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Spinal Tumor – Types, Symptoms, Diagnosis And Treatment

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.

One way to describe a spine tumor is by whether it is primary or metastatic:

  • primary tumor is one that originated in the area in the area in which it is found.
  • metastatic tumor is one that develops as an extension of another cancer (such as lung, breast, colon, or kidney).

Another way to describe a tumor is by whether it is benign vs. malignant:

  • benign spinal tumor usually has definite borders and clean edges and does not infiltrate into healthy tissue. A benign tumor is not cancer, but it may need to be removed if it’s causing symptoms or creating pressure on the spine. Benign spine tumors include meningiomas, schwannomas, osteoid osteomas, and osteoblastomas.
  • malignant tumor is a cancerous growth that spreads and infiltrates into other tissue. Malignant spine tumors include chondrosarcomas, Ewing sarcomas, and osteosarcomas.

Spinal tumors may be referred to by the region of the spine in which they occur. These basic areas are cervical, thoracic, lumbar and sacrum. Additionally, they also are classified by their location in the spine into three major groups: intradural-extramedullary, intramedullary and extradural.

  • Intradural-extramedullary: These are tumors that occur outside the spinal cord but within its protective covering. These tumors are often meningiomas, Schwannomas, or neurofibromas. Like intramedullary tumors, these tumors are often benign, but they can be difficult to remove surgically and may recur after treatment.
  • Intramedullary: These tumors grow in the spinal cord itself, or in the nerves extending from the spinal cord, usually in the upper spine or neck (called the cervical spine). They are often astrocytomas, ependymomas, or hemangioblastomas. Intramedullary tumors are usually benign but can also be difficult to remove due to their location.
  • Extradural: These are the most common type of spinal tumors, forming outside the spinal cord and the dura in the bones and cartilage of the vertebrae. Some extradural tumors, such as osteosarcomas, osteoblastomas, and osteoid osteomas, arise from the vertebrae themselves (primary), but extradural tumors are more often metastatic tumors that spread from cancers of the lung, breast, prostate, and kidney.

Symptoms

Non-mechanical back pain, especially in the middle or lower back, is the most frequent symptom of both benign and malignant spinal tumors. This back pain is not specifically attributed to injury, stress or physical activity. However, the pain may increase with activity and is often worse at night. Pain may spread beyond the back to the hips, legs, feet or arms and may worsen over time — even when treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes. Depending on the location and type of tumor, other signs and symptoms can develop, especially as a malignant tumor grows and compresses on the spinal cord, the nerve roots, blood vessels or bones of the spine. Impingement of the tumor on the spinal cord can be life-threatening in itself.

Additional symptoms can include the following:

  • Loss of sensation or muscle weakness in the legs, arms or chest
  • Difficulty walking, which may cause falls
  • Decreased sensitivity to pain, heat and cold
  • Loss of bowel or bladder function
  • Paralysis that may occur in varying degrees and in different parts of the body, depending on which nerves are compressed
  • Scoliosis or other spinal deformity resulting from a large, but benign tumor

Diagnosis

A thorough medical examination with emphasis on back pain and neurological deficits is the first step to diagnosing a spinal tumor. Radiological tests are required for an accurate and positive diagnosis which includes – X-ray, CT scan, MRI

After radiological confirmation of the tumor, the only way to determine whether the tumor is benign or malignant is to examine a small tissue sample (extracted through a biopsy procedure) under a microscope. If the tumor is malignant, a biopsy also helps determine the cancer’s type, which subsequently determines treatment options.

Treatment Options:

Treatment options include surgery, radiation, chemotherapy, or a combination of all three depending on the unique circumstances associated with each individual tumor.

Tumors that are asymptomtic or mildly symptomatic and do not appear to be changing or progressing may be observed and monitored with regular MRIs. Some tumors respond well to chemotherapy and others to radiation therapy. However, there are specific types of metastatic tumors that are inherently radioresistant (i.e. gastrointestinal tract and kidney): in those cases, surgery may be the only viable treatment option.

Multiple surgical treatment options are available ranging from surgery to correct spinal deformity or neural compression to interventional techniques where cement is injected into the bone to help strengthen the spine.

 

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Medical Travel To India

Accessibility to superlative medical treatment that is being provided by skilled doctors at internationally accredited hospitals has made India grow as a hub for the medical tourists every year. The prime reason being the cost of medical treatment in India being cheaper when compared to Western Europe, North America and some Southeast Asian countries.

