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TREATMENT

Alzheimer’s disease

Alzheimer’s disease is complicated as it comprises many unknowns. The symptoms of it transform as per the stages. However, it is known that this condition worsens across time, however, treatment could assist in delaying the symptoms & improve the quality of life of a patient.If we doubt having Alzheimer’s we shall 1st consult a doctor. They can try to diagnose it and talk regarding what to expect & help connect us with services & support.

Prevention of Alzheimer’s Disease

Researches haven’t yet found a way of preventing Alzheimer’s. But there are some points which researches suggest could help. We can do the below to help curb the progress or possibly prevent this disease:-

  • Keep our mind active with puzzles, word games & memory games or keep trying other cognitive training exercises
  • Stay physically active and exercise regularly
  • Continue to learn new things. This is another avenue to keep our minds active
  • Stay socially active
  • Quit smoking
  • Consume more antioxidants
  • Treat high blood pressure
  • Get adequate sleep
  • Take a plant-based diet

Researchers currently are aiming at overall healthy lifestyle activities or habit as an avenue for preventing of cognitive decline

There isn’t a proof currently that any of them would prevent us from getting Alzheimer’s. But they all do promote good brain health & have many other advantages beyond helping to battle Alzheimer’s.

Treatments can curb the progression of Alzheimer’s disease. But we shall start early as the earlier we begin on them, the better our quality of life could be.

Researchers have been working to better comprehend Alzheimer’s disease and its effect on our brains. Once they understand it better, it would be easier to explore the treatments. Meanwhile, research on Alzheimer’s disease is 1 of the top forms of studies being done currently. New updates are being learned every day & new treatments are being researched. If we are diagnosed with Alzheimer’s, the best thing we could do is speak to a doctor & being the treatment as soon as possible

WHAT IS ALZHEIMER’S DISEASE

Alzheimer’s disease is a progressive kind of dementia. A dementia is a broader term for the conditions that result from injuries to the brain or the diseases which negatively affect thought, memory & behavior. The transformations interfere with the everyday life.

Alzheimer’s disease alone accounts for 60% – 80% of the cases of dementia. Most patients having this disease are diagnosed post the age of 65 years. If it is diagnosed earlier then it is usually termed as early onset of Alzheimer’s disease.

Facts about Alzheimer’s disease:

Although many individuals know about Alzheimer’s, some of us are not sure as to what exactly it is. Mentioned below are some facts regarding Alzheimer’s disease:

  • Alzheimer’s disease is an ongoing chronic condition.
  • The symptoms of it progress gradually & the effects on the brain are degenerative as they result in a slow decline.

  • There is no cure for Alzheimer’s disease however, treatment could help curb the progression of it & may improve the quality of living.
  • Anybody may suffer from Alzheimer’s; however, certain individuals are at an increased risk of it. This includes the individuals over the age of 65 years & those having a family history of this condition.
  • Alzheimer’s disease & dementia aren’t the same. Alzheimer’s is a kind of dementia.
  • There isn’t a single anticipated outcome for individuals having Alzheimer’s disease. Some individuals live long with mild cognitive damage whereas, other people experience a comparatively more rapid onset of the symptoms & faster progression of the disease.
Dementia & Alzheimer’s Disease

The terms Alzheimer’s & dementia are sometimes thought to be the same. But the 2 conditions aren’t the same. Alzheimer’s is a kind of dementia.

Dementia is a broader terminology for the conditions having symptoms relevant to memory loss i.e. confusion and forgetfulness. Dementia includes conditions that are more specific like Alzheimer’s disease, Parkinson’s disease & others. The symptoms, causes & treatments could be different for these diseases.

DOWN SYNDROME – SYMPTOMS, CAUSES, DIAGNOSIS AND TREATMENT

Down syndrome is a set of physical and mental traits caused by a gene problem that happens before birth. Children who have Down syndrome tend to have certain features, such as a flat face and a short neck. They also have some degree of intellectual disability.

Causes of Down Syndrome:

Most people with Down syndrome have 47 chromosomes. Down syndrome is caused by a problem with a baby’s chromosomes. Normally, a person has 46 chromosomes. In rare cases, other chromosome problems cause Down syndrome. Childbirth at an advanced age (> 35 yrs) is a risk factor for Down syndrome.

Symptoms of Down Syndrome:

Most children with Down syndrome have:

  • The groove between the first and second toe (sandal gap).
  • Broad hands with short fingers.

