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Spine Surgery in India

Slipped Disc Surgery in India


Understanding the back in India

The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.

The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body.

Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine. (The muscles and ligaments are not shown in the diagram below for clarity.)


At what age can a slipped disc occur?

A slipped disc in the lower back is most often seen between the ages of 30 and 50. In the cervical vertebrae around the neck, slipped discs are most often seen between the ages of 40 and 60.


Who Gets A Slipped Disc?

Bouts of back pain are very common. However, less than 1 in 20 cases of acute (sudden onset) back pain are due to a prolapsed disc. (Most cases on back pain are classed as 'simple low back pain'. This is thought to be caused by a minor problem to a muscle, ligament, or other structure in the back. For example, a strained muscle. See separate leaflet called 'Low back Pain in Adults' for a general overview of the different types of back pain.)

The commonest age to develop a prolapsed disc is between 30 and 50 years. Twice as many men as women are affected.


What Are The Symptoms Of A Slipped Disc?

Back pain

The pain is often severe, and usually comes on suddenly. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze.


Nerve root pain (usually 'sciatica')

Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on ('trapped') by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Nerve root pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc, the sciatic nerve is the most commonly affected nerve. (The term 'sciatica' means nerve root pain of the sciatic nerve.) The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg. There is a sciatic nerve for each leg.


Other nerve root symptoms

The irritation or pressure on the nerve next to the spine may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot. The exact site and type of symptoms depends in which nerve is affected.

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Cauda equina syndrome - rare, but an emergency

Cauda equina syndrome is a particularly serious type of nerve root problem that can be caused by a prolapsed disc. This is a rare disorder where the nerves at the very bottom of the spinal cord are pressed on. This syndrome can cause low back pain plus: problems with bowel and bladder function (usually unable to pass urine), numbness in the 'saddle' area (around the anus), and weakness in one or both legs. This syndrome needs urgent treatment to preserve the nerves to the bladder and bowel from becoming permanently damaged. See a doctor immediately if you develop these symptoms.


Some people do not have symptoms

Research studies where routine back scans have been done on a large number of people have shown that some people have a prolapsed disc without any symptoms. It is thought that symptoms mainly occur if the prolapse causes pressure or irritation of a nerve. This does not happen in all cases. Some prolapses may be small, or occur away from the nerves and cause minor, or no symptoms.


The benefits in India

The operation should stop the pain in your leg. If you have some weakness in your leg this should improve.


Are there any alternatives?

If you do not have any muscle weakness, you can wait and see if your pain settles with time. Only the minority of patients with sciatica need an operation, even if they are shown to have a herniated disc on a scan.

Some patients find that an injection of anti-inflammatory steroid around the nerves in the back relieves their pain; this is called an epidural injection.

Physiotherapy or osteopathy can help reduce back pain but cannot help reduce sciatica.


Physical Therapy in India

As part of your treatment programme, you may be referred to a physiotherapist. A physiotherapist will be able to draw up an individually tailored exercise plan for you. This will keep you active, minimise pain, and help prevent any further damage being caused to your back.

See the Health A-Z topic about Physiotherapy for more information.

You might also be referred to an osteopath or a chiropractor. An osteopath uses a mix of gentle, and forceful, massage techniques to help reduce pain and swelling. A chiropractor uses careful manipulation of the joints and muscles to help relieve pain.


Treatment in India

The symptoms arising from the first attack of a slipped disc settle down over the first 6 weeks and half of the remainder will settle over the next 6 weeks. Treatment during this period is focused upon reducing the irritation with anti-inflammatory drugs (Steroids or Non-Steroidal Anti-Inflammatory Therapy such as Ibuprofen, Diclofenac, Acemethacin) and correcting posture and maintaining mobility by using Muscle Balance Physiotherapy.

Conservative therapy consists of Muscle Balance Physiotherapy, injection, Cognitive Behavioural Therapy and coping courses and a restricted lifestyle and the hope that the symptoms will abate over time. Whilst not without risk altogether surgical options carry greater risk and can not guarantee success. The surgical options are tabulated below and details of these treatments may be explored through the list on the right


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spine-surgery in india

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