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Cervical Spine Surgery in India Overview: To best understand the Cervical Spine Surgery, it is important to know about your spine. The spinal column surrounds and protects your spinal cord. Your spinal column is made up of 24 vertebrae (bones), plus the sacrum and the tailbone (coccyx). Each vertebra is separated by shock-absorbing discs. These discs give your spine flexibility to move and bend. Nerves branch out from your spinal cord and pass through openings in these vertebrae to other parts of your body. The goal of cervical spine surgery is to relieve pain, numbness, tingling and weakness, restore nerve function and stop or prevent abnormal motion in the spine. What is Cervical Spine Surgery? Cervical Spine Surgery is a procedure aimed at alleviating weakness, tingling, numbness and pain associated with the cervical spine. At the same time, the surgery seeks to correct any abnormalities in the function of the spine and help to restore a proper level of nerve function. The exact form of cervical surgery will depend on the general condition of the patient and what must be done in order to ease pressure on the nerves along the spinal column or any irritants to the vertebrae of the back.
Why Cervical Spine Surgery? Cervical Spine Surgery becomes necessary when a degenerative disease or deformity occurs. With degenerative disease, the intervertebral discs shrink, which causes a wearing down of the disc. The wearing down may lead to disc herniation, which is a bulging of the discs. Degeneration results in compression to the nerves which cause pain, numbness, tingling, and weakness. Individuals with cervical deformity, such as hyperlordosis or swan neck may have cervical spine surgery to help straighten and stabilize the spine. Cervical deformities leave the neck vulnerable to injury, and some injuries may lead to dislocation or fracture of the cervical vertebrae. Surgery in this case is beneficial for relieving pressure on the spinal cord.
What Conditions are treated with Cervical Spine Surgery? The various conditions cervical conditions treated with surgery are: •
Degenerative Disc Disease- In degenerative disease the discs or cushion pads between your vertebrae shrink, causing wearing of the disc, which may lead to herniation. You may also have arthritic areas in your spine. This degeneration can cause pain, numbness, tingling and weakness from the pressure on the spinal nerves.
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Cervical Deformity- Patients with a deformity in their cervical spine, such as hyperlordosis or swan neck deformity may benefit from surgery to straighten and stabilize the spine. Injury
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Fractures, Dislocations & other Injuries- Patients with a fracture, especially with spinal cord damage, undergo surgery to relieve pressure on the spinal cord and stabilize the spine.
What are the Symptoms for Cervical Spine Surgery? The Cervical spine surgeries are generally indicated for spine problems like degenerative disorders, trauma or instability. The surgery in such conditions helps in reducing pressure on the spinal cord or on the nerves coming from the spine.
How to Prepare for Cervical Spine Surgery? Preparing for cervical spine surgery goes beyond just mentally and physically preparing yourself. Of course you need be in good physical condition before you can have your surgery, but you will also want to prepare your home so that things are accessible once you return from surgery. Just follow the tips below: Stop taking medications, pain relievers and vitamin supplements two weeks prior to surgery. If there are medications or supplements you must take, keep a log of these to review with your surgeon prior to surgery. If you smoke, stop two weeks prior to surgery. Smoking interferes with bone graft healing. Have a pre-surgical physical. This should be done within 10 days of your surgical date to ensure you are in good enough health to have the procedure done. This will include blood work, urine analysis, EKG and a medical history. Organize your home so that things you may need once you return are easily accessible. This means putting the phone, shoes and toiletries in easy-to-reach places that don't require any bending. Make sure that rugs are either removed or secured to prevent you from tripping over them. Organize a ride to and from the hospital. You won't be able to drive when you are released and for some time after. Make sure you have someone who can assist with grocery store runs and other errands, such as making postoperative medical appointments or physical therapy, until you are released to drive. Donate blood. Depending on your procedure, you may be required to donate blood or have donations made in your name. Prepare your hospital bag. This should include comfortable clothing such as pajamas or sweat pants, as well as a robe and comfortable non-slip slippers. Gather toiletries such as a comb, toothpaste and toothbrush. You should also include your health insurance card and credit or debit card for co-payments at the hospital. Prepare an advanced directive. This is your living will that gives authority to a family member or friend to make medical decisions on your behalf if you are unable to. Do not eat or drink anything at least nine hours before your surgery. Ask your physician about any last-minute instructions that may be particular to your case.
