Spinal Fusion Surgery in India

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Minimally Invasive  Spinal Fusion Surgery at
India Best Spine Surgery Hospital in India A
persons spine is subjected to a lot of forces
throughout its lifetime. It may be subjected to
age related wear and tear or infections like
tuberculosis. As a result it undergoes
degeneration which gives rise to a variety of
problems like spinal osteoarthritis, disc
prolapse, spondylolisthesis, osteoporotic
fractures, vertebral collapse etc. All these
conditions manifest as severe pain in the back
and radiating pain, numbness, tingling in the
upper or lower extremities (lower leg or arm) due
to compression of spinal nerves, spinal cord and
spinal instability. When these symptoms become
debilitating enough to preclude the patients day
to day activity, a Spinal Fusion Surgery is
advised.

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What is Spinal Fusion Surgery?   Spinal fusion
(spondylodesis or spondylosyndesis) is the
surgical method of joining two or more verebrae.
It is done most commonly in the lumbar region of
the spine, but it is also used to treat cervical
and thoracic problems. In this procedure, the
damaged and painful vertebrae are fused into a
solid stable bone. Fusion of the spine is used
primarily to eliminate the pain caused by
abnormal motion of the vertebrae by immobilizing
the faulty vertebrae themselves, which is usually
caused by degenerative conditions. However,
spinal fusion is also the preferred way to treat
most spinal deformities, specifically scoliosis
and kyphosis. But, the results may vary according
to the individual. Some may not feel any
improvement in their back pain even after the
surgery.

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• When is Fusion Recommended
• Fracture
• Tumor
• Infection
• Spondylolisthesis
• Degenerative disc disease
• Scoliosis
• Spinal Stenosis

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• Types of Spinal Fusion Surgery
•  
• Lumbar spinal fusion can be divided into two
  categories
•  
• Posterolateral Fusion  In the back of the spine,
  the bone graft is placed in amid the transverse
  processes. With the help of wires and screws, the
  vertebrae is carefully fixed throughout the
  particles of every vertebrae. A rod is made up of
  metal which is attached on the side of
  vertebrae.
• Interbody Fusion  In this, the graft of the bone
  is placed in between the vertebrae and the area
  is generally engaged by the intervertebral disc.
  The disc is entirely removed in preparing for the
  spinal fusion. In order to maintain the disc
  height and spine alignment, a device can be
  placed in between the vertebrae. This device
  (intervertebral device) can either be prepared
  from titanium or plastic. Then the fusion starts
  in between the vertebraes endplates. Interbody
  fusion is of 3 types-
• Posterior Lumbar Interbody Fusion (PLIF)
• Transforaminal Lumbar Interbody Fusion (TLIF)
• Anterior Lumbar Interbody Fusion (ALIF)
• Transpsoas Interbody Fusion (XLIF or DLIF)
•  

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Posterior Lumbar Interbody Fusion (PLIF)   In
Posterior lumbar interbody fusion, the spinal
fusion is achieved through a surgical incision
made on the posterior (back) aspect of spine. It
aims at fusion of two adjacent vertebrae in cases
of spinal instability and associated back pain.
It is a popular procedure as it gives excellent
results. The procedure provides almost complete
relief of symptoms in 90-95 of the cases and the
patients are able to return to their daily
activities within a few weeks. The patients can
also return to most of their recreational
activities.

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Procedure for Posterior Lumbar Interbody Fusion
(PLIF)   PLIF surgery aims at achieving spinal
stability through bony fusion by two ways   The
Open PLIF is the traditional technique which is
performed using general anesthesia. The patient
is made to lie down on his front side on the
table with the low back exposed. A 3-6 inch long
incision is made on the skin overlying the
affected vertebrae. The skin and the fascia are
cut open. The underlying muscles are retracted
and the affected vertebrae are identified.
Fluoroscopic X-ray is used to confirm the exact
location of the affected vertebrae. Then a
complete laminectomy (removal of the lamina of
the vertebrae) followed by bilateral foraminotomy
(enlargement of the foramen by removing the bony
spurs) and/or discectomy (removal of offending
disc) are performed.   This relieves the
compression off the spinal nerves, allowing them
to come to their normal size and shape. The area
is checked for any remaining bony outgrowth or
disc fragments that may compress the nerves.
Autogenic bone grafts or Metal or plastic
implants are fitted in the empty disc space for
initiating bone growth.

