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August 9, 2020 0

SPONDYLOSIS

Also known as osteoarthritis, it is associated with the wear and tear of the bones, ligaments, and weakening of the spinal discs. Spondylosis usually affects the elderly, but the symptoms can seem as early as 20 years of age. Spondylosis has affected over 80% of people above the age of 50 Globally. It is different from spondylitis; while spondylitis is associated with inflammation, spondylosis implies pain and degeneration of bones.

Causes

The possible causes for Spondylosis condition could be:

  • Bone spurs or overgrowth that the body initiates to support the spine. This extra growth does not find space and tends to press the delicate areas like the spinal cord, nerves or the discs.
  • Dry spinal discs is one major cause. The soft cushioning discs between the vertebrae absorb jerks and shocks and provide padding against friction due to movement. The disc holds a gel-like substance which tends to dry out due to age or any internal disorder. The vertebrae are devoid of padding and rub against each other while moving. This causes roughness and pain.
  • Herniated discs develop when the cushioning disc cracks or juts out and the gel within leaks. Now, this protruding disc can press the cord or nerves which causes sciatica.
  • Any past injury or accident trauma that might have affected the neck or lower back can render the bones weak and lead to spondylosis in later age.
  • Connecting ligaments between bones tend to stiffen over time and restrict movement, especially in the neck region. These, when moved with force, can cause pain.
  • Occupations that involve lifting heavyweight or a continuous repetitive movement of the back cause wearing out of the bones that have been exerted the most. Heavy weight lifting in the gym over time can cause spinal wear and tear.

SpondylosisSymptoms

This can occur in the cervical spine (neck region), middle back or the lumbar spine (lower back). Common signs are stiffness in neck or headaches.

Symptoms include:

  • A localized pain in the area of damage, mostly along the shoulder blade.
  • If the spondylosis has resulted in a herniated disc the person might experience a sharp shooting pain that increases with movement. The other symptoms then are similar to that of a slipped disc.
  • If there is an injury to the spinal cord it is referred to as myelopathy and the symptoms include pain, numbness, weakness, and tingling.
  • If spondylosis results in nerve pinching, the symptoms are felt along the course of the nerve and include pain, tingling, and weakness.
  • Spondylosis in the lumbar spine can cause pain the shoots down the thighs to behind the knees and sometimes can go lower to the calf muscles. It is called radiculopathy.

When to seek medical help?

If the back pain is unbearable and seems to worsen with movement, or if it is followed by weakness in limbs or stiffness in neck which restricts activity, it is a sign to seek medical attention.

Diagnosis

Beginning with a physical examination of the neck and lumbar region, the doctor will check abnormalities in nerve function, sensations, reflexes, muscle strength, range of movement, changes in gait along with understanding the history of symptoms and injuries if any.

Taking the diagnosis further, the doctor will suggest imaging tests like X-ray, CT scan or MRI to trace bone spurs, pinched nerves or protruding discs. A nerve function test follows this.

Treatment

Spondylosis treatments

Depending on the cause of Spondylosis and the intensity of damage the doctor would begin with medication followed by low-intensity physical therapy and adequate rest. The therapy includes stretching neck and shoulder muscles. A doctor can also suggest few sessions of neck traction, where weights are used on the neck to increase cervical space and relieve the pressure on the cord or nerves. Medication should generally be a combination of pain reliefs, muscle relaxants, and anti-epileptic drugs for nerve relief. Acupuncture is another alternative therapy to treat spondylosis in the initial stage.

Surgery

Is rarely necessary for cervical spondylosis. But where the preliminary treatment fails, and the condition gets worse, it recommended in severe cases. To eject bone spurs or the bulging disc, and to create space for the cable and nerves doctors to surgery. Sometimes to stabilize the spine, vertebrae fusion follows this procedure.

  • Laminectomy is the procedure to remove the bone curvatures of the spinal canal to increase the size of the canal and reduce pressure on the cord.
  • Discectomy is to remove the bulging portion of the disc that exerts pressure.
  • Foraminotomy or foraminectomy is to expand the openings for the nerve to exit the spinal canal without compression.
  • Osteophyte is the removal of bone spurs that pinch nerves.
  • Corpectomy is a procedure to remove a vertebral bone and discs.

