Spinal Deformity Surgery in Delhi, India

Spinal deformity is a condition that affects the alignment and structure of the spine, resulting in abnormal curvature. This condition can cause a variety of issues, including pain, limited mobility, cosmetic concerns, and even organ dysfunction in severe cases. Spinal deformities can be congenital or develop over time due to factors such as aging, trauma, infection or certain medical conditions.

Spinal deformity surgery is a procedure aimed at correcting these abnormalities and restoring the health and quality of life of individuals affected by this condition. It is an important treatment option that can provide relief from pain and improve functionality.

The surgical procedure for spinal deformity typically involves a thorough evaluation of the patient's medical history, physical examination, and diagnostic tests such as X-rays or magnetic resonance imaging (MRI). The patient will be given anesthesia to ensure they are comfortable and pain-free during the procedure. Using specialized instruments, the surgeon will carefully realign the spine into a more normal position. This may involve removing bone or inserting implants such as rods and screws to provide stability.

Types of Spinal Deformities

Scoliosis

Scoliosis is a common 3 dimensional spinal deformity characterized by an abnormal sideways curvature of the spine. It can affect people of all ages, but it most commonly develops in children during their growth spurt just before puberty. Some key points to know about scoliosis include:

• Causes: While the exact cause of scoliosis is often unknown, it can be classified as either idiopathic (without a known cause) or non-idiopathic (caused by factors such as birth defects, neuromuscular conditions, or injuries).
• Symptoms: Mild cases of scoliosis may not cause any noticeable symptoms. However, as the curvature progresses, symptoms such as uneven shoulders, a tilted waist hunp in the back, or a prominent ribcage may become evident.
• Diagnostic methods: To diagnose scoliosis, a doctor will conduct a physical examination and may order X-rays or other imaging tests to assess the severity and location of the spinal curvature.

Kyphosis

Kyphosis is characterized by an excessive forward rounding of the upper back, resulting in a hunched appearance. It can occur at any age and has different causes. Here are some important facts about kyphosis:

• Causes: Kyphosis can be caused by several factors including poor posture, degenerative disc disease, osteoporosis (a condition that weakens bones) inflammatory diseases, infection, or congenital malformations.
• Symptoms: Mild cases of kyphosis may not cause any noticeable symptoms. However, more severe cases can lead to pain, stiffness, and difficulty breathing due to compressed lungs. As the severity of kyphosis increases it can also lead to neurological worsening and cause weakness of lower limbs.
• Diagnostic methods: A doctor will conduct a physical examination to evaluate the curvature of the spine. Imaging tests such as X-rays or MRI scans may be used to determine the severity and underlying cause of kyphosis.

Lordosis

Lordosis is an excessive inward curvature of the lower back, commonly referred to as "swayback." Here are some important details about lordosis:

• Causes: Lordosis can be caused by several factors including poor posture, obesity, and certain medical conditions such as spondylolisthesis (a condition where a vertebra slips forward) or achondroplasia (a form of dwarfism).
• Symptoms: Mild cases of lordosis may not cause noticeable symptoms. However, more severe cases can lead to lower back pain and an exaggerated sway in the lower back.
• Diagnostic methods: A doctor will evaluate the curvature of the spine through physical examination and may order imaging tests such as X-rays or CT scans to determine the extent and underlying cause of lordosis.

When is Spinal Deformity Surgery Necessary?

Indications for Surgery

Spinal deformities, such as scoliosis or kyphosis, can cause significant discomfort and impact a person's quality of life. While non-surgical treatment options are often considered first, there are certain cases where spinal deformity surgery is necessary. Here are some indications for when surgery may be recommended:

• Severe curvature: If the curvature of the spine exceeds 40-50 degrees, surgery may be necessary to prevent further progression and correct the deformity.
• Pain and discomfort: When conservative treatments fail to alleviate pain and discomfort associated with the spinal deformity, surgery may be recommended to provide relief.
• Breathing difficulties: In cases where the spinal deformity restricts lung function and causes breathing difficulties, surgical intervention may be necessary to improve respiratory function.
• Neurological symptoms: If the spinal deformity is causing neurological symptoms such as numbness, weakness, or loss of coordination, surgery may be required to decompress nerves and alleviate these symptoms.