  • Palm may have only one crease (palmar crease)
  • Flattened face
  • Small head
  • Short neck
  • Protruding tongue
  • Upward slanting eyelids (palpebral fissures)
  • Unusually shaped or small ears
  • Poor muscle tone
  • Broad, short hands with a single crease in the palm
  • Relatively short fingers and small hands and feet
  • Excessive flexibility
  • Short height
How to diagnose Down Syndrome?
  • Screening tests, such as an ultrasound or a blood test during your first or second trimester. These can help show if the developing baby (fetus) is at risk for Down syndrome. But these tests sometimes give false-positive or false-negative results.
  • Diagnostic tests, such as chorionic villus sampling or amniocentesis. These can show if a baby has Down syndrome.
Treatment Overview of Down Syndrome.

It is common to experience a wide range of emotions when your baby is born with Down syndrome. While you have joy from your child’s birth, you will also need to learn about and care for his or her special care needs. Treatment for Down syndrome focuses on making sure that your child has regular medical checkups, helping your child develop, watching for early signs of health problems, and finding support.

WHAT ARE THE EARLY SIGNS OF PARKINSON’S DISEASE?

Parkinson’s Disease can be defined as a neurodegenerative disorder that affects the nerve cells. This disorder is due to the absence of dopamine. The signs and symptoms of Parkinson’s include – muscle rigidity, tremors, and changes in speech and gait. It is important to understand that Parkinson’s cannot be cured. It can only be managed with the right medication and medical attention.

Signs and Symptoms associated with Parkinson’s Disease: Symptoms of Down Syndrome:

Most children with Down syndrome have:

  • Tremors: Tremor in your finger, thumbs, hand or chin. It is a common early sign of Parkinson’s disease..
  • Loss of Smell: The patient may have trouble smelling foods like bananas, dill pickles or liquorice.
  • Sleeping Trouble: Sudden movements during sleep may be a sign of Parkinson’s disease.
  • Trouble Moving or Walking: An early sign might be stiffness or pain in your shoulder or hips.
  • Constipation: If enough water or fibre is not n your diet, it can cause problems in the bathroom.
  • Soft or Low Voice: A chest cold or other virus can cause your voice to sound different.
  • Masked Face: Depressed or mad look on your face, even when you are not in a bad mood.
  • Dizziness or Fainting: Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson’s disease.

  • Stooping or Hunching Over: If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

Brain Tumor-Related Epilepsy

In 20-40% of the patients who are diagnosed with Brain Tumour, seizures are the most common first symptom. Moreover in 20-45% of the cases these seizures are associated with the patient during the entire time, till the tumour is present in the body. Post surgery only this symptom is seen to disappear. These patients are present with a complicated therapeutic profile and it requires a unique and multidisciplinary approach. The choice of the antiepileptic drugs is challenging for this particular patient population because brain tumor-related epilepsy is often drug resistant has a strong impact on the quality of life and weighs heavily on public health expenditures.

Brain Tumors and Epilepsy:

The most of the common symptom in patients with Brain Tumors is seizure. Majority of the patient has this symptom to highlight the onset of the disease. However all seizures cannot be associated with brain tumors. Seizures are basically caused to due abnormal brain activity and the same could be a result of any other complication. In majority cases epilepsy-related seizures are associated in patients that have high grade tumors.-

Overall epilepsy in Brain Tumors, regardless of histological type and anatomical site of the lesion varies from 35% to 70 %.Epilepsy due to the Brain Tumors constitutes 6 % to 10% of all cases of epilepsy as a whole and 12% of acquired epilepsy.

Brain tumor-related epilepsy is an episode by its pharmacological resistance. Pharmacoresistant Epilepsy can be known as a primary related to an intrinsic component of the illness and secondary.

Types of Seizures in Brain Tumor patients:

Seizures are usually grouped according to:

  • Where they commence in the brain – Know as Onset
  • Where the patient’s consciousness is affected due to the presence of a tumor – alters their level of awareness : Focal aware (previously called simple partial seizures), Focal impaired awareness (previously called complex partial seizures), Generalised seizures
  • Where the seizures are affecting the movement of the patient : Motor seizures, Non-motor seizures

WHAT DISEASE IS ASSOCIATED WITH AUTISM?

