Complex Spine SurgeryThe spinal column is made up of several small bones known as the vertebra which is stacked one on top of the other and held together by joints, ligaments, muscles and discs. There are about 29 vertebras all jointed together to make the spinal column. This spinal column houses the delicate structures known as the spinal cord and nerves. The spinal cord and nerves are like the electrical cables that transmit impulse from the brain to the organs of the body for example the leg in order to move as well as feel. The normal spinal column in the way it is designed allows wide range of movement of the back and neck without causing any impingement or compression of the spinal cord or nerves during the movement.
There can be various problems that can occur within the spinal column, cord or the nerves that could affect the smooth function of this amazing structure. The problems could range from minor “wear and tear” known as degenerative conditions to more sinister conditions such as tumours. The other condition that could affect the spine includes infection, disc prolapses, traumatic fractures, osteoporotic fractures, vascular malformation and developmental problems such as spinal lipoma and tethered cord syndrome.
These problems need to be evaluated clinically by taking a good history and complete physical examination. Then the relevant investigations need to be conducted eg. X rays, CT scan, MRI scans, nerve conduction studies etc. The MRI images are of high resolution (1.5 to 3.0 Tesla). Once the exact problem has been identified, the management strategy is formulated that is suitable to that particular patient considering all factors eg. age, medical background, degree of disability etc.
The surgical treatment is varied depending on the condition. It is carried out in operation theatre mostly under general anaesthesia. The “state of the art” equipments are available at our disposal and are used for the cases in order to obtain the best possible outcome. The equipment available to be used includes high end microscope, BRAINLAB image guidance system, intraoperative neurophysiological nerve monitoring, endoscopes, ultrasonic aspirators etc.
Post operative recuperation is managed with adequate analgesia eg oral analgesic, patient controlled analgesic (PCA) etc. Few days after surgery, physiotherapy and rehabilitation therapy is instituted.