Minimal Invasive / Less Invasive Surgery Procedure

This is an advanced surgical procedure that involves an incision of barely 1 inch in the back and the surgeons use micro tools, endoscope, and indirect monitoring through a high definition monitor to perform the surgery.

Like in the case of spondylosis due to herniated discs, to evict the bulging part and repair the disc keyhole surgery is use. This takes less than a day and the patient can feel instant relief. To ease a compressed nerve, minimally invasive surgery is vital for spinal decompression. Bone graft and screws or plates to hold it in place and support the spine. To control critical pain, doctors can insert in the vertebral bone near the trigger points of the patient.

Duration of surgery: If it is less invasive surgery the hospital time can be 1-3 days. In the case of the traditional procedure, hospital time can range from 3-5 days.

Follow-up

This is necessary for the doctor to monitor the response to treatment and the onset of any case of sciatica. As the treatment progresses the doctor might suggest changes in physical therapy too. Imaging and scan is not necessary.

Cost of Spondylosis surgery

This depends on the cause of spondylosis and the type of surgery. In India, the cost of surgery to treat spondylosis can range from 2.5 lacs to 4 lacs which includes the cost of surgery procedure, hospital charges, and doctor consultation.

Dr Arun Saroha


August 7, 2020 0

Degenerative Disc Disease

Our spine goes through a lot of wear and tear as it supports movements. The spinal vertebrae are cushioned by discs that safeguard against shocks and jerks from activities like walking, lifting and twisting. Degenerative disc disease is associated with changes in these intervertebral discs that arise with age. The abnormalities can occur anywhere in the spine but most often it is observed in the neck region (cervical spine) and the lower back (lumbar spine) because these bones support the maximum movement. The changes in the discs that can be termed as degenerative disc disease are:

  • Osteoarthritis, the impairment of the tissue that protects and cushions vertebral joints
  • A herniated disc, protruding or cracking of spinal disc
  • Spinal stenosis, abnormal contraction of the spinal canal,

Causes Degenerative disc disease

The discs hold a soft gel-like substance that prevents friction and with age, the spinal discs degenerate and undergo changes like:

  • Loss or drying of disc fluid: This affects the shock absorption capacity of the discs and its flexibility and the disc narrows down and the gap between the disc and vertebrae increases.
  • Bulging disc or herniation: Weakness or external injury results in a minor crack on the outer layer of the disc. The gel substance leaks out, and with movement, it comes out of the gaps. This can cause the disc to bulge, rupture or break.
  • Bone spur: If the disc narrows or cracks, the gap between disc and vertebrae increases and the spine become less stable. The body responds to this by initiating bony growths called bone spurs also known as osteophytes. These spurs can exert pressure on the spinal cord or nerve roots that shoot from the cord.
  • People with jobs or hobbies that involve heavy weight lifting, can face this issue. Smokers, elderly people or people with a past injury can also suffer from degenerative disc disease.

Symptoms of degenerative disc disease

Back or neck pain is the most common symptom in any of the degenerative disc diseases. However, there have been cases where the person does not experience any pain even with the same intensity of the damage.

The pain occurs around the affected area. If the disc is damaged near the neck, the pain is experienced along the shoulder blade and the arms. If the lumbar spine is affected the pain spreads to the buttock, thighs till the knees. This pain gets worse with movement like twisting, bending and stretching.

Another common symptom is numbness and weakness in limbs. A tingling sensation can also be felt because a spinal nerve is pinched either by the bone spur or bulging disc.

Elderly patients experience loss of bladder control, difficulty in keeping balance, handing smaller objects, etc. This happens due to the narrowing of the spinal canal and compression of nerves and spinal cord. The nerve function weakens.

How is degenerative disc disease diagnosed?

It begins with understanding the medical history and a thorough physical exam. The doctor will seek information on the symptoms, duration, past injuries, illnesses or lifestyle, habits, nature of everyday activities, etc.

The second step would be to check the range of motion, muscle strength, ease of movement, nerve reflexes, tenderness, and inflammation is any. The doctor might also check for fractures or infections. Post this the patient is suggested Imaging tests to identify the level of compression and exact location of the damage.