Top Reasons Why India Is A Preferred Destination For Medical Travel:

Everybody can avail tertiary medical treatment in India which is either not available or people cannot afford it in their home country. Here are 7 major factors which make India an ideal medical tourism spot:

  1. Low Cost Of Treatment. India has one of the most affordable cost of treatment in the world. Some treatments can be provided for little as 10% of the cost that it would be available for in other countries like the US or UK. People can expect to save about 50-60% while receiving treatment in India compared to that in the West. Medical care in India is of supreme quality. It enables the patient to receive life-altering or life-saving treatment that may not otherwise be afforded.
  2. Easy to obtain medical visas. Visas are easily granted in a short period of time and the waiting period for most life-altering or life-saving procedures are almost non-existent. Government of India has introduced an e-visa program which enables citizens of more than 150 countries to get visa within 24-48 hours. Patients that need help in order to avoid more medical complications, permanent disabilities, or sometimes even death are given priority. The government of India has ensured that people who need critical, life-saving treatment should get their visas in a timely manner.
  3. No waiting period to get surgeries done. In the Western nations, sometimes people have to wait weeks or months for vital, life-saving treatments which can extend to years for elective procedures. Having procedures done so quickly helps avoid further complications and health problems in the future.  India provides this welcome change of pace to many patients from all around the world who desperately needs medical attention. Having procedures done in a timely manner has saved countless lives, and will save much more in the future.
  4. High skill level of doctors in India. Doctors are mostly always trained in the country’s top medical universities or in other Western-style schools. India has a strong base of qualified and skilled doctors. Another major factor that has made India succeed in inviting the medical tourists is the populace of good English speaking doctors, guides and medical staff which makes it easier for the foreign tourists to correlate well to Indian doctors. Language barriers are rarely an issue. These doctors also travel and conduct medical camps in different countries in Africa, Middle East, South East Asia, and the CIS region.
  5. World-class and standardized medical services and care with state of the art facilities and equipments. Indian hospitals are equipped with best in class technology and systems which compare very well with the top hospitals around the world. Despite being a “developing” nation, premium, Western-standardized care to their patients are being provided. Some of these services can include things like language translators or personal assistance for those who are disabled. Patients are provided with 24/7 access to the hospital facilities as a standard of excellent services.
  6. Offer therapies like Ayurveda, Naturopathy and Yoga. Availability of holistic, natural treatments like Ayurveda, Naturopathy, and Yoga which have originated in India itself. These are fabulous techniques to aid in post-retreatment recovery for many patients. The therapies provide a relaxing aspect to healing, which helps many patients feel better much sooner. The psychological benefits are oftentimes positive as well.
  7. Exotic destinations. Great sightseeing and opportunities to go see parts of the world and experience cultures that you may never otherwise experience can enhance the benefits of medical tourism. India provides an opportunity to the medical tourists to visit some of the most alluring and awe-inspiring places which can sometimes be the best part of medical tourist trip.
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Neck Pain – Symptoms, Causes, Diagnosis and Treatment Options

Best Neck Pain Treatment in Delhi And Gurugram – Dr. Arun Saroha

Pain located in the neck is a common medical condition. Neck pain is also referred to as cervical pain. The neck is made up of vertebrae that extend from the skull to the upper torso. Cervical discs absorb shock between the bones. The bones, ligaments, and muscles of the neck support the head and allow for motion. Any abnormalities, inflammation, or injury can cause neck pain or stiffness.

Many people experience neck pain or stiffness occasionally. In many cases, it’s due to poor posture or overuse. Sometimes, neck pain is caused by injury from a fall, contact sports, or whiplash.

Most of the time, neck pain isn’t a serious condition and can be relieved within a few days. But in some cases, neck pain can indicate serious injury or illness and require a doctor’s care. If the pain continues for more than a week, is severe, or is accompanied by other symptoms, seek medical attention immediately.