Non-surgical Treatment Options

Before considering spinal deformity surgery, doctors typically explore non-surgical treatment options. These may include:

• Physical therapy: A specialised exercise program can help strengthen muscles surrounding the spine and improve posture.
• Bracing: Wearing a brace can help prevent further progression of spinal deformity in growing adolescents.
• Pain management: Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be prescribed to manage pain associated with spinal deformities.
• Lifestyle modifications: Adopting a healthy lifestyle that includes regular exercise, maintaining a healthy weight, and avoiding activities that exacerbate symptoms can help manage spinal deformities.

Preparing for Spinal Deformity Surgery

Patient Evaluation

Before undergoing spinal deformity surgery, patients must undergo a thorough evaluation. This evaluation helps the healthcare team understand the patient's overall health and identify any potential risks or complications that may arise during or after the surgery. The patient evaluation includes:

• Medical history review: The medical team will review the patient's medical history, including any previous surgeries, chronic conditions, and medications.
• Physical examination: A physical examination will be conducted to assess the patient's general health, vital signs, and the extent severity, and flexibility of the spinal deformity.
• Diagnostic tests: Imaging tests such as X-rays, MRI scans, or CT scans may be ordered to get a clearer picture of the spine's condition.

Pre-operative tests

To ensure the patient is in optimal health for surgery, several pre-operative tests may be required. These tests may include:

• Blood tests: Blood tests are performed to assess blood cell counts, liver function, kidney function, and overall health.
• ECG: An electrocardiogram (ECG) may be performed to evaluate heart function and detect any abnormalities.
• Pulmonary function tests: These tests assess lung capacity and can help determine if any additional measures need to be taken during surgery.
• Special tests such as 2D echo, using the abdomen may be needed in cases of spinal deformities.
• X-ray whole spine & and MRI spine to assess spine deformity.

Medication adjustments

In some cases, medication adjustments may be necessary before spinal deformity surgery. Patients need to inform their healthcare team about all medications they are taking.

• Blood thinners: If a patient is taking blood thinning medication, such as aspirin or clopidogrel warfarin, their doctor may recommend adjustments or temporary discontinuation of these medications to minimize bleeding risks during surgery.

Surgical consultation

Once the evaluation and pre-operative tests have been completed, patients will have a consultation with their surgeon. During this consultation:

• Surgical options will be discussed: The surgeon will explain the different surgical approaches available for treating spinal deformities and help the patient understand which option is most suitable for their condition.
• Risks and benefits: The surgeon will explain the potential risks and benefits of the surgery, allowing the patient to make an informed decision.
• Recovery expectations: The surgeon will discuss what to expect during the recovery period, including pain management, physical therapy, and follow-up appointments.

The Spinal Deformity Surgery Procedure

Anesthesia

• Spinal deformity surgery is typically performed under general anesthesia. This means that the patient will be unconscious and pain-free during the procedure.
• An anesthesiologist will administer the anesthesia and monitor the patient's vital signs throughout the surgery.
• Intra-operative neuromonitoring: The spinal deformity surgery will be performed under nerve monitoring to avoid any neurological complication during the deformity connection.

Surgical Techniques

Instrumentation

• Rods: These are metal rods that are attached to the spine with screws or hooks. They provide stability and help correct the curvature of the spine.
• Screws: Pedicle screws are commonly used in spinal fusion surgeries. They are inserted into the vertebrae and hold the instrumentation in place.
• Hooks: Hooks can be used instead of screws to provide a stable anchor for the rods.
• Plates: Metal plates may be used in certain cases to provide additional support.
• Spinal osteolomies: Bone resection is done depending on the severity of the deformity to connect the spine alignment and decompress the nerves.

Bone Grafting

In spinal deformity surgery, bone grafting is often performed to promote fusion between the vertebrae.

