Institute Of

Orthopaedics

Spine Surgery

The Spine Unit at SIMS-AJRI is your one stop solution to all spinal problems. Dr. K. Appaji Krishnan is heading the Spine Unit. It consists of a team of spine surgeons, orthopaedic surgeons, neurosurgeons, physiotherapists and other non-surgical specialists who provide complete care for any spinal disorders.
Spine is a complex structure that helps you move and gives you strength. Proper functioning of the neck and back helps in the ease of movement. But, when there is a deformity, injury, or disease of the spine, common activities such as turning, bending, or even stretching can become painful.

Some of the spinal conditions and solutions:

Complex Spine Deformities – Scoliosis, Kyphosis & Spondylolisthesis

Scoliosis

Scoliosis, a common but complex spinal deformity, is a lateral (side bend) curvature in the normally straight standing spine. When viewed from the side, the spine shows a slight rounding in the upper back and shows a degree of swayback (inward curvature) in the lower back. When a person with a normal spine is viewed from the front or back, the spine appears to be straight. When a person with scoliosis is viewed from the front or back, the spine tends to look curved. Corrective surgery for scoliosis: This is considered for those who have a spinal curve from 40 degrees to 50 degrees. It is only a preemptive measure for the curve to not get any worse. However, the spine does not get straightened perfectly. In this procedure, the utilisation of metallic implants corrects the curvature partially and holds it in the right position until a bone graft, which is placed at the time of the surgery, ensures a rigid fusion in the curvature area. The surgery involves the permanent joining of the vertebrae, which is called spinal fusion.

Kyphosis

Kyphosis is the poor posture with a hump at the back or commonly, a ‘hunchback’, muscle fatigue, stiffness and pain the back. Most often, these symptoms tend to be constant and do not get worse with time. Kyphosis progresses and results in an exaggerated hunchback. Rarely, this particular spinal deformity can even lead to compression of the spinal cord along with a few neurological symptoms such as a loss in sensation, weakness, loss of bowel and bladder control. Extreme cases of thoracic kyphosis even restricts the space in the chest and can cause cardiac and pulmonary problems which results in shortness of breath and chest pain.

Spondylolisthesis

Spondylolisthesis is a condition of the spine when one of the vertebra slips forward or backward in comparison to the next vertebra. Spondylolisthesis may lead to spinal deformity and cause narrowing of the spinal canal (central spinal stenosis) or compress the exiting nerve roots (foraminal stenosis).

Degenerative Disc Disease

The discs act as the spine’s shock absorbers and allow it to bend, flex, and twist. Degenerative disc disease refers to degenerative changes in spinal discs that develop with age. It is a common condition, can happen throughout the spine, but mostly takes place in those discs in the lower back (lumbar region) and the neck (cervical region). An affected disc in the neck area may cause pain in the neck or arm, whereas an affected disc in the lower back may cause pain in the back, buttock, or leg. The pain often worsens with movements such as bending over, reaching up, or twisting.

Disc Herniation

A herniated disc, which is also known as a slipped or ruptured disc is a fragment of the disc nucleus which is pushed out of the annulus, inside the spinal canal through a rupture or a tear. The spinal canal has very limited space, which is not enough for the spinal nerve and the displaced herniated disc fragment. Due to this displacement, the disc presses on spinal nerves, often causing pain, which can be severe. Herniated discs can take place in any part of the spine. Herniated discs are more common in the lower back (lumbar spine), but also happen in the neck (cervical spine).

Low Back Pain

Sciatica often is the result of a herniated disc in the lower back. Pressure on one or many nerves that contribute to the sciatic nerve may result in causing pain, tingling, burning and numbness that grows from the buttock into the leg and sometimes even into the foot. Usually only one side (left or right) is affected. This pain often is said to be sharp like an electric shock. It may get worse with standing or walking. One may even experience low back pain, along with the leg pain.

Microdiscectomy

In a microdiscectomy or microdecompression spine surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to relieve neural impingement and create more space for the nerve to heal. A microdiscectomy surgery is typically performed for a herniated lumbar disc and is more effective in treating leg pain (also known as radiculopathy) than lower back pain. Impingement on the nerve root (compression) can result in substantial leg pain. It takes weeks or months for the nerve root to completely heal and any numbness or weakness to get better. Patients normally feel relieved from the leg pain soon after a microdiscectomy spine surgery.

Spinal Fusion Surgery

Lumbar & Multilevel Spinal Fusion Surgery A spinal fusion surgery joins two or more vertebrae. This is performed at any level in the spine and prevents movement between the fused vertebrae, at a painful segment. The purpose of this surgery is to reduce and alleviate discomfort caused due to painful joints and degenerated discs.

Neck Pain

This will have symptoms such as a dull or sharp pain in the neck or between the shoulder blades – a pain that travels all the way down the arm to the hand or fingers, or tingling or numbness in the shoulder or arm. The pain can increase with certain movements or positions of the neck.

Anterior Cervical Discectomy and Fusion (ACDF)

Anterior Cervical Discectomy and Fusion (ACDF) is a surgical procedure that treat s nerve root or spinal cord compression by decompressing the spinal cord and nerve roots of the cervical spine to stabilise the corresponding vertebrae. This procedure is carried out when other non-surgical treatments have failed. Most of the neck fusions, about 90% of them are 1 and 2 level.

Cervical Myelopathy

Cervical Myelopathy occurs when the spinal cord gets compressed with age, due to wear and tear. It is usually seen in patients who are 50 years or older. This results in a variety of symptoms such as weakness in the hands, numbness, loss of coordination and balance and neck pain etc., Bone spurs occur when the disks in the spine bulge and stiffen with age, causing the body to form more bone around the collapsed disk, to strengthen it. Spine Unit at SIMS is effectively addressing spine trauma, spine tumours, spine TB and spinal infection disorders.