Paralysis following spine surgery is actually very rare. It does occur in some types
of diseases like Fluorosis and complex spine surgeries, but the percentage of
occurrence is far less than what used to be 15 to 20 years back. However, even today
it is indeed an intrinsic risk factor that under weighs the benefit percentage of
patients. Moreover, the patients who are operated for existent paralysis following
fractures are never likely to improve. In such instances surgery is conducted to
reduce pain, to make them comfortable and make nursing them easier. These patients
and their relatives are always made aware before the surgery why it is being done,
yet the general notion persists that surgery is the root cause of their paralysis,
thus putting the blame squarely on the surgeon and the spine specialty. In a
nutshell, currently due to great advances in technology, advanced trainings, new
invented techniques and safe surgery equipment, the chances of paralysis are very
less
They are disabling but 80 % of them are non pathological and benign. Most of the
backaches don’t even last long. Poor ergonomics, lack of exercise and psychological
overlap(stress/low motivation/psychiatric illness) are a very big contributors of
back and neck pains.
Not necessarily, unless specially prescribed by the doctor. A patient with a back
pain can do everything keeping well within the limitations imposed by his disease.
Not all of it is true. Patient with backaches should lie on a normal bed with a coir
mattress that is at least 3 inches wide. High Density u-foam or cotton can also be
used in the mattress. Floor sleeping is not recommended.
This is certainly a myth. The spinal injection used during a C-section surgery in
women does not cause back pain; rather due to the inactive lifestyle of the patient
pre and post delivery. In India, women do not exercise during pregnancy or after
delivery thereby weakening the muscles. This leads to back pain, which becomes
chronic with the addition of obesity.
No. Most often the symptoms of nerve-spinal cord compression starts with a tingling
numbness. But 90% of the times they may not even lead to partial paralysis. At the
same time,post surgery or conservative treatment courses, disabilities improve and
pain reduces significantly depending on the type of disease, but tingling numbness
are routine. This is due to the irreversible imprints left on the sensitive nerves.
They are distracting but they don’t necessarily increase.
All exercises in general are good. But muscle training and strengthening must start
from childhood and unfortunately our culture is not sports friendly. One should
exercise under the guidance of physiotherapists and doctors especially after middle
age. Exercising while in severe pain must be avoided; it is recommended that one
starts after the pain comes down and stops if the pain shoots up. Lack of exercise
and weak muscles are two of the biggest reasons for mild to moderate nonspecific
backaches.
Back pain is seen in both the sexes but women suffer more because of their wrong
postures and movements during household activity, hormonal variations and lack of
exercise. The social structures of our homes and lack of self-motivation and
awareness add to the problem.
Every medicine does not increase weight. There are some medicines which retain water
in the body especially steroids and strong painkillers,when taken over a long period
of time. Otherwise, weight increases whenever there is decreased physical activity
or more consumption of calories.
There is negligible need for the removal of implants. The implants are made of
titanium that does not harm our body. They are MRI compatible.
Yes, ideally, the incision size – cutting of bones tissues- should be kept as small
as possible as it is usually in many keyhole surgeries, endoscopy and minimally
invasive spine surgeries. But there are many surgeries that are complex and where
the size of incision has to be unavoidably big.
No, absolutely not. Most of the patients who do not have profound paralysis
of the legs or hands, start walking right from the day after the surgery.
Generally, they all are comfortable and ambulatory and are capable of basic
self-care activities within a week. Within 3 weeks they can walk short distances
with regular, long sitting intervals. Mild climbing of stairs is also possible.
Post six weeks,physiotherapy starts with stair-climbing, squatting and sitting
cross-legged; soon patients are allowed driving and they can easily resume
everyday activities. Patients can lift weights after 2 -4 months of surgery.
However, care should be taken to see that the weights are not heavy and are
evenly distributed between the two sides and are lifted in an ergonomic way.
Absolutely not. Earlier the treatment,the better the outcome. Postponing a treatment
is riskier and complete correction of the deformity may not be possible.
No. A single surgery usually addresses the problem in a single shot.There are
chances of recurrence of the disorder, but they are very less. It is important to
understand that the whole spine is made of multiple vertebra and joints. Like one
heart attack due to a block in one of the blood vessels cannot preventdisorder in
another blood vessel, spine surgery or treatment to correct disorder in one section
of the spine does not mean there cannot be disorders or degeneration in any other
part of the spine.
Spinal cord injury (Complete Paralysis)is one of the most devastating of ailments.
It has serious consequences and affects the patient and his or her family. Since the
nerves are unable to regenerate, there is no recovery from complete paralysis. In
such cases, treatment including surgery is to rehabilitate the patient, so that he
or she can lead a happy and a maximum functional life from the wheelchair. In
desperation, often patients and their families opt for the hi-cost stem-cell therapy
but there is no established evidence that it can cure complete paralysis. As per the
latest national guidelines for stem-cell research published by ICMR and DBT “any
stem cell use in patients must only be done within the purview of an approved and
monitored clinical trial(research) with the intent to advance science and medicine,
and not offering it as therapy. In accordance with this stringent definition, every
use of stem cells in patients outside an approved clinical trial shall be considered
as malpractice.”