Common Symptoms Of Neck Pain:

  • Stiff neck. Soreness and difficulty moving the neck, especially when trying to turn the head from side to side.
  • General soreness. The pain is mostly in one spot or area on the neck, and it’s described as tender or achy, not sharp.
  • Sharp pain. This symptom can be pain localized to one spot and might feel like it’s stabbing or stinging. Often, this type of pain occurs in the lower levels of the neck.
  • Radiating pain. The pain can radiate along a nerve from the neck into the shoulders and arms. The intensity can vary and this nerve pain might feel like it’s burning or searing.
  • Tingling, numbness, or weakness. These sensations can go beyond the neck and radiate into the shoulder, arm or finger. There could be a “pins-and-needles” sensation. Typically, pain that radiates down the arm is felt in only one arm, not both.
  • Trouble with gripping or lifting objects. This can happen if tingling, numbness, or weakness in the fingers is present.
  • Headaches. Sometimes an irritation in the neck can also affect muscles and nerves connected to the head.

Common Causes Of Neck Pain

In order to effectively treat neck pain, it’s important to understand the underlying medical condition that’s causing the pain. This is especially true if the pain has lasted 4 or more weeks. Neck pain causes include:

  • Muscle strains. Overuse, such as too many hours hunched over computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting teeth, can strain neck muscles.
  • Worn joints. Just like the other joints in the body, neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between the bones (vertebrae) to deteriorate. Bone spurs are then formed that affects joint motion and cause pain.
  • Nerve compression. Herniated disks or bone spurs in the vertebrae of the neck can press on the nerves branching out from the spinal cord.
  • Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
  • Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain.

Diagnosing Neck Pain:

As a first step to diagnosing the specific cause of neck pain, the doctor will take a thorough history of the patient in order to better understand the nature of the patient’s pain, such as if the pain is worse at certain times of day or exacerbated by certain activities. Physical examination will also be conducted to assess the neck movements.

Certain imaging tests are advised to get a better picture of the cause of the neck pain which includes:

  • X-rays.X-rays can reveal areas in your neck where your nerves or spinal cord might be pinched by bone spurs or other degenerative changes.
  • CT scan.CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
  • MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.

It’s possible to have X-ray or MRI evidence of structural problems in the neck without having symptoms. Imaging studies are best used as an adjunct to a careful history and physical exam to determine the cause of pain.

Treatment:

The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks. If neck pain persists, other treatments might be recommended.

Medications: Many over-the-counter pain relievers are available to either reduce inflammation or hinder pain signals from reaching the brain. However, these drugs must be used with caution. Read the pain reliever’s entire label for directions and warnings, and be careful not to overdose. Consult a doctor who might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.

Therapy:

  • Physical therapy.Correct posture, alignment and neck-strengthening exercises, use of heat, ice, electrical stimulation and other measures can help ease the pain and prevent a recurrence.
  • Transcutaneous electrical nerve stimulation (TENS).Electrodes placed on the skin near the painful areas deliver tiny electrical impulses that may relieve pain.
  • Traction uses weights, pulleys or an air bladder to gently stretch the neck. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.
  • Short-term immobilization.A soft collar that supports the neck may help relieve pain by taking pressure off the structures in the neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.

Surgical and other procedures

  • Steroid injections.Your doctor might inject corticosteroid medications near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in the neck to help with pain. Numbing medications, such as lidocaine, also can be injected to relieve neck pain.
  • There are three common reasons to have surgery for a problem in the neck:
  1. To remove the damaged disc and/or other structures irritating a nerve root
  2. To stabilize the cervical spine
  3. To decompress the spinal cord

Common Types of Surgery for Neck Pain

  • Anterior cervical discectomy and fusion (ACDF): The most common surgery for neck pain symptoms involves a discectomy, which is the removal of a problematic disc in the cervical spine. Typically, the surgery is done through the front of the neck, called anterior cervical discectomy; this procedure is done in conjunction with a cervical spinal fusion to maintain spinal stability where the disc was removed, so the entire surgery is called an anterior cervical discectomy and fusion, or ACDF for short.
  • Posterior cervical decompression (Microdiscectomy) surgery: Another way to do a discectomy is through the back of the neck, where only part of the disc is removed and no spinal fusion is needed.
  • Cervical artificial disc replacement: somewhat newer option is discectomy with artificial disc replacement. This surgical procedure involves removal of the damaged disc and replacement with an artificial disc. This surgery is an alternative to ACDF. A potential benefit of this surgery is that it retains more neck flexibility.
  • Spinal decompression: There are a few different surgical options available to relieve symptoms of myelopathy and increase space in the spinal canal for the spinal cord:
    • Anterior cervical corpectomy. This surgery is similar to anterior cervical discectomy, except that it involves the removal of at least one vertebral body (the cylindrical bone at the front of a vertebra) along with the adjacent discs above and below that vertebra. After the removal, a bone graft and/or cage will be placed to fill the space and set up a favorable environment for the bones to fuse together into one solid segment of bone. This surgery may be done for someone who has spinal stenosis at more than one vertebra.
    • Posterior cervical laminectomy. This surgery is done through the back of the neck and involves the removal of a lamina, which is the back part of a vertebra. A potential advantage to this surgery is that more flexibility in the neck can be retained if a spinal fusion can be avoided. However, sometimes a spinal fusion is still done in conjunction with laminectomy.
    • Posterior cervical laminoplasty. This surgery is similar to the laminectomy, except the lamina isn’t completely removed. Rather the lamina is cut and restructured to make more space in the spinal canal.
    • Posterior cervical foraminotomy. This surgical procedure goes through the back of the neck and a small part of the foramen is removed. If a nerve is irritated by a herniated disc, then the surgeon might remove part of the disc. If a nerve is irritated by a bone spur, then the surgeon will chisel away that bone spur. No spinal fusion is needed.
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افضل جراحة عمود فقري وجمله عصبيه في مدينة نيودلهي _ جرجاون