Autism is a disorder of the brain, a condition where a part of the brain stops functioning. Some areas of the brain find it hard to communicate or relate to others. Hence, people who have this disorder find it difficult to relate to others. However, diagnosis and treatment at an early stage can help people overcome the situation. Autism is an inherited disorder. Research to discover the exact gene that carries autism is ongoing. Scientists are also exploring to see if medical problems can cause autism. Although some childhood vaccines (for measles-mumps-rubella or MMR vaccine) have been linked to autism, there is no evidence as such to prove the same. Hence, ensure that your child gets vaccinated against all serious diseases.

What are the symptoms of Autism?

Autism symptoms can be detected even before the chid is 3 years old. Some signs would be when:

  • A child fails to speak or does not show an inclination or ability in learning syllables.
  • He/she may also seem deaf despite having a normal hearing capacity.
  • The child exhibits repeated and overused patterns of behavior. For e.g. a child may compulsively repeat body movements in a certain pattern or may be acutely obsessed with certain objects.
  • The child may also show signs of agitation if there is a change in routine

All the patterns may range from mild to severe.

Other problems associated with autism include:
  • Most children have below-normal intelligence.
  • Teens become victims of depression and those with average or above-average intelligence experience anxiety.
  • Some teens may also experience seizures such as epilepsy.

EPILEPSY: CAUSES, SYMPTOMS AND TREATMENTS

Healthy people may have seizures under certain circumstances. If the seizures have a known cause, the condition is referred to as secondary or symptomatic epilepsy. Epilepsy has no identifiable cause in about half the people with the condition. In the other half, the condition may be traced to various factors. Below are a few factors listed that can cause epilepsy:

  • Genetic Factors:
    Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, may run in families. In these cases, it’s likely that there’s a genetic influence. Certain genes may make a person more sensitive to environmental conditions that trigger seizures.
  • Head Injury or Trauma :
    Head trauma as a result of an accident or another traumatic injury can cause epilepsy. It is important to report any such incident to your neuro specialist.
  • Stooping or Hunching Over: If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

  • Brain conditions:
    Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35.
  • Infectious diseases:
    Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy.
  • Prenatal injury:
    Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy.
  • Developmental Disorders:
    Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis.
  • Symptoms associated with Epilepsy:
    Before a seizure, many people experience a warning sign called an aura, which may involve a particular smell, feeling, or visual effect. After a seizure, a person may be confused, tired, or sleepy, may experience muscle aches or soreness, and may not remember what happened.
    • Temporary confusion
    • A staring spell
    • Uncontrollable jerking movements of the arms and legs
    • Loss of consciousness or awareness
  • Dizziness or Fainting: Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to Parkinson’s disease.

BRAIN PET SCAN AND WHY IT IS PERFORMED

A PET or brain positron emission tomography scan is an imaging test which facilitates doctors to assess the functionality of a brain. This scan captures the images of the brain activities post the radioactive ‘tracers’ have been absorbed into the bloodstream. The tracers are linked to compounds such as sugar (glucose). Glucose is principal fuel for the brain.

Active areas of brain utilize glucose at a higher rate than the inactive part. When highlighted through a PET scanner, this allows doctors to identify the working status of the brain & assists them to identify any abnormality.

It is usually an outpatient process, meaning that we are able to leave about our day after the test has been done.

Why is PET Scan done?

This test accurately details the shape, size & function of the brain. Unlike the other scans, the PET scan facilitates doctors to see the structure of the brain and it’s functioning.

It allows doctors to:-
  • Check and Identify cancer
  • investigate dementia including the Alzheimer’s disease
  • Determining whether cancer has spread to our brain
  • Differentiate Parkinson’s disease from the other conditions
  • Prepare for the epilepsy surgery

Our doctor could ask us to undergo a PET scan of brain regularly when we undergo treatment for a brain disorder. This could assist him/her in monitoring the progress of our treatment.

Preparing for a Brain PET scan

Doctors provide us a complete update to assist us in preparing for our brain PET scan. We shall alert our doctor to any medication we may be taking, whether they are over the counter, prescription or even a nutritional supplement.

We may be instructed for not eating anything for up to 8 hours prior to our procedure. We can drink water.

Women should inform their doctors if they are pregnant or even if they believe they could be pregnant as the test could be unsafe for the fetus. We shall also update our doctor regarding any medical condition we may have i.e. individuals having diabetes would likely be provided special instructions for this test. Prior fasting can negatively affect the blood sugar levels.