What are the Common Procedures for Cervical Spine Surgery? The most common Cervical Spine Surgeries are: Anterior Cervical Decompression (Discectomy): A discectomy is a surgery done to remove a herniated disc from the spinal canal. When a disc herniation occurs, a fragment of the normal spinal disc is dislodged. This fragment may press against the spinal cord or the nerves that surround the spinal cord. This pressure causes the symptoms that are characteristic of herniated discs. A discectomy is performed under general anesthesia. The procedure takes about an hour, depending on the extent of the disc herniation, the size of the patient, and other factors. A discectomy is done with the patient lying face down, and the back pointing upwards.
Anterior Cervical Spinal Fusion Surgery (Arthrodesis): is a surgery that joins selected bones in the neck. Arthrodesis is a surgical procedure, also known as joint fusion. The goal of this surgery is to provide pain relief, restore skeletal stability, and improve alignment in people with advanced arthritis. Not all arthritic joints are candidates for joint replacement surgery. Sometimes Arthrodesis is the better surgical treatment option for those with arthritis. Anterior plates may be used. Some posterior decompress procedures may require Arthrodesis accompanied by lateral mass plates. Instability in the upper cervical spine may require a posterior Arthrodesis with plating to the occipital. Anterior Cervical Corpectomy Spine Surgery: When the cervical disease encompasses more than just the disc space, the spine surgeon may recommend removal of the vertebral body as well as the disc spaces at either end to completely decompress the cervical canal. This procedure, a cervical corpectomy, is often done for multi-level cervical stenosis with spinal cord compression caused by bone spur (osteophytes) growth. The approach is similar to a discectomy (anterior approach), although a larger and more vertical incision in the neck will often be used to allow more extensive exposure. Posterior Cervical Decompression (Microdisectomy) Surgery: Some spine surgeons may prefer the posterior approach (from the back of the neck) for a cervical discectomy. This approach is often considered for large soft disc herniations that are lateral to (to the side of) the spinal cord. A Microdisectomy is typically performed for a herniated lumbar disc and is actually more effective for treating leg pain (also known as radiculopathy) than lower back pain. It is performed through a small (1 inch to 1 1/2 inch) incision in the midline of the low back. Posterior Cervical Laminectomy: Cervical stenosis can place pressure on the spinal cord. If most of the compression is in the back, the cervical stenosis can be treated with a posterior cervical laminectomy. The objective of this procedure is to remove the lamina (and spinous process) to give the spinal cord more room. The results of the laminectomy are variable, since some people have more extensive disease than others. In general, after the laminectomy most patients can expect to regain some spinal cord function improvement in their hand function and walking capabilities.
What is the Procedure of Cervical Spine Surgery? The specific cervical spine procedure depends on what is causing the problem. Generally, surgeons use two techniques: decompression and stabilization. With cervical spine decompression surgery, the tissue that is impinging on a nerve structure is removed. A decompression procedure may be performed from the front (anterior cervical spine surgery) or the back (posterior surgery). The types of decompression procedures are: Foraminotomy: This creates a bigger space in the vertebra Laminotomy: creates a whole in the lamina of the vertebra to make more space for the spinal cord Facetectomy: removes the facet joint to relieve pressure on a nerve Laminoplasty: reconstructs the lamina to create more space for the spinal cord Discectomy: removes all or part of the herniated disc Corpectomy: the entire vertebral body is removed to gain access to the disc.