Treatment

  • Medication and hot/cold packs help ease the pain. If the pain is unbearable, the doctor will prescribe stronger pain reliefs and application ointments.
  • The next step is physical therapy, where the therapist will move every joint in a specific sequence. It involves stretching and strengthening the muscles in the back.
  • Surgery is the last resort. It depends on the type of degeneration and is necessary if the spinal cord or nerves are compressed either by the narrowing canal or the bulging disc or maybe the bony spurs.
Traditional decompression surgeries performed from the back (posterior) of the spine are:

Facetectomy: Spinal joints called facet joints are removed if they exert pressure on the nerve or cord.

Foraminotomy: Enlargement of the opening is made for the nerve to exit without pressure in case a part of the disc or bony spur blocks its path.

Laminectomy: Lamina is the posterior portion of the vertebrae that protect the spinal canal and cord. If it is pressing the spinal cord, surgery is done to remove part or whole of the lamina to ease the pressure on the cord.

Laminotomy: Similar to the foraminotomy, a bigger opening is made in the lamina if it is pressing a nerve structure. The nerves are given more space to exit the cord and reach the limbs.

Traditional decompression surgeries performed from the front (anterior) of the spine are:

These are preferred in case of herniated disc or narrowing of the spinal canal and if the spinal cord comes in way of the surgery path.

Discectomy: Parts or all of the herniated disc is removed that exert pressure on nerves.

Corpectomy: (Vertebrectomy): If the damaged disc is lodged between the vertebrae and the spinal cord, the surgeon might have to remove the entire vertebral body and gain access to remove the part of the disc.

  • Minimal invasive surgery or less invasive surgery has come in as a relief for patients that suffer from degenerative disc surgery. Discectomy is done with this technique where microscope and advanced surgical tools are used for the process. A very small incision is used to insert the tools and procedure indirectly monitored.

These surgeries leave a gap between the organs, which is filled using FUSION and an environment is created using bone graft which will gradually fuse with the spine.

Recovery and post-surgery follow-up

If the surgery involves a fusion, it takes some months for the area to heal completely and the bones to fuse together. Local pain might persist. In minimally invasive surgery, the incision heals faster and since the muscles are not involved, the pain is lesser. There can be few follow-up sessions where the doctor will monitor the progress and check the range and ease of movement.

Cost of surgery

Degenerative disc disease is a condition and there are different types of surgeries that can cure it depending on the exact abnormality. Minor surgeries can cost between 2lacs – 4lacs. Complicated surgeries that involve fusion or removal of the vertebral body can cost between 4lacs-6lacs. This includes charges for the procedure, consultation, hospital stay, etc.

Dr Arun Saroha

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January 26, 2020 0

Gurgaon Hub of Neurosurgery

Neurosurgery is a specialty in medicine that handles the prevention, diagnosis, surgical treatment, as well as rehabilitation of disorders that affect any part of the nervous system. The parts include the brain, spine, peripheral nerves, as well as the extra-cranial cerebrovascular system. The top hospital for neurosurgery in India incorporates different modern procedures in its service to ensure that it covers the entire range of neurological conditions present. In addition, the facility employs the use of complex modern equipment which sets them apart from other facilities in terms of the conditions that they can successfully handle with minimum human effort and reduced occurrence of complications.

There are quite a number of neurosurgical procedures aimed at handling different neurological conditions. These procedures range from minor and simple to those that are quite extensive and complex. The top Hospital for Neurosurgery in Gurgaon employs modern procedures from its diagnostic and imaging processes which enables a successful diagnosis of the patient’s conditions. Some of the technically surgical procedures that are employed include craniotomy, spinal fusion, ventriculostomy, pallidotomy, trepanning, and much more. These procedures are aimed at repairing, rehabilitating, and treating different kinds of neurological conditions.

The best spine surgeons in Gurgaon specializes in treating a different kind of neurological conditions. This specialization leads them down different paths as far as procedures are concerned. As such, the surgeons end up performing different procedures that are relevant to their area of expertise throughout their career, unless they decide to get training on other procedures. This kind of specialization has made it possible for surgeons to deeply interact with the conditions the handle as well as the equipment used to treat them. In effect, this interaction has made the surgeons become masters in their areas of expertise, therefore, greatly increasing their success rate and reducing the chances of recurring complications after a surgical procedure has been conducted.

