SPINE TREATMENT

WHAT IS A SPINAL TUMOUR? A tumour is an abnormal growth of cells. Spinal tumours can be- Vertebral tumours –affecting the bones of spinal column Spinal cord tumours—affecting the nerves and cord. If cells in the spine grow and multiply abnormally to cause a tumour, this is called a primary tumour. If abnormal cells have spread to the spine from a tumour in another part of the body, this is called a secondary tumour or metastasis. WHAT ARE THE DIFFERENT TYPES OF SPINAL TUMOURS AND WHERE DO THEY OCCUR? NON-MALIGNANT SPINAL TUMOURS Low grade or slow growing spinal tumours can grow but they do not spread to other parts of the body. However, these tumours can grow to a considerable size, causing damage by putting pressure on the tissue around them in the spine. MALIGNANT SPINAL TUMOURS High grade or rapidly growing tumours are called malignant. They are cancerous. They do spread and destroy the tissue surrounding them. The most common spinal tumours are malignant metastases that have spread to the spine from malignant primary tumours in other parts of the body such as the prostate, breasts, lungs, kidneys and bowel. Procedures Done for them are- 1. Transpedicular Biopsy 2. Vertebroplasty 3. Decompressive laminectomy ± Tumor excision 4. Piecemeal or enbloc tumour excision and complex spinal reconstruction Dr. Pravin decides the line of treatment as per international guidelines after thorough clinical and imaging reports evaluation.

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications.

Back pain is frequent complaint. It is the commonest cause of work-related absence in the world. Although back pain may be painful and uncomfortable, it is not usually serious. Even though back pain can affect people of any age, it is significantly more common among adults aged between 25 and 55 years. Pain in the lower back may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles. Pain in the upper back may be due to disorders of the aorta, tumors in the chest, and spine inflammation. The risk factors for back pain? • A mentally stressful job • A sedentary lifestyle • Age – older adults are more susceptible than young adults or children • Gender – back pain is more common among females than males • Obesity • Smoking • Strenuous physical exercise • Strenuous physical work What are the symptoms of back pain? The main symptom of back pain is, as the name suggests, an ache or pain anywhere on the back, and sometimes all the way down to the buttocks and legs. If any of the following symptoms accompanies a back pain your should see your doctor: • Weight loss • Elevated body temperature (fever) • Swelling on the back • Persistent back pain – lying down or resting does not help • Pain down the legs • Pain reaches below the knees • Arecent injury, blow or trauma to your back • Difficulty urinating – passing urine is hard • Loss of bowel control • Numbness around the buttocks

INJECTIONS FOR YOUR BACK & NECK CERVICAL EPIDURAL CERVICALFACET BLOCKS LUMBAR EPIDURAL FACET BLOCKS ROOT BLOCKS A lumbar caudal epidural steroid injection is an outpatient procedure for treating low back and leg pain. Facet & root blocks are injection into a specific joints of spine and along the nerve roots as required. Introduction In a lumbar epidural injection, an anti-inflammatory medicine is injected into the epidural space to reduce inflammation. A local anesthetic (numbing medicine) may also be injected. When the injection is done through the bony opening in your tailbone then this is called a caudal epidural injection. An injection in a joint of the back is called a facet joint injection. An injection along the nerve root sleeve is called a root block. Getting Ready for Treatment : • Provide a list of all medicines you take, including aspirin and anti-inflammatory drugs. • Don’t eat 6 hours before the injection but you can have a light drink 4 hours before injection. • Arrange for a responsible adult to drive you home after the procedure. • Bring all X-ray & MRI images on the day of the procedure • You need to stop blood thinning drugs like asprin, clopidogriel etc. 5 – 7 days before the injection. But consult your cardiologist before hand. During the Procedure: The injection takes just a few minutes. But extra time is needed to get ready. Alocal anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the epidural space. A type of X-ray or C-arm may be used to ensure the safe and proper position of the needle. Contrast “dye” may be injected into your back, this helps get a better image. Once the doctor is sure the needle is correctly placed the medicine will be injected.