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Minimally Invasive Posterior Lumbar Interbody
Fusion (PLIF) in India   The other method is the
Minimally Invasive PLIF procedure which is
performed using x-ray guidance. 2.5-cm incisions
are made on either side of the lower back The
muscles are gradually dilated and tubular
retractors inserted to allow access to the
affected area of the lumbar spine. The lamina is
removed to allow visualization of the nerve
roots. The offending disc material is removed
from the spine and replaced with a bone graft and
structural support from a cage made of bone,
titanium, carbon-fiber, or a polymer, followed by
placement of rod and screws. The tubular
retractors are removed, allowing the dilated
muscles to come back together, and the
incisions are closed. This procedure typically
takes about 3 to 3 ½ hours to perform. There was
less blood loss,tissue trauma, operative time,
and quick recovery in this procedure as compared
to the traditional one.Generally the patients can
go home within 3-5 days after traditional PLIF
and within 1-2 days after a minimally invasive
PLIF.

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Extreme lateral Interbody Fusion (XLIF)   The
XLIF (Extreme Lateral Interbody Fusion) is an
approach to spinal fusion in which the surgeon
accesses the intervertebral disc space and fuses
the lumbar spine (low back) using a surgical
approach from the side (lateral) rather than from
the front (anterior) or the back
(posterior). The XLIF is one of a number of
spinal fusion options that a surgeon may
recommend to treat specific types of lumbar
spinal disorders, such as lumbar degenerative
disc disease, spondylolisthesis, scoliosis and
deformity and some recurrent lumbar disc
herniations and types of lumbar stenosis. It
cannot be used for all types of lumbar conditions
for which spinal fusion is a treatment option.
For example, it cannot treat conditions at the
lowest level of the spine, L5-S1 or for some
people at L4-L5.

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• What are the Advantages of Spinal Fusion
  Surgery? 
• In most cases, spinal fusion can eliminate the
  pain and other symptoms. It is important for a
  surgeon to explain the options, and benefits of
  spinal fusion surgery. There are many advantages
  of Spinal fusion surgery such as
• By fusing the level, there is less concern that
  the patient will need surgery again at
• that level. If the discs and/or facets are
  pain generators, as is often the case, a fusion
  
• will ensure that motion at the level is
  stopped, potentially eliminating the low back
• pain. 
• A second advantage of spinal fusion surgery is
  that it reduces post-decompressive
• deformity. Some patients develop
  post-laminectomy kyphosis, which is an abnormal
• alignment of the spine. This too can often
  lead to additional surgery. Similarly, a
• fusion can correct any deformity the patient
  had before surgery and ensure that the
• normal alignment of the spine is restored.
  This may reduce wear and tear (and need
• for future surgery) on the neighboring levels.

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FAQ - Spine Surgery and Treatment in India
  When is Spine Fusion surgery recommended? The
potential reasons for a surgeon to recommend this
procedure are treatment of a fractured vertebra
correction of deformity (spinal curves) getting
rid of pain due to painful vertebral motion
treatment of spinal instability and treatment of
some cervical disc hernia. What are the benefits
of getting Spine Surgery in India? Spine
Hospitals in India are equipped with the most
advanced medical treatment. They have the most
extensive Spine -diagnostic and imaging
facilities including Asias most advanced MRI and
X-rays technology. Personalized care and
attention is provided with value added services
besides results of world class standard at a very
low cost affordable to all sections of
society. Which is the Best Hospital in India for
treatment of Spine? India has not one but many
better than the best hospitals for Spine r
treatment. Mail us your medical report and we
will find the hospital most suitable to treat
your medical condition. Is it safe to get Spine
Treatment and Surgery in India? The medical
fraternity in India is famed for excellence, and
leads in Spine surgeries. Thousands of Spine
operations are performed in India each year with
maximum success rate, making the safety obvious.

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