CAUSES, SYMPTOMS AND TESTS OF PARAPLEGIA

Paraplegia is a medical condition wherein which an individual suffers from loss of feeling and/or loss of movement in the body. This generally takes place post some injury in the nervous system. Paraplegia may include partial or complete paralysis of legs and/or trunk. The location and severity of damage of the nervous system define the extent of paralysis. Only the lower half of body gets paralyzed in paraplegia whereas, paralysis of the complete body along with arms is called Quadriplegia.

Depending on the location & extent of damage to the nervous system, there are certain patients who are able to resume minimal function. Majority of the patients having paraplegia would have the condition permanently. The treatment is dependent on causes & comprises of rehab & physical therapy mainly.

Causes

Most common reason for paraplegia is an injury or trauma to the nervous system. Other causes are:

  • Injury to neck leading to fracture of cervical vertebrae
  • Broken or fractured back wherein which lumbar vertebrae get fractured
  • Injury to the spinal cord
  • Hereditary spastic paraplegia which happens to be a genetic disorder
  • Stroke
  • It could be congenital e.g. present at birth
  • Autoimmune diseases
  • Presence of a tumor within spinal cord or constriction of spinal cord
  • Spinal cord disorders like the syrinx
  • Infection
Symptoms

Symptoms depend on the degree of involvement of the spinal cord

We may be instructed for not eating anything for up to 8 hours prior to our procedure. We can drink water.

  • Patients experience loss of muscle control or movement in legs, toes, feet or trunk.
  • Tingling sensation in legs, toes, feet or trunk could be felt as well
  • Patients experience loss of sensation in legs, toes, feet or trunk
  • Sexual dysfunction
  • Bladder & bowel incontinence
Tests

Tests for diagnosing Paraplegia are:

  • Medical history & physical exam
  • CT Scan for assessing any injury to spine or head
  • MRI Scan, wherein which the magnetic waves are used for taking pictures of structures within spine and head
  • Blood tests like CBC
  • Myelography is a type of X-ray that used an injection of contrast medium to have a clearer vision of spinal cord
  • Lumbar puncture is performed wherein a sample of cerebrospinal fluid or CSF is taken from the lower back
  • The evoked potential nerve test is made for assessing the pathways of nerve


MONOPLEGIA AND HEMIPLEGIA

In reality, there exist several kinds of paralysis as there are many ways in which our body could be injured. Paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the way messages pass between your brain and muscles. Paralysis can be complete or partial. It can occur on one or both sides of your body. It can also occur in just one area, or it can be widespread. Here we would discuss 2 categories of paralysis.

Monoplegia

It is the paralysis of a single portion of the body, most typically a limb. Individuals having monoplegia, usually retain control over the rest of their body, however, cannot feel sensations in or cannot move the affected limb. Cerebral Palsy is the biggest reason for monoplegia but there are also other ailments and injuries which can cause this form of a partial paralysis, comprising:

  • Strokests
  • Nerve damage because of diseases or injuries
  • Tumors

    Nerve impingement
  • Brain injuries
  • Motor neuron damage
  • Severed or impacted nerves at an affected location

Monoplegia could also sometimes be a temporary condition & is especially common post a brain injury or stroke. When the nerves that affect the paralyzed part aren’t fully severed, it is often possible to also regain significant function by physical therapy.

Hemiplegia

It affects a leg or an arm on the same side of our body & as with monoplegia, the biggest cause happens to be cerebral palsy. With hemiplegia, the extent of paralysis varies from individual to individual & could change over time. Hemiplegia often starts with a sensation of pins & needles, increases to the weakness of muscles & escalates to form a complete paralysis. But many individuals having hemiplegia have found that the extent of functioning varies day to day & depending on their activity level, overall health and also other factors.

Hemiplegia shall not be confused with a hemiparesis which refers to the weakening of 1 side of the body. Nevertheless, a hemiparesis is often a precursor to a hemiplegia, mainly for the patients having neurological problems.

Hemiplegia sometimes is temporary & the overall prognosis is dependent on treatment, along with early intervention in physical & occupational therapy.

There isn’t anyone approaches for treatment which works for all individuals. Instead, the treatment mainly depends on the reason of hemiplegia.



WHAT IS QUADRIPLEGIA

Quadriplegia is also called tetraplegia. It is named so as it affects all the 4 limbs along with the torso. Most individuals having tetraplegia get significant paralysis under the neck & many aren’t able to move at all. Such paralysis is unavoidably a product of damage high in the spinal cord, usually in the cervical spine between C1 & C7. The higher the injury, the more severe the damage would be. Very high SCIs are often immediately lethal.

