Slip Disc Treatment

Spinal surgery is a complex and critical surgery and requires highly trained and skilled surgeons, excellent infrastructure, good post- op care for a successful outcome. Our surgeons use neuro-monitoring technique during the surgery for complete safety of the patient and a great outcome. Besides, the cost of slip disc surgery in India is much affordable, thus attracting people from across the world for their slip disc surgery in India.

Overview
A slipped disc is also known as a prolapsed or herniated disc. It is a condition when the inner soft part of the disc (known as nucleus pulposus) bulges out through the weakened or ruptured part of the disc pressing on the structures close to it (nerves coming out off the spinal cord) resulting in numbness, tingling sensation or even pain in the area.
Slipped disc or disc herniation can happen at any level, but usually occurs in the lumbar region. The extent of the prolapsed and herniation can vary from person to person, the larger the prolapse the severe the symptoms.
Early stage symptoms of degeneration of the spine are intermittent and lingering back pain, but you would be able to perform your daily activities. However, as the ‘jelly’ pushes its way out from the ‘shell’, symptoms begin to get severe- pain gets intense, frequent and lasts longer. You may also experience numbness or weakness in legs and buttocks when the spinal nerves in the lumbar region begin to get pinched by the pressing gel.
If there is a rupture in the neck (cervical spine), there would be discomfort in shoulder and arms and further compression could lead to permanent paralysis.
Slipped disc is usually the last stage of degeneration of spine. When your disc is subjected to repeated bending or awkward bending, compression, rotation, lifting heavy objects, sitting in the same position for long, increasing age etc, the shell of the disc begins to tear. If no efforts are made to prevent further damage, the gel inside the disc starts to move out causing severe back pain. If the pressure continues to build, it causes tear and the water inside the nucleus pulposus leaks, just like a punctured car tyre – causing the disc to lose its buoyancy and strength.
Surgery is often the last resort and is advised in patients where symptoms have not settled in six weeks of conservative treatment like medication, injections and physiotherapy. The aim of the surgery is to remove the prolapsed part of the disc releasing pressure from the spinal cord.

Causes
Some of the common causes that cause slip disc are:

1. The water content in the discs decreases with age and shrinks it causing disc degeneration
2. Lifting heavy objects and in improper way
3. Sitting in particular position like extended driving hours
4. Overweight or sedentary lifestyle
5. Sporting activities which require heavy lifting
6. Excessive smoking

Treatment options:
Treatment options for a slipped disk include rest with pain medication, physical therapy or sometimes further treatments like injections and surgery.

1. Medications and lifestyle changes: Nonsteroidal anti-inflammatory medications are given for pain control andnarcotics are prescribed in cases of severe pain non-responsive to NSAIDs. Muscle relaxants are given for back spasms. Overweight individuals are recommended diet and exercise. Physical therapy helps in strengthening the spine muscles and give flexibility to the spine and legs.
2. Injections: Steroid injections control pain and swelling in the herniated disk for several months with several other symptoms.
3. Surgery: Surgery is the treatment option for cases where the above treatments have not worked. Various surgical techniques of herniated disc surgery include:

Discectomy or open discectomy involves removing herniated disc material which is pressing the nerve root or spinal cord resulting in pain and other symptoms.
Percutaneous discectomy is done for for bulging discs and discs that have not ruptured into the spinal canal.
Laminotomy and laminectomy – Laminotomy involves removing a part of the lamina to relieve the pressure over the nerves, while laminectomy involves removing the entire lamina. Lamina is the thin part of the vertebrae which forms an arch over the spinal cord to protect it.

Candidates
People with back pain, numbness or weakness in upper or lower limbs who are not responding to non-surgical treatments like pain killers, non-steroidal anti-inflammatory drugs and physiotherapy can consider surgery. They need further investigations like X-ray/ CT scan/ MRI to confirm bulging or protruding disc which can be corrected by surgery.
Surgery for herniated disc should be considered emergency if there are symptoms of pressure on the spinal cord or on the cauda equine or cases involving serious or increasing paralysis.

Procedure
Micro Endoscopic Discectomy
It is a minimally invasive procedure done with a tubular device which carries the surgical instruments. The incision is small and the procedure done as a day surgery.The first step is a guide wire insertion through the small incision to the disc in question. A fluoroscope can tell the exact route and position of instruments to correct the herniated disc.Diluting tubes are passed over the guide wires inserted to part the tissues and make way for the vertebrae. The guide wire is then removed. A retractor is slid over the diluting tubes to perform the surgery. As soon as the retractor is placed on the bone surface, diluting tube is removed. ]A camera and light source ease the surgery procedure. Surgical instruments are passed through the tube and the bone and corresponding soft tissue is cleared to provide proper access to the spine. The nerves of the spine are moved away from the herniated disc. Surgical instruments inserted through retractor remove the herniated part of the disc and nerve is moved back to its original position. The incisions are closed and dressed

Expected Results
The results of herniated disc surgery are good. A successful surgery relieves the symptoms of herniated or slipped disc in up to about 90% of the patients.

Recovery
Recovery is different for each patient. However, it is normal to feel pain at the site of surgery for the first few days which can be controlled with medications. You would be advised to start physical therapy after a week of the surgery for rehabilitation. You would be able to return to normal activities in about two weeks while full recovery may take few weeks to months. Your treating surgeon would advise you about the rehabilitation and when to start rigorous activities.

Time and Cost
You would stay at the hospital for about a week after the surgery to make sure you are on the right healing path. Another week to ten days are required for recovery and initial rehabilitation before you can go back after slip disc surgery in India.