Dr. Arun Saroha is the Director and Head of the Neurosurgery Unit at Spine and Brain India hospital. He is a neurosurgery genius with an incredible 6,000 successful neurosurgeries performed in his 15 years as a spinal surgeon. The wealth of experience that the doctor has gained throughout this time has made it possible for him to attend to a wide range of neurological problems. However, the doctor’s areas of specialization are Complex Spine Surgery, Disc Replacement, Brain Tumors, Transnasal Surgery, Stroke, and Cerebrovascular malformation, Pediatric Neurosurgery, and Trauma. His wide range of expertise has made him operate on people from all walks of life from all over the world making him one of the most renowned experts in the industry. Having gone through the rigorous and required training, Dr. Arun Saroha dispenses the best of service to all the patients who happen to cross his path.

Spine and Brain India has invested in the best of equipment in the industry which sets them apart from other facilities. This bold step has made it possible for the facility to handle complex neurosurgical procedures competently giving its patients an incredible opportunity to go back to their normal lives. In addition to this, the facility has a number of well-trained spine experts in India. These experts ensure that the entire processes leading to surgery are professionally handled. From the diagnosis of the problem to the treatment option that may be recommended before surgery, these experts closely observe how the patients respond in order to advise on the most appropriate way forward. As one of the top hospitals for neurosurgery in India, the facility has gained popularity throughout the country, and the world at large for its services and successes that have left many happy with their services.

Dr Arun Saroha

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January 26, 2020 0

Complex Brain Tumor Surgery

A brain tumor is a mass of tissue that forms in any part of the brain due to the accumulation of abnormal cells. The normal cycle of a cell in the body involved its production, aging, then death and replacement by other cells. This is not the case for tumors as the cycle is disrupted making the tumor cells to grow despite not being needed by the body. The reasons for the formation of brain tumors are unknown to medical practitioners. However, some risk factors have been researched on and have been found to increase the chances of someone getting a brain tumor. For instance, children that are exposed to radiation in the head are highly likely to develop tumors as adults, the case is the same for people who have some rare genetic conditions like Li-Fraumeni syndrome. Top neurosurgeons in Gurgaon, however, express this as a fraction that also as a degree of uncertainty because not all people exposed to these risk factors end up developing brain tumors.

Tumors can be classified as either benign or malignant. Benign tumors are noncancerous and they usually have clearly defined borders. For these reasons among others, brain tumors of this nature can easily be removed using surgical means if they are not located in delicate hard to reach areas. Malignant tumors, on the other hand, are deeply rooted in the brain tissues which make them hard to surgically remove. Top neurosurgeons in Gurgaon also explain that these tumors have a high probability of reoccurring after their removal, and also that they are cancerous.

Brain tumors have a wide range of symptoms which vary based on the type and the place they are located. Some of the symptoms may not show until the tumor has grown to a considerably big size. However, the most common indicators that someone may have a brain tumor include headaches that do not respond to painkillers and other headache remedies out there. However, this is just an initial indicator that may not even be related to a brain tumor. Top neurosurgeons in Gurgaon have also identified seizures, changes in speech or hearing, changes in vision, and much more as indicators that one may have a brain tumor. Despite these symptoms being associated with brain tumors, they do not necessarily prove its existence and may be caused by other ailments.

Complex brain tumor surgery is a technique that is employed to remove a brain tumor once its diagnosis has been made. However, unlike benign brain tumors that may not be deeply rooted in the brain, complex brain tumor surgery is devoted to the extraction of lesions and tumors that are deeply rooted to the brain, and are located in hard-to-reach regions of the brain. The surgery addresses tumors that are regarded as high-risk and inaccessible. The best spine hospital in Gurgaon ensures that its specialists provide gentle, precise, and safe procedures to their patients eliminating instances of a complication occurring after the surgery.