Stabilization surgery limits movement between the vertebrae. This becomes necessary when there is abnormal movement in the spinal column, which potentially leads to nerve injury. Stabilization surgery is usually necessary after a discectomy or corpectomy. The two stabilization techniques include:
Fusion, which bonds the bones together via a bone graft; stop the motion between the vertebrae Instrumentation, fusion is supplemented by devices such as plates, screws, wires, cables, and rods.
A new medical technology known as artificial disc replacement is another option for cervical spine surgery. Instead of fusing the spine together after surgery, a disc is replaced so the patient can retain normal neck movement. Depending on the severity of the condition, a patient may qualify to undergo minimally invasive cervical spine surgery. In this surgery, a small incision is made with the help of an endoscope to disrupt the muscles minimally. Compared to normal cervical spine surgery, the pain and recovery time is less. This surgery relieves patients from scoliosis, herniated discs, and several other painful conditions. Any type of surgery is performed while a patient is under general anesthesia.
What is the Post-operative care after Cervical Spine Surgery? This is a major surgery and you need to give your body time to heal. Below is a list of instructions that you should follow until your first follow-up visit after surgery. You no longer need to wear the stocking (heavy white stockings) once you are home. You may sleep either on your back, stomach or side. You may also use pillows for support, when lying on your side. Place pillows behind your back and between your legs, when on your back place pillows underneath your legs. You may climb stairs, just try not to over-do. After your cervical spine surgery, please lie only on a bed. No sofas or recliners. Sit only in a straight back chair (such as a dining room or kitchen chair or a structurally substantial chair such as a “Wing Back�.) No bending, stooping, pushing, lifting or straining from a lying down position by turning first on one side or the other. Do Not push backwards. Begin walking in the house and progress to outdoors. Take someone with you the first few times. Slowly in- crease the distance each day so that you will be walking 1 mile/day by your 2nd post-operative week, 2 miles/day at 2 weeks postoperative.
What is the Cervical Spine Surgery Recovery? The hospital stay following Cervical Spine Surgery may up to seven days. Activity is an important part of recovery; a patient is encouraged to walk the first or second day after surgery. This is to reduce the risks of blood clots. Normally a surgeon orders a collar/neck brace, and gives the patient specific instructions about its use. Full recovery takes about 5 weeks. There are no restrictions for walking or stair climbing during the recovery period. For the first six weeks at home, objects heavier than 10 pounds should not be lifted, especially over the head. Any sleep position that is comfortable for the patient is acceptable as long as the neck brace is worn properly. Driving is prohibited during recovery, but short rides as a passenger is allowed. Prescription medications are also provided for when the patient leaves the hospital. In the event of a bone graft procedure, non-steroidal anti-inflammatory medications are prohibited for six weeks following surgery, as these medications may interfere with the healing. As an alternative, a patient may use hot or cold moist compresses over the site or shoulders. Incisions may be washed with mild soap and water, but tub baths, swimming pools, or any water immersion should be avoided for six weeks after surgery.
