FAQ

SPINAL SURGERY

The commonest symptom is neck/back pain. Pain may also be referred to upper limb, shoulder girdle area, along the trunk, along the back of thigh and leg (sciatica).
Other symptoms include stiffness in the neck or back, weakness in the limbs, any deformity in the back or trunk or change in posture (e.g. excessive forward bending of the neck), tenderness in any part of the spine etc.

Spinal problems can be the result of trauma (fractures), infective or inflammatory conditions (e.g. tuberculosis of spine, ankylosing spondylitis), degenerative disorders like osteoarthritis, disc prolapse or slipped disc, benign or malignant tumours etc. Spinal disorders can often be congenital

Intervertebral disc is the fibrous cartilage pads that lie between the spinal vertebrae made up of two parts: a jelly-like center (the nucleus pulposus) that loses moisture with age, and a tough outer ring (the annulus fibrosus) that can split with age or injury. A ‘slipped disc’ occurs when the jelly-like centre protrudes into the spinal column through a rent in the outer ring and oozes through small openings in between the vertebrae, where nerves come out from the spinal column. It can happen in neck and back.

Acute back pain/acute disc prolapse, as a rule, is treated conservatively unless there is compression over nerve roots/spinal cord causing paralysis, acute retention of urine etc. It may require surgical correction when adequate conservative management fails.

Spinal surgeries, like all other major surgeries, do have associated risks. But these kind of risks are completely avoidable. The key is proper pre-operative counseling. All patients have to be screened for co-morbid conditions like diabetes, heart disorders etc. Pre-operative optimization of such co-morbid conditions can contribute effectively to guard against risks and complications. Appropriate surgical technique and extensive post-operative rehabilitation ensure uneventful and risk-free surgery.

Due to use of modern anaesthesia techniques and pain medications most patients have minimal pain following spine surgery.

After spinal surgeries, post-operative rehabilitation measures are initiated early. The patients are made to sit up within 24 hours following surgery and within 48 hours they are made to stand up and walk, all under the supervision of a dedicated physiotherapist. Long-term post-operative follow up and physiotherapy are maintained. Most patients respond well and go back to their routine life in 4-6 weeks.

Yes, absolutely. Surgeries are called “surgical correction” for a reason. Correction, as a whole, means early relief from symptoms, freedom from disease and enabling the patient to go back successfully to his/her routine life. Surgeries are meant to create a difference in the patient’s lives, not to disable them.

HIP / KNEE REPLACEMENT

There are many different causes of such symptoms. These include injury, arthritis and infections.

No. Often such problems can be corrected by conservative measures such as lifestyle rectification and physiotherapy. Other cases may require surgery.

If there is difficulty or inability to walk or perform daily activities like getting dressed i.e. severe disability due to hip/knee joint disorders, you may require a joint replacement surgery. In cases of advanced disease, a joint replacement surgery provides early relief from symptoms and return to normal day-to-day activities.
However, it is entirely up to the doctor. He knows what’s best for you.

Joint replacement surgery, is a procedure of orthopaedic surgery in which the arthritic or dysfunctional joint surface is replaced with prosthesis (artificial parts of a joint). Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by less-invasive therapies.

Rehabilitation and physiotherapy are started soon after a joint replacement surgery. Within 48 hours, patients are made to stand up and walk under the able guidance of a dedicated physiotherapist. Post-operative follow up and extensive rehabilitation measures are maintained to ensure early return to normal routine life.

Normally within 3-6 weeks most patients return to normal activities. Mobilization and physiotherapy are initiated early. 

Most prosthetic implants have longevities ranging from 15-25 years. They do literally “replace” the natural, healthy joint and meet almost all physical requirements.

To ensure the continuation of a normal life, a revision surgery may be done. It is not uncommon by any means. 

Yes, absolutely. Again, corrective surgeries are certainly not meant to disable or restrict you in any way.

 People of all ages have received joint implants. Natural course of life is not impeded in any way after a joint replacement surgery. Again, pre-operative work up, appropriate surgical technique and extensive post-operative rehabilitation forms the base of any successful surgery.

Yes, this may happen. For all purposes, you will be provided with a document from your doctor certifying that you have undergone joint replacement surgery and have metallic implants fitted in your body. You need to carry that to airports, railway stations, even shopping malls, cinema theatres etc.
However, while travelling abroad or long distance via flights or trains, it is better that you carry all the documents related to the surgery, along with the certifying document signed by your doctor.

FRACTURE MANAGEMEN

 Although most fractures encountered in day-to-day orthopaedic practice are the result of trauma/accident, it is not the only cause. Often degenerative, infective or neoplastic processes may weaken the bone. In such cases little or even no force is required to cause a fracture, which is then known as a pathological fracture. Principle of management is almost the same in both cases, except treatment to the cause has to be followed in cases of pathological fractures.

 Some fractures e.g. fracture of scapula (shoulder girdle), ribs etc may not require a surgery at all. They heal inspite of normal functioning of the bone. These fractures may not even require immobilization.

Fractures are treated in three phases-

  1. Emergency care- care immediately after trauma/accident
  2. Definitive treatment of fractures
  3. Rehabilitation
Definitive treatment has different methods including conservative approaches such as normal functional use of the part (simple splinting and pain relief), immobilization only (e.g. using plaster casts) etc. In selected cases fracture management may involve surgical correction. Surgical fixation of fractures is done following AO (Association of Osteosynthesis) guidelines. These include reduction of fracture, stable fixation and early mobilization following surgery. These ensure early restoration of bone and joint function.

Most important is early mobilization. Prolonged immobilization may lead to stiffness of joints. Extensive physiotherapy, muscle re-education exercises, continued functional use of the fractured part etc leads to early restoration of bone and joint function. It is important to know that fractures heal by themselves. These methods hasten the process and supplement natural healing.