Spine and Brain India hospital acknowledge the fact that some brain tumors cannot be removed. The facility, however, emphasizes on treatment because as brain tumors keep on growing, there is a high chance that the bodily functions of the afflicted may deteriorate. For tumors that cannot be surgically removed after they have been diagnosed, a biopsy is recommended which helps the specialists to study the type of cells that make up the tumor, therefore, giving them a clear picture on the right treatment approach to take. With a team of competent, and rigorously trained neurosurgeons, and a facility that is the state-of-the-art machines, Spine and Brain India hospital ensures that all the patients that are diagnosed with brain tumors at the hospital are aggressively treated.

Dr Arun Saroha

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January 25, 2020 0

Brain Surgery – A Surgeon’s Viewpoint

Brain surgery involves a number of medical procedures and processes that are aimed at repairing structural problems in the brain. There are a number of procedures associated with the term brain surgery. These procedures are considered different based on the area of the brain where they are applied as well as the condition they are intended to treat. Brain Surgery in India has greatly advanced employing the use of modern medical technology in achieving successful procedures. This advancement has made it possible for surgeons to operate on sections of the brain without the need for making an incision in or near the head.

Brain surgeons are trained to handle each surgery on a case-to-case basis. This is key because every case they handle has its unique feature despite the similarities in symptoms from patient to patient. This begs the need for extreme care and thorough practice when handling the procedures. Additionally, as earlier stated, every brain surgery to be performed is greatly hinged on the condition that is being treated. A brain aneurysm, for instance, can be repaired using a catheter that is implanted into an artery in the groin area. However, an open surgery referred to as a craniotomy is employed if in any case, the aneurysm ruptures. Spine surgery in Delhi understands the importance of the brain in the optimal functioning of the central nervous system, a system formed by the brain and the spinal cord. Therefore, brain surgery ensures that the network of nerves, tissues, and fibers that form the CNS are repaired in order to restore normal body functions.

Spine surgery in Gurgaon

Spine surgery in Gurgaon is used to help patients restore communication between the brain and other parts of the body. The spinal cord forms the pathway for the transmission of these impulses and, therefore, it is very important. It is impossible to talk about normal functioning without mentioning this relationship between the spinal cord and the brain. For the optimal functioning of the CNS, the brain needs to be functioning properly without any structural problems. Through brain surgery, the normal functioning of the brain is achieved. However, it is important to get to know the different conditions that may necessitate surgery of the brain. These conditions include abnormal blood vessels, blood clots, abscesses, Parkinson’s disease, pressure after sustaining a head injury, skull fracture, and much more. Brain surgery may help correct these conditions, however, the procedure may not be necessary especially if they pose a risk for more serious health problems.

Dr. Arun Saroha (Brain Surgeon’s Viewpoint)

Dr. Arun Saroha is the Director and Head of the Neurosurgery Unit at Spine and Brain India. The doctor has gained a wealth of knowledge and experience to boot throughout his fifteen years in practice. This level of expertise has brought him an outstanding success rate throughout his career having performed over 6,000 neurosurgical procedures. The doctor ensures that all his patients are taken through all the necessary optional treatment present before resorting to performing surgery. This aspect is important because not all conditions that affect the brain require treatment through brain surgery.

Spine and Brain India hospital offer comprehensive brain surgery for all the patients that are brought to their attention. The facility is well equipped to handle the most complex types of brain surgery procedures making it possible for its surgeons to handle procedures like minimally invasive endonasal endoscopic surgery. The facility shows its prowess in the area of brain surgery from the point of diagnosing the different conditions affecting the brain. This kind of investment paired with a team of competent specialists, the facility guarantees the highest success rates that are imaginable in the field of brain surgery.

Dr Arun Saroha

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About Dr. Arun Saroha


Dr.Arun Saroha is working as Neurosurgeon with a special interest in spine surgery for the last 15 years. He specializes in Neuro-oncology, Paediatric Neurosurgery, Neurotrauma, Stroke & Cerebrovascular surgery including Transnasal surgeries. He has also been performing instrumented/ Non-instrumentation spine surgeries, including minimally invasive spine surgeries. He has performed more than 6,000 Neurosurgeries (Spine and Brain) successfully till date with patients from all over the world.

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