Why Cervical Spine Surgery in India? Of late, India has emerged a new medical destination for foreign patients. A large number of patients from across the globe travel to India every year in order to get Cervical Spine Surgery. Patients especially from UK,USA, Canada and Africa do come in abundance due to many factors for people from most of the western countries come in order top get urgent medical attention some come due to better healthcare facilities in lowest and the most affordable price. The high quality, training and specialization of surgeons and medical staff contribute to India being a worldwide reference in almost all medical procedures. India comprises some of the worlds best equipped hospitals and highly skilled surgeons. India is the second country in the world that most performs Cervical Spine Surgeries (USA is in first place). The hospitals and clinics catering Cervical Spine Surgery in India are spread all over the country with presence of more than five thousand healthcare professionals treating with the most advanced medical amenities in the world. These are available at hospitals in the following cities with latest amenities and state-of-art-facilities. Mumbai
Hyderabad
Kerala
Delhi
Pune
Goa
Bangalore
Nagpur
Jaipur
Chennai
Gurgaon
Chandigarh
What is the Cost of Cervical Spine Surgery in India? The cost difference is very vast which goes from 60-80% less as compared to medical treatments performed in USA and other developed nations. If a person opts to get the Low cost Cervical Surgery in India he/she can have not just the cost saving but even enjoy tourism in India arranged by the medical tourism in India. The following table can give you a fair idea of the cost difference which is evident in India. Medical Treatment Cervical Spine Surgery Spinal Fusion Disc Replacement Surgery Orthopedic Surgery
Procedure Cost (US$) United States 58,000 77,000 55,000 20,000
India 10,000 9,000 11,000 5,000
Some of the common countries from which patients travel to India for surgery are: USA
UK
Canada
Australia
New Zealand
Nigeria
Kenya
Ethiopia
Uganda
Tanzania
Zambia
Congo
Sri Lanka
Bangladesh
Pakistan
Afghanistan
Nepal
Uzbekhistan
ABOUT INDIA Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service. Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city. Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world. Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving. Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India, Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra. Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet. Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors. Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism. Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India. Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery. Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium
Patients Testimonial:
Mrs. Joan, Canada Cervical Spine Surgery in India
I am Joan Ference from Canada. I came to India for my Cervical Spine Surgery in India. I was looking forward for getting an Cervical Spine Surgery from a long time. I contacted two disc replacement surgeons in Canada for my surgery and I was told that there was a long waiting list for my surgery and the price was also very expensive. Then I decided to take the matter in my own hands and then I started looking on the internet to say if I can find any reasonable alternative abroad for my surgery and nowadays we are very much familiar with the concept of medical tourism in India. So I started researching for Cervical Spine Surgery in India. Then I found Dr Dheeraj Bojwani’s company Dr Dheeraj Bojwani Consultants. I want to thank Dr Dheeraj Bojwani and the whole team of Dr Dheeraj Bojwani Consultants for their help and assistance in arranging my Cervical Spine Surgery in India with the best medical facilities in India and the best medical treatment for my Cervical Spine Surgery in India
Mr. Lew Heskewich, Canada Cervical Spine Surgery in India
Hi. I am Lew from Calgary, Canada. Last month, I got my Cervical Spine Surgery in India. I would like to thank the Dheeraj Bojwani Group for their coordination. Without your support, my medical tour to India couldn’t have been so easy. I came to know about Dheeraj Bojwani Group from the internet and I immediately contacted them to arrange my Cervical Spine Surgery in India. They asked for my relevant medical reports, MRI and X-Ray reports. They were studied by thee senior spine surgeons. After going through my medical reports they, considered me a perfect candidate of Cervical Spine Surgery in India. I was suffering form severe neck pain. I also experienced shooting pain in my arm. My doctor had suggested that I should go for a Cervical Spine Surgery. I chose India for my surgery was mainly because of the low cost. If I was getting the same quality at a much lower price then why not consider it. When I entered the hospital where I got my Cervical Spine Surgery in India, I was stunned to see the medical facilities around me. My hospital room was very cozy and comfortable. It seemed more like a 5 star hotel room rather than a hospital room. My Cervical Spine Surgery in India was carried out by expert surgeons. My surgery was performed successfully and ever since then, I am not experiencing pain at all. I am very grateful to my doctor for doing an excellent job. Thank you, Lew
Knee Replacement Surgery in India Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.
Knee Replacement Surgery Candidates A person would be considered a candidate for knee replacement if there is: • • • • • •
Daily pain The pain is severe enough to restrict work, recreation and ordinary activities of daily living Significant stiffness in the knee Significant instability (constant giving way) of the knee Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis
Success Rate of Knee Replacement Surgery: Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.
Knee Replacement Surgery Preparations: • • • •
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If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery. If you drink, don't have any alcohol for at least 48 hours before surgery. Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to strengthen your upper body will help you cope with crutches or a walker after surgery. Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia. The results of this examination should be forwarded to your orthopaedic surgeon, along with a surgical clearance. Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last-minute questions. You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray. Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.