Motorcycling, sky diving and scuba diving are a few activities that Jill Misangyi, a registered nurse from Canada, never imagined she would be able to do until her spinal decompression surgery with fusion and instrumentation recently in India through Healthbase . Jill had been suffering from chronic back pain for 16 years.

Back pains are as common as headaches. Most back pains disappear on their own with some rest and / or medication. Some may stay longer but can still be managed with conventional treatments of medication, therapy and back building exercises. But, there are a few types of back pain that are so chronic that they render the person disabled. Such chronic conditions necessitate surgery so as to improve the person’s condition.

There are different reasons that cause backaches. In this article we take a look into conditions caused by compression of the structures that form the spinal column, and the surgical solutions to these spine problems .

Conditions associated with spinal compression are: disc herniation, sciatica, spinal stenosis and spondylolisthesis. To relieve pressure on one or many pinched nerves of the spinal column caused by the compression, spinal decompression surgery in its different forms - discectomy, laminectomy and foraminotomy - is employed. Let us start with a description of each of these conditions followed by an understanding of the surgical options.

CONDITIONS

1.Disc herniation: Discs or disks are pads of cartilage between two adjacent vertebrae (i.e. spinal bones) that separate the vertebrae and provide cushioning to them. When the disc herniates (moves out of place), the soft gel inside pushes through the wall of the disc putting pressure on the spinal cord and nerves that are coming out of the spinal column thereby resulting in a severely painful condition. Disc herniation can occur in any disc in the spine - cervical (neck), thoracic (upper back) or lumbar (lower back) region. Disc herniations occur especially in jobs that require lifting, but can also occur from jobs that require constant sitting.

2.Sciatica: Sciatica refers to pain, weakness, numbness, or tingling in the leg caused by injury to or compression of the sciatic nerve located in the back of the leg. Sciatica is a symptom of another medical problem, not a medical condition on its own. The sciatic nerve controls the muscles of the back of the knee and lower leg and provides sensation to the back of the thigh, part of the lower leg and the sole of the foot. Sciatica may be caused by degenerative disc disease (DDD), pelvic injury or fracture, piriformis syndrome (a pain disorder involving the narrow piriformis muscle in the buttocks), slipped disk, spinal stenosis, tumors, etc.

3.Spinal stenosis: Affecting mainly middle-aged or elderly people, spinal stenosis is a narrowing of the spinal canal in the lumbar (lower back) or cervical (neck) region that results in compression of the nerve roots. It may be caused by osteoarthritis or Paget’s disease or by an injury that causes pressure on the nerve roots or the spinal cord itself.

4.Spondylolisthesis: Spondylolisthesis is a condition in which a vertebra in the lower back slips forward and onto a vertebra below it. The slip usually occurs between the fourth and fifth lumbar vertebrae. In adults, it is most commonly caused by a degenerative disease such as osteoarthritis. Other causes are stress fractures (caused during gymnastics), traumatic fractures, and bone diseases.

TREATMENT OPTIONS

Depending upon the underlying reason behind the above conditions, surgical decompression might be used to help relieve the pain. Surgical spinal decompression can take the form of a diskectomy, a laminectomy, or a foraminotomy.

1.Spinal discectomy: Diskectomy or discectomy is the removal of all or part of the affected disc. Spinal discectomy can be done in a few different ways:

a.Microdiscectomy or microdiskectomy: This is a minimally invasive way of carrying out the discectomy procedure so that the bones, joints, ligaments or muscles of your spine are not touched resulting in faster healing and recovery.

b.Lumbar diskectomy: Lumbar discectomy, as the name implies, is performed to address conditions of the lumbar spine or lower part of the back. It may also be part of a larger surgery that also includes a laminectomy, foraminotomy, or spinal fusion (fusing the vertebrae together to stop motion at the painful joint).

c.Cervical diskectomy: Cervical discectomy is performed to treat conditions of the cervical spine or the neck region of the spine. It is most often done with laminectomy, foraminotomy, or fusion.

2.Spinal laminectomy: A laminectomy is the removal of a small portion of the arch of the vertebra to increase the size of the spinal canal to alleviate the pressure on the spinal cord and the pinched nerve. Laminectomy is most commonly performed to treat spinal stenosis. It is usually done along with a diskectomy, foraminotomy, and spinal fusion. Laminectomy can be done either using the conventional open method or using the minimally invasive method.

3.Spinal foraminotomy: A foraminotomy is the removal of bone and other tissue to expand the openings for the nerve roots to exit the spinal cord. Foraminotomy, which be performed on any level (region) of the spine, takes pressure off of a nerve in the spinal column and allows it to move more easily. The procedure is commonly performed as a minimally invasive procedure.

Spinal decompression surgery is successful in relieving pressure and pain in 80% to 90% of patients. When your back pain is getting the better of you, a decompression surgery can greatly help improve your quality of life.

As for Jill Misangyi, she feels her life after surgery has taken a total turn around for the good. She is off all pain medication and is back exercising building muscle. Her 16 years of painful prolonged waiting for surgery at an NHS hospital in Canada are wasted but she considers herself lucky to have found out about Healthbase and affordable medical tourism in India. She now has a second chance at life.