Sushrut-Spine-Conditions

Spinal Disc Surgery

A spinal disc or intervertebral disc is a spongy cushion that separates the bones (vertebrae) of the spine and performs important functions like absorption of shock, the stability of vertebral column, and allows movement of vertebrae. Although the disc is quite strong and can bear a lot of pressure some factors can damage and push its contents out leading to spinal disc problems.

Types of disc problems

The most common disc-related problems include the following:

• Degenerative disc disease which is usually Age-related

• Ruptured or slipped or herniated disc can occur at any age but usually in young

Risk factors for disc problems

Although there is no known specific cause of disc problems, the following risk factors make any individual more susceptible to disc problems than others:

• Obesity or being overweight

• Poor muscle tone

• Lack of regular exercise

• Sedentary lifestyle

• Excessive cigarette smoking

• Alcohol or other drug addiction

• Advancing age

• Age-related degeneration

• Poor posture during daily routine activities like sitting, walking, etc.

• Incorrect weight lifting techniques even in day to day activities like lifting water bucket etc.

• Occupational hazards like repetitive bending and lifting

• Trauma to the back

• Genetic inheritance

• Improper Gym training

Symptoms of disc problems

The symptoms and severity of disc problems specifically depend upon the location and extent of the damage. Some people may not show any symptom while others may present with any of the following:

• Pain in the back that can occur all of sudden or on mild activity

• Pain that worsens on bending over or sitting down for a long time and with activities like coughing or sneezing

• Pain radiating down the legs

• Tingling or numbness

• Neurological symptoms like weakness, numbness, or tingling sensations in the extremities leg, foot, arm, or hand

• Patient may complain of “sharpshooting current like sensation”

Diagnosis of Spinal Disc problems

Diagnosis of spinal disc problems plays a very crucial role in deciding the appropriate treatment that can give maximum relief to the patient.

It starts with a physical examination of the patient by the physician to evaluate the location and extent of pain. Neurological examination is also done to check the reflexes, muscle strength, walking ability, and response to stimuli. This may give a fair idea to the physician about the damage but the following diagnostic tests are most of the times performed to confirm the diagnosis and start appropriate treatment:

• X-rays • Computerized tomography (CT scan)

• Magnetic resonance imaging (MRI)

• Myelogram • Electromyograms

• Nerve conduction studies

Treatments

Cervical Disc Replacement Surgery

Pain in the neck is a very common complaint and one of the major causes of disability among people of all ages. Although it can be managed by conservative pain treatment some patients may fail to get any relief from it. In such cases, disk replacement is the most probable option that can improve the patient's condition and provide relief from pain.

Cervical disk replacement is a type of surgery that involves the replacement of a worn or degenerated cervical disk with an artificial disk. An artificial disk is made of medical-grade metal or a combination of medical-grade metal or plastic. It is a relatively new procedure that is seen as an alternative to spinal fusion surgery.

Indications for Cervical disk replacement surgery

Narrowing of space between cervical vertebrae due to cervical disk degeneration, or wear and tear
Pressing of the spinal cord or spinal nerves by part of cervical vertebrae or cervical disk
Collapse and bulging of the cervical disk due to age
Damaged cervical disk due to trauma
The patient complains of neck pain, numbness, or weakness for more than 6-12 weeks
No response from nonsurgical types of treatment

The ideal candidate for Cervical Disc replacement surgery: Not all patients with neck pain are suitable for disc replacement. The surgeon will evaluate the overall health and other factors in the patient to find the best possible procedure that will provide relief to the patient. Most commonly, cervical disc replacement surgery is suggested to the following patients:

Pain associated with only 1 or 2 disks in the cervical spine
Healthy weight individuals
No additional deformity
No significant joint disease or compression on the nerves
No prior major spinal surgery

The procedure is performed under general anesthesia with a one- to two-inch incision (surgical cut) being made on the side or front of the patient neck. This is followed by the careful moving of the important structures of neck to the side until the surgeon is able to see the bones of the vertebrae and the cervical disk. Now the the diseased or damaged cervical disk is removed and replaced by an artificial disk in the empty space. Now the incision is closed using absorbable sutures (stitches) under the skin. A small dressing is applied over the incision and the patient are advised to use a rigid or soft neck collar for a few days.

The patient is then kept under observation for three-four days in the hospital. Early ambulation in terms of standing and walking is started on the day of surgery itself but without putting any strain on the disk. Complete recovery may take a few weeks or months of time and meanwhile, the patient is advised to avoid any jarring activities or motion. Simple exercises and therapies are suggested during the post-operative period to strengthen the spine.