We may think that a total paralysis of legs & arms features damage to limbs, however; most of the quadriplegics have perfectly healthy arms & legs. Instead, the problem starts in the spinal cord or brain & occasionally in both as well. The spinal cord is charged with transferring signals to & from the brain, whereas the brain processes & interprets those signals. Hence an SCI prevents our brain from delivering & receiving signals, whereas a brain injury dents the ability of our brain to process them.

Injuries which result in quadriplegia are unpredictable as several complex structures are often involved. There is a lot more to be researched about the delicate nature of the spinal cord and brain. Researches so far suggest that i.e. our brain compensates for injuries in some parts & also for extensive damages, however, that healing from injuries in other parts may be virtually not possible.

Therefore, it may be tough to provide a precise prognosis to individuals having quadriplegia. S the swelling on the injury site goes down, some function could be restored. Few tetraplegics also spontaneously heal up. Other treatments & surgery can help, mainly if the surgeon is capable of moving something which compresses the spinal cord or is impeding the function of the brain.

Major Causes of Quadriplegia :

Any injury that takes place high in a spinal cord or affects many areas in our brain could result in paralysis in all 4 limbs. SCIs account for most of the cases of quadriplegia, with the top causes of SCIs being the below

  • Car accidents
  • Falls
  • Violence like gunshots are the top reason for violent injuries
  • Sports & recreational activities
  • Medical & Surgical accidents

WHAT IS A SPINAL CORD INJURY?

The spinal cord is the continuation of the brain. It starts at the junction of the head with the neck. It further extends in a bony canal which is present within each vertebra. This canal is present throughout the vertebral column. The spinal cord extends till the junction of lumbar 1 and lumbar 2 vertebrae. Beyond this only nerve, rootlets called as cauda equina extends. The spinal cord is made up of neurons or cells and nerve fibers. The neurons act as intermediate relay centers which help in relaying signals from the brain to respective peripheral nerves and in reverse direction. The nerve fibers act as cables carrying signals from the brain to peripheral target organs and carrying sensation from the periphery to cells in the brain. As this spinal cord passes through each vertebra, it gives out a couple of branches at each level – meant for right and left side of body.

What are common causes of spinal cord injury?

Most common cause of injury is trauma. Trauma- vehicular or fall can result in fracture or dislocation of the vertebra. Bony fragment or intervertebral disc can lead to compression of spinal cord. Other causes include – infection, tumor, vascular insult, deformity of long standing duration – kyphosis and kyphoscoliosis.

What are the effects of spinal cord injury?

In an event of trauma, there occurs mechanical injury to the neural elements which is followed by a various inflammatory process of the body. The chemical released also adds to secondary injury. Further movement at the injury level leads to secondary injury to cord. As the cord suffers injury the recovery depends on the degree of impact and presence of a secondary insult. In most of the traumatic cases, this injury is permanent in nature. Few lucky individuals have incomplete cord injury leading to only temporarily shut down of cord function which recovers eventfully. This temporary period is called as spinal shock.

Depending on the level of injury, the neurons gets damaged. Hence all the nerves below the level of injury stops functioning. Hence the person has difficulty in moving the limbs and having sensation below the level of injury. For example if the injury level is cervical vertebra C5 – C6 level, the person will have all the nerves c6 downwards affected. In case of permanent injury the arms, forearm, hands and legs movement and sensations will not be present. Also patient will not have sensation and control over urine, stool and sexual function.

In case of deformity or tumor tissue causing spinal cord injury, the injury occurs over a period of time due to slowly increasing compression and alteration in vascularity. The spinal cord can get stretched out and subsequently have permanent damage leading to myelomalacia.

In usual scenario, spinal cord injury is synonymous with acute injury sustained due to some trauma. Hence it is advised that you take care of yourself and prevent any falls trauma or injury that can cause a spinal injury.

JUVENILE IDIOPATHIC ARTHRITIS (JIA)

uvenile idiopathic arthritis was previously known as juvenile rheumatoid arthritis (JRA). It is a persistent, autoimmune, most common form of arthritis in children and adolescents with onset before age 16 lasting for more than 6 weeks. It is more common in females. Idiopathic refers to a condition with no defined cause. Juvenile idiopathic arthritis causes inflamed, swollen joints and in severe cases, eye inflammation (uveitis) which can lead to cataracts, glaucoma and even blindness. The joints commonly involved are knee, hand/wrist, ankle, hip and cervical spine. Early onset denotes onset before teens while late onset denotes onset during teens or later.