لماذا العمود الفقري والدماغ الهند – الدكتور آرون ساروها

الدكتور آرون ساروها هو جراح عصبي وعمود فقري شهير يتمتع بخبرة تزيد عن 18 عامًا. وهو عضو في العديد من المنظمات المرموقة في مجال جراحة الأعصاب والعمود الفقري في جميع أنحاء الهند والولايات المتحدة الأمريكية. لديه خبرة في مجالات مختلفة من جراحة الأعصاب والعمود الفقري

وهو متخصص في علاج الأورام العصبية ، الصدمة العصبية ، جراحة المخ والأعصاب لدى الأطفال ، تشوهات الدماغ والسكتة الدماغية ، العمليات الجراحية عبر الأنف ، استبدال القرص ، تثبيت العمود الفقري المركب وجميع أنواع تشوهات العمود الفقري

رأي الطبيب: قبل السفر إلى الهند لتلقي العلاج ، يمكنك مشاركة تقاريرك الطبية وسنعلمك بخط العلاج المطلوب ، وتكلفة العلاج ، والبقاء في الهند – عدد الأيام في المستشفى والإقامة بعد التخريج ومعدل النجاح من العلاج.

المساعدة السريعة للتأشيرة: سيتم إصدار خطاب دعوة مجانية للحصول على تأشيرة دخول من المستشفى عند مشاركة نسخ جواز السفر الخاصة بك (المريض + مضيف) معنا. الحصول على تأشيرات لغرض طبي هو أسهل بكثير من أي وقت مضى. تعطى الأولوية للمرضى الذين يعانون من أكثر الظروف تهديدا للحياة.

اختيار المطار و التنقل : بمجرد قيامك بحجز تذاكر الطيران الخاصة بك ، يمكنك مشاركة بيانات سفرك معنا. ستكون هناك خدمة استقبال مجانية عند وصولك وتوصيلك الى الفندق وأيضًا في وقت المغادرة بعد الانتهاء من العلاج.

دورة العلاج: سيتم تحديد موعد استشارة الطبيب وفقًا لذلك. سيتم إجراء تقييم وشامل في البداية للمضي قدماً في العلاج. لن تكون هناك فترة انتظار لإنجاز الإجراء. يساعد تنفيذ الإجراءات بهذه السرعة على تجنب المزيد من المضاعفات والمشكلات الصحية في المستقبل. هذه هي المشاكل التي يمكن أن يكون سببها الانتظار لفترة أطول في وطنك. يتم تقديم خدمات ورعاية قياسية وعالمية بمساعدة أحدث التقنيات

عادة ما يظل أي مرضى الجراحه في الجهاز العصبي أو العمود الفقري في المستشفى لمدة 3-5 أيام حسب إجراءات المريض وحالته. بعد الخروج من المستشفى ، ستكون هناك حاجة إلى 10-14 يومًا في الهند للمتابعة في العيادة الخارجية

المساعدة اللغوية: سيتم تعيين مترجمين للمرضى الذين لا يتحدثون الإنجليزية بما في ذلك العرب والكونغوليين والروس والأفغان طوال فترة العلاج. نحن نؤكد تفسيرات واضحة وواضحة وهو أمر مهم للغاية حيث يجب أن يتم إيصال القضايا الصحية بدقة وكذلك ينبغي أن يقترح العلاج الذي اقترحه الطبيب لتجنب أي شكوك  او اسأله محيره و التي يمكن أن تنشأ عن فقدان الترجمة