• Autograft: This involves using bone from the patient's own body, typically taken from the pelvic bone, to stimulate fusion.
• Allograft: If there is not enough autograft available, donor bone from a bone bank may be used.
• Synthetic grafts: These are man-made materials that can also be used as alternatives to promote fusion.

Duration of Spinal Deformity Surgery

• The duration of a spinal deformity surgery can vary depending on the complexity of the case.
• On average, these procedures can take anywhere from 4 to 8 hours.
• Surgeons prioritize precision and accuracy over speed during these operations to achieve the best possible outcome.

Potential Risks and Complications of Spinal Deformity Surgery

• As with any surgical procedure, there are risks involved in spinal deformity surgery.
• Possible complications may include infection, bleeding, blood clots, nerve damage, or poor wound healing.
• Patients need to discuss these potential risks with their surgeon before proceeding with the operation.

Alternative Treatments Options of Spinal Deformity Surgery

When it comes to treating spinal deformities, such as scoliosis, there are alternative options available that may be considered before resorting to spinal deformity surgery. These alternatives can provide relief and help manage symptoms without the need for invasive procedures. Here are some of the alternative treatments that individuals with spinal deformities can explore:

Bracing

Bracing is a commonly used non-surgical treatment option for spinal deformities, such as scoliosis. It involves wearing a specially designed brace that helps correct the curvature of the spine and prevent further progression of the condition. The brace is customized to fit each individual's specific needs and is typically worn for several hours a day. However the indications of bracing are limited that need to be discussed with the breathing surgeon.

Physical therapy

Physical therapy plays a crucial role in managing spinal deformities. A skilled physical therapist can develop a tailored exercise program to strengthen the muscles surrounding the spine, improve flexibility, and promote better posture. Physical therapy can help alleviate pain, improve mobility, and enhance overall quality of life.

Observational approach

In some cases, especially when the spinal deformity is mild or not causing significant symptoms, an observational approach may be taken. This involves closely monitoring the condition through regular check-ups and X-rays to track any changes in the curvature of the spine. If there is no progression or worsening of symptoms over time, invasive interventions like surgery may not be necessary.

Recovery and Rehabilitation

After undergoing spinal deformity surgery, proper recovery and rehabilitation are essential for a successful and smooth healing process. Here are some key aspects to consider during this stage:

• Hospital stay: Following the surgery, the patient will typically be required to stay in the hospital for a few days for monitoring and initial recovery. The length of the hospital stay may vary depending on the complexity of the surgery and the patient's overall health.
• Pain management: Pain is a common concern after spinal deformity surgery, but the medical team will ensure that you receive appropriate pain management. They will prescribe medications to help alleviate any discomfort or pain the patient may experience during his/her recovery.
• Post-operative care: After being discharged from the hospital, it is crucial to strictly follow the surgeon's post-operative care instructions. This may include keeping the surgical incision clean, changing dressings as instructed, and taking prescribed medications as scheduled.
• Physical therapy: Physical therapy plays a vital role in restoring mobility, strength, and flexibility after spinal deformity surgery. The medical team will create a personalized physical therapy plan tailored to the patient's specific needs and capabilities.
• Returning to daily activities: Gradually reintroducing oneself to daily activities is an important part of the rehabilitation process. The medical team will guide the patient on when it is safe to resume activities such as walking, driving, and working.

Expected Results and Outcomes

When it comes to spinal deformity surgery, patients can expect significant improvements in their condition and overall quality of life. With advancements in medical technology and surgical techniques, the outcomes of these surgeries have greatly improved in recent years. Here are some of the expected results and outcomes patients can look forward to:

• Improvement in deformity: pinal deformities can cause pain, discomfort, cosmetic concern, and limitations in mobility. Spinal deformity surgery aims to correct these abnormalities and restore proper alignment and balance to the spine. After surgery, patients can experience a noticeable improvement in their spinal curvature, leading to a more symmetric and functional spine.
• Quality of life post-surgery: Spinal deformities not only affect physical health but also have a significant impact on a person's quality of life. Chronic pain, difficulty in performing daily activities, and self-consciousness can take a toll on mental well-being. However, after spinal deformity surgery, patients often experience a reduction in pain, increased mobility, and improved self-esteem. This can lead to a significant enhancement in their overall quality of life.
• Long-term follow-up: While the initial outcome of spinal deformity surgery is important, long-term follow-up is equally crucial. Spine surgeons typically schedule regular check-ups to monitor the patient's progress and ensure that the corrective measures continue to be effective over time. This includes evaluating post-operative healing, monitoring hardware integrity (if used), assessing mobility and functionality, as well as addressing any concerns or complications that may arise.

Risks and Complications of Spinal Deformity Surgery

Spinal deformity surgery is a complex procedure that can greatly improve a patient's quality of life. However, like any surgical intervention, there are risks and potential complications involved. It is important to be aware of these risks and to understand the importance of having a skilled surgeon perform the procedure.

Here are some of the risks and complications that can occur during or after spinal deformity surgery:

• Infection: Any surgical procedure carries the risk of infection. Infection can occur at the site of the incision or deep within the surgical area. Symptoms of infection may include redness, swelling, warmth, pain, or drainage from the incision site. It is essential to follow post-operative care instructions, including keeping the surgical wound clean and taking prescribed antibiotics if necessary.
• Bleeding: During spinal deformity surgery, blood vessels may be cut or damaged, leading to bleeding. While surgeons take precautions to control bleeding during the procedure, excessive bleeding can sometimes occur. This may require additional interventions such as blood transfusions or further surgery to address the bleeding.
• Nerve damage: The spine is a complex structure that houses delicate nerves. During spinal deformity surgery, there is a risk of nerve damage due to manipulation of the spine or proximity to nerves. Nerve damage can lead to pain, numbness, weakness, or even paralysis in severe cases. Skilled surgeons take great care to minimize this risk by using advanced techniques and technologies.
• Fusion failure: Spinal deformity surgeries often involve fusion, where two or more vertebrae are joined together using bone grafts or implants. Fusion failure refers to when this fusion does not heal properly, causing instability in the spine. Factors such as poor bone quality or inadequate immobilization can contribute to fusion failure. Additional surgery may be required to correct this complication.
• Implant Failure: Screws and Rods can loosen or break requiring revision of surgical procedure.

It cannot be stressed enough how vital it is to have a skilled surgeon perform spinal deformity surgery. A skilled surgeon has the expertise and experience necessary to navigate potential complications and minimize risks. They have a deep understanding of the spine's anatomy and can make surgical decisions that will optimize outcomes for their patients.

Why Did You Choose the BLK-MAX Hospital?

When it comes to spinal deformity surgery, choosing the right hospital and surgeon is of utmost importance. BLK-MAX Hospital stands out as a top choice for several reasons:

• Qualifications: The hospital boasts a team of highly qualified and skilled surgeons who specialize in spinal deformity surgery. They have completed rigorous training programs and possess advanced degrees in their respective fields.
• Experience: BLK-MAX Hospital has a wealth of experience in performing spinal deformity surgeries. The hospital has successfully treated numerous patients with various types of spinal deformities, providing them with the highest quality of care.
• Patient reviews: One of the most reliable ways to gauge the effectiveness of a hospital is through patient reviews. BLK-MAX Hospital consistently receives positive feedback from patients who have undergone spinal deformity surgery there. These testimonials highlight the exceptional care, successful outcomes, and compassionate approach provided by the hospital's team.
• Consultation process: BLK-MAX Hospital understands the importance of personalized care and effective communication. They prioritize thorough consultations with patients to fully understand their specific conditions, concerns, and goals. This allows them to develop tailored treatment plans that prioritize patient well-being and maximize the chances of success.
• Advanced equipment and surgical: Blk-Max processes every advanced equipment needed for those kinds of complex surgeries including robotic systems, navigation, intra-op, neuro monitoring, ultrasonic scalpels, high-speed burns, etc.