What are common causes of spinal cord injury? Juvenile idiopathic arthritis affects children:

JIA is a type of arthritis seen in children, which may be either transient and self-limited or chronic. It is significantly different from arthritis commonly seen in adults like osteoarthritis, rheumatoid arthritis and other types of arthritis that can present in childhood which are chronic conditions like psoriatic arthritis and ankylosing spondylitis..

It is an autoimmune disorder. The disease commonly occurs in children from the ages of 7 to 12, but can also occur in adolescents as old as 15 years of age, as well as in infants. JIA affects approx. 1 in 1,000 children in any given year, with about 1 in 10,000 having a more severe form. 50% patients symptoms resolve without sequelae.25% are slightly disabled.25% have crippling arthritis or blindness. Best prognosis is for pauciarticular > polyarticular > systemic

Types of Juvenile idiopathic arthritis:

It is of four major types

  • Oligoarticular-most common, mild, affects one to four joints,involves large joints and is symmetrical
  • Polytarticular-affects five or more joints, involves small joints and is asymmetrical.
  • Systemic-most severe form ,can also affect organs.includes still’s disease.
  • Spondyloarthropathy- affects tendons and ligaments as well as the spine
Signs and symptoms of Juvenile idiopathic arthritis:

The common symptoms are morning stiffness and joint pain, visual changes and fever. It can also present with one of the following -rash, presence of RF, iridocyclitis, C-spine involvement, pericarditis, tenosynovitis. The X-ray is often normal at presentation but when progressive shows late osteopenia and joint destruction.

The nonoperative treatments are immunomodulating drugs (DMARDs),high dose aspirin,salicylates ,intraarticular steroids and frequent ophthalmologic exams.

The operative treatments are synovectomy, epiphysiodesis , corrective osteotomies ,arthrodesis and arthroplasty.

Consult your orthopedician to know your options .

BACK PAIN AND SURGERY

Lower back pain (LBP) refers to pain in back arising between the D12 vertebra and pelvis. LBP can be due to specific causes- protruded lumbar intervertebral disc (PIVD), lumbar canal stenosis, spondylolisthesis, deformity, infection (tuberculosis or pyogenic), post traumatic – fracture / spondylolysis, tumor or metastasis of lumbar vertebrae, osteoporotic fracture. LBP occurring in absence of specific cause is referred as non-specific LBP which usually responds to physiotherapy and life style modification.

If there is no major neurological weakness / major disability, these conditions can be managed with rest, medication, physiotherapy, lifestyle modification, weight reduction.

LBP can be associated with severe leg pain, restriction of mobility, difficulty in walking / standing / activities of daily living. There can be neurological weakness. Patient presenting with severe disability and/ or weakness, warrants surgery. Depending on the condition and the pathology, the approach and type of surgery is determined. Surgery also depends on medical condition and other factors.

Surgeries for Spine Treatment:
  • Discectomy –indicated in PIVD (sciatica). This involves removal of disc fragment compressing nerves. Minimal or no bone fragment is excised. This can be done through traditional discectomy, fenestration discectomy, micro- discectomy, endoscopic discectomy.

  • Lumbar Decompression –indicated in lumbar canal stenosis. This involves removal of lamina, medial halves of facets, hypertrophied flavum and at times, disc fragment- depending on causative factor.
  • Lumbar Decompression and Fusion – indicated in cases presenting with severe back pain, existing or expected instability. Lumbar decompression is accompanied with screw fixation in pedicle of vertebrae and bony fusion. Depending on type of fusion- surgery is called – postero-lateral (inter transverse process) fusion; PLIF (posterior lumbar interbody fusion); TLIF (transforaminal lumbar interbody fusion); ALIF (anterior lumbar interbody fusion); Axial LIF, XLIF (extreme-lateral lumbar interbody fusion).
  • Lumbar Fusion Surgery – only fusion is done. Indicated in cases presenting with instability without neural compression.
  • Minimal Invasive Spine Surgery (MISS) – above mentioned surgery achieved through smaller incision and lesser tissue handling.
  • Revision Surgery – surgery done in previously operated cases.
  • Deformity Correction Surgery – done for lumbar scoliosis or kyphosis deformity.
  • Tumor Excision / Resection – for metastasis or primary spinal tumor.

Depending on indication variety of surgery can be performed for LBP.