الإقامة في الفنادق / الفنادق: يوجد العديد من دور الضيافة / الفنادق القريبة من المستشفى على بعد 1- 3 كيلومترات. سنساعدك في العثور على أفضل ما يناسب ميزانيتك

جعلت الجودة العالية والتكلفة المنخفضة للعلاج الهند واحدة من أكثر الوجهات المفضلة للسياح الطبيين. الهند ، مع تراثها القديم والحديث ، وتنوع الثقافة والوجهات الغريبة هي دائما عامل جذب للمسافرين الدوليين. يوفر السفر الطبي مزيجًا من المتعة والرعاية الصحية الفائقة الجودة للمرضى الطبيين القادمين إلى الهند

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Cervical Disk Replacement Surgery in India

Defining Cervical Disk

Cervical disk syndrome is the neurosurgical condition that is caused by displacement or compression of cervical cord or root. It can be characterized by

  • radicular– suboccipital
  • cervical, interscapular

And

  • thoracic pain

Which radiates into the upper extremities, aggravated by movement and accompanied by paresthesias. Cervical Disk may be accompanied by muscle fasciculation’s, spasms, and atrophy, and spastic bladder Diagnosis Narrowed disk spaces,

osteophytes, or spinal stenosis by radiology, myelography. Most of the cervical disk syndromes are caused by injuries that involve hyperextension.

The cervical disc is a disk-shaped piece of specialized tissue that separates the vertebral bones of the spinal column in the neck.

When the disc has ruptured, it creates pressure against one or more of the spinal nerves which can cause pain, weakness or numbness in the neck and arm.

Cervical Disk Replacement Surgery in Gurgaon

The nucleus is the center of the disk. It is soft, springy and is able receives shock because of standing, walking, running, etc.

There is a ring that at the outer side the ring, it is called annulus. It provides structure and strength to the disc.

Also, it consists of complex interwoven layers of fibrous tissue that are responsible for holding the nucleus in place.

If part of the disc has moved out of normal position where it used to be it will cause pressure on the spinal cord in the center or on the individual nerve roots that exit from the spinal canal.

Over time, the body’s reaction to a disrupted disc is the formation of bone spurs called osteophytes which can also cause pressure on the spinal cord or nerve roots.

Cervical Disk Replacement Surgery in Delhi

Disc disruption and degeneration can cause neck pain as well as cause neurologic symptoms which may include pain, numbness or weakness that radiates from the neck into one or both arms.

Dr. Arun Saroha, is a degenerative spine disorder and disc replacements, specialist. He was Awarded “Best Spine Surgeon”

by BIG RESEARCH AWARDS at New Delhi 2013. Dr. Arun Saroha has also been a neurosurgeon at PGIMER, Chandigarh. He explains the process of treatment for Cervical Disk

Process of treatment

The initial treatment for cervical disc disease generally involves physical therapy, medications, and occasionally spinal injection procedures.

If the symptoms continue to persist for more than 6-12 weeks, surgical treatment can be considered. The most common and traditional treatment for symptomatic cervical disc disease involves an anterior cervical discectomy and fusion surgery.

The anterior cervical discectomy and fusion technique

In this technique, an incision is made in the front of the neck. Therefore allowing the surgeon to remove the damaged and protruding disc in order to relieve any pressure on the spinal cord and nerve roots. After the disc is removed,

the gap that has been created between the two bones is then filled with a piece of bone graft or with a synthetic cage device. Once the pressure on the nerves is relieved,

Cervical Disk Replacement Surgery

procedure has to cause the two bones to grow together which is called a fusion, resulting in a complete loss of any kind of motion at the surgical level.

In the anterior cervical discectomy and fusion procedure, a plate with screws is applied to the front of the spine to provide initial stability which assists in achieving a solid fusion.

After that the fusion, patients are often immobilized for up to six weeks in a cervical collar. A disc replacement device composes of two metallic surfaces one of which is attached to the upper and the other to the lower vertebra at the affected disc level.

These metal implants can then slide on each other directly or can be separated by a piece of medical grade plastic. The device allows for movement between the two vertebrae to be maintained and avoids the need for a fusion.

 

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