Frequently Asked Questions

1. How do I know if I need spinal deformity surgery?

Spinal deformity surgery is typically recommended for individuals with severe spinal deformities that cause pain, difficulty in performing daily activities, or affect their quality of life. Your doctor will evaluate your condition and determine if surgery is the best treatment option for you.

2. Is spinal deformity surgery the only treatment option available?

Spinal deformity surgery is not always the first line of treatment. Depending on the severity of your condition, non-surgical treatments such as physical therapy, medication, or bracing may be recommended initially. Surgery is usually considered when conservative treatments fail to provide relief.

3. How long does a typical spinal deformity surgery take to complete?

The duration of spinal deformity surgery can vary depending on the complexity of the case and the specific procedure being performed. On average, the surgery can take anywhere from four to six hours.

4. What is spinal fusion, and how is it performed during the surgery?

Spinal fusion is a surgical technique that involves joining two or more vertebrae together. It is commonly performed during spinal deformity surgery to stabilize and correct the alignment of the spine. During the procedure, bone grafts or implants are used to promote fusion between the vertebrae.

5. Can spinal deformity surgery correct both scoliosis and kyphosis?

Yes, spinal deformity surgery can address various types of spinal deformities, including scoliosis (sideways curvature) and kyphosis (abnormal forward curvature). The specific surgical approach will depend on your condition and the goals of treatment.

6. How painful is the recovery process after spinal deformity surgery?

Pain levels vary from person to person, but modern pain management techniques have significantly improved post-operative comfort. Your surgical team will work closely with you to manage your pain effectively during the recovery period.

7. What kind of physical therapy is required post-surgery?

Physical therapy is an integral part of the recovery process after spinal deformity surgery. It helps restore strength, flexibility, and mobility. Your physical therapist will design a personalized exercise program tailored to your specific needs.

8. When can I return to normal daily activities after spinal deformity surgery?

The timeline for returning to normal activities varies from patient to patient. On average, most individuals can expect to gradually resume their usual activities within six to twelve weeks after surgery. However, it's important to follow your surgeon's guidance and not rush the recovery process.

9. What restrictions should I follow after the surgery?

Your surgeon will provide specific instructions regarding activity restrictions, which may include avoiding heavy lifting, high-impact exercises, and certain movements that put strain on the spine. It's crucial to follow these restrictions to ensure proper healing and prevent complications.

10. Can spinal deformity surgery improve my quality of life?

Spinal deformity surgery has been shown to significantly improve the quality of life for many patients. It can relieve pain, improve mobility and function, and enhance overall well-being. However, it's important to have realistic expectations and discuss your goals with your surgeon.

11. How do I choose the right surgeon for my spinal deformity surgery?

Choosing the right surgeons crucial for a successful outcome. Look for a surgeon who specializes in spinal deformity surgery and has extensive experience in performing these procedures. Ask for recommendations from your primary care physician or seek opinions from trusted sources.

12. What is minimally invasive spinal deformity surgery, and is it an option for me?

Minimally invasive spinal deformity surgery is a newer technique that involves smaller incisions and less tissue disruption compared to traditional open surgery. Not all patients are candidates for this approach, as it depends on the complexity of the deformity. Your surgeon can determine if you're a suitable candidate.

13. Are there age restrictions for spinal deformity surgery?

Spinal deformity surgery can be performed on individuals of various ages, including children and older adults. However, the timing of surgery may vary depending on the individual's growth and overall health. It's essential to discuss the appropriate timing with your surgeon.

14. Can spinal deformity surgery be performed on children?

Yes, spinal deformity surgery can be performed on children who have significant spinal deformities that are impacting their growth or causing pain. Pediatric spine surgeons specialize in treating these conditions in children and are experienced in providing age-appropriate care.

15. What should I expect in terms of post-operative pain management?

Your surgical team will develop a personalized pain management plan to keep you comfortable after surgery. This may include a combination of medications, nerve blocks, and other interventions. The goal is to minimize pain and help you recover as smoothly as possible.