior Lumbar Interbody Fusion: The bone spacer is implanted from the backside of the spine.
Transforaminal Lumbar Interbody Fusion: The bone spacer is implanted from the side of the spine.
Artificial Disc Replacement: The spine is made up of vertebral bones with a disc in between these bones. The discs allow smooth movement of the vertebral bones. If the disc degenerates it is surgically replaced with an artificial disc.
Osteoporotic Spine Fracture Management: As we age our bones become weak and susceptible to the vertebral compression fractures. Osteoporotic spine fractures are managed using: Non-surgical or Surgical methods
Nonsurgical Treatment: Nonsurgical treatments such as bed rest for a short duration, painkillers and wearing a brace to restrict the movement of the affected area help to heal vertebral compression fractures.
Kyphoplasty: A balloon tamp is inserted into the fractured vertebra through a needle. Once in place, the balloon tamp is inflated to create a space which is filled with special bone cement to strengthen the vertebra.
Vertebroplasty: Instead of the balloon tamp, cement is injected directly into the affected vertebra.
SpineTrauma: Spine fractures caused by trauma-road traffic accidents or fall from height are managed using: Non-surgical or Surgical methods. If the Spine is stable - Conservative or non-operative method is followed. If the spine is found to be unstable, surgical stabilization or spinal fusion surgery is the treatment of choice. If the patient has suffered a neurologic injury along with spine fracture, decompression of the neurological structure is performed along with the surgical stabilization of the spine.
Vertebral Column Tumours: both primary, as well as secondary/ metastatic tumours, are found in the vertebral column. In fact, the spine is the most common site of skeletal metastasis (tumour developed and spread from another organ). Stabilization and decompression surgery is often required along with the need for Radiation and chemotherapy, depending upon the type of tumour as revealed on Biopsy.
Scoliosis and Kyphosis Deformity Correction Surgery: These are complex surgeries, which are performed to straighten the crooked spine to achieve a balance and pain-free spine.
Instrumented fusion Vs fusion less surgeries:
Instrumented fusion: Instrumented fusion is a gold standard surgical procedure for correcting scoliosis deformity. Screws, hooks or wires are put in the vertebrae and slowly connected to rods and with some maneuvers deformed spine is corrected. A bone graft is then placed over the back of spinal bones (laminae) to obtain a bony fusion. Fusion simply means fusing together two or more vertebrae so that they heal into a single, solid bone and maintain the deformity in the corrected position.
Fusionless surgery: Growth rods or growth guidance system
It is performed to manage early-onset scoliosis (EOS), which refers to spine deformity that is present before 10 years of age. These techniques stop the progression of a curve without adversely affecting the future growth of the spine and thorax. This requires 6 monthly small distraction procedures till the age of 11-12 years (by then most of the spine growth is over). After that final instrumented fusion is performed.
Radiofrequency Ablation: For patients suffering from chronic pain in the lower back, neck and arthritic joints, an electric current is used to burn the nerve that sends pain signals to the brain.
Spinal Cord Stimulator: Spinal Cord Stimulator consists of electrodes and a generator that sends electrical impulses when the patient feels pain.
Baclofen or morphine Pump Application: Medications such as baclofen or morphine are muscle relaxing drugs that are used for managing chronic back pain. A small pump is used to deliver medication to the spinal cord and nerve to lessen the pain.
Spinal Injections: Spinal injections are helpful in the diagnosis and management of pain in the leg, back, neck, or arm. Spinal injections are administered using fluoroscopy (x-ray) that aids in the correct placement of the medicine. Spinal injections are of various types including:
Transforaminal Epidural injections: Epidural injections are used to administer local anaesthetic drugs and/or anti-inflammatory medication (e.g.: steroid/cortisone) to reduce inflammation and relieve pain. The medication is injected into the “epidural space,” near the spinal cord.
Facet Joint Injections: Facet joint injections are administered to treat neck and backache that is caused by degenerative/arthritic diseases or injury. The medication is injected in and around the facet joints (small joints between the vertebrae located on the back of the spine).
Sacroiliac Joint Injections: Sacroiliac joint injections are administered to treat the lower back, buttocks, and leg pain. The medication is injected in the sacroiliac Joint (joints between the sacrum and pelvic bone).
Provocation Discography: Provocation discography helps to find out the location and source of back pain. The intervertebral disk is stimulated and pressurized by injecting a liquid into the nucleus pulposus of the vertebral disk.
Conditions treated at Manipal Hospitals' Spine care, but not limited to, are
1. Non-operative treatment of neck and back pain
2. Spinal injections of all types including RFA
3. Microdiscectomy and spinal decompressions
4. Endoscopic surgeries
5. Minimal invasive surgeries – PLIF, TLIF, OLIF
6. Artificial disc replacements
7. 24X7 Treatment of Spinal fractures and trauma
8. Vertebroplasty and Kyphoplasty Procedures for Osteoporotic fractures
9. Stem cell therapy for spinal cord injury
10. Scoliosis and Kyphosis treatment – Bracing to major corrective surgeries
11. Treatment of congenital defects and deformities of spine
12. Management of Spinal infections
13. Treatment of Spinal and spinal cord tumours
You may be in the hospital for 1 to 3 days; longer if you have spinal fusion. Rest is important. But doctors at the best spine hospital in Delhi want you out of bed as soon as possible. Most people start physical therapy within 24 hours.
Conditions affecting the spine are complex, Manipal Hospitals help manage your pain and restore function. Our experts are the leaders in spine surgery, interventional spine therapies, and spine wellness. Together they ensure patient's recovery and improved quality of life with the least invasive, most appropriate, and most advanced treatment available. Contact us to know more about Spine care and book an appointment with one of our Spine care specialists today.