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Scoliosis is a problem that relates to the curvature of the spine. It develops in early childhood years, or may also be present before birth. Congenital Scoliosis occurs due to the malformation of vertebrae in the embryo. It causes curvature in the spine because there is no uniformity in the growth and lengthening of the vertebrates. The rate and progress depend on the location of the abnormalities within the spine. Since this dysfunctionality is present ever since the fetus develops in the womb, it starts becoming acute and noticeable as the child grows in age and health. Therefore, it becomes detectable at a young age. Idiopathic Scoliosis gets its name from the term Idiopathic, which means ‘no cause’ Ironically, it is the most common type that has a greater tendency of affecting girls than boys. It can target children of any age. Based on age Idiopathic Scoliosis have three classifications. Infantile Idiopathic Scoliosis start showing symptoms within three years from the time of birth. Juvenile idiopathic scoliosis shows up in children between three and nine years of age. Adolescent idiopathic scoliosis affects children between ten and eighteen years of age. The last classification has the highest percentage amongst the other two in pediatric cases. Idiopathic Scoliosis has better chances of healing if it gets detected at an early stage of growth. Neuromuscular scoliosis occurs due to disorder in the nerve or muscular system. Weak and fragile muscular systems fail to give support and strength to nerves and spine that results in developing curves in the spine. Treatment of scoliosis includes therapeutic measures, medications, and spinal fusion surgery. Surgeries aim at straightening the spine using instruments, metal rods, screws, and wires, and they also attempt to strengthen the spine preventing further curves. The spinal fusion surgery solves help in stabilizing the spine curves, balancing the spine and pelvis, restoring the sitting ability, and improving the functionality of the lungs.

Selective Nerve Root Block is the procedure of injecting a small amount of steroid and medicine to numb the area around the specific nerve. The process serves a two-way function. First, it helps the doctors to know which roots, nerves are affected, and second it also acts as a therapy relieving the pain. Therefore it is both a diagnostic and therapeutic measure. Selective Nerve Root Block is more commonly helpful in treating problems in Cervical, thoracic, and lumbar back areas problems. The Selective Nerve Root Block performs the mechanisms like inhibiting the secretion by enzymes that cause irritation and pain, blocking the fibers and decreasing the permeability of nerve fibers to receive blood that reduces pain. The process of injecting the medicine into the body involves cleaning the skin to prevent infection, injecting a dye that helps to locate the target nerve. Selective Nerve Root Block yields more fruitful results for the people practicing strengthening exercises and therapeutic measures, as suggested by the doctors.

Transforaminal Percutaneous Endoscopic Discectomy has gained more preference over time because of the advantages it offers in the form of a shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. The pre-requisite it asks for is neurosurgeon should have experience and capability of beating and handling the challenges that one may encounter during or after the surgery. Bone Spine and joint clinic have expert neurosurgeons fulfilling the demands and requirements of this challenging yet effective procedure Transforaminal Percutaneous Endoscopic Discectomy for treating herniated lumbar disc and many other spinal dysfunctionalities. Techniques while performing the surgery need to be accurate and precise for fruitful results. The first challenge comes in deciding the position and approach for surgery that surgeons do according to the location of disc herniation. More crucial than the first step is inserting and exiting the spinal root, wherein no nerve should get damaged or disturbed. The process makes use of local anesthesia which, allows doctors to monitor changes in symptoms of the patient. Giving pain-relieving medicines before the needle insertion into the skin allows the distinction between pathological and other disc tissues facilitating the completion of the entire procedure of removal of epidurally extruded disc fragments in the lumbar spine.

This is a two-way process that begins with the removal of degenerated and deformed disc causing pain. The gap which occurs due to the removal of the deformed disc needs a filler. Spacer bone graft fills the gap and prevents the further wearing and tearing of the vertebrae. Bone graft joins the two vertebrae and over the period form one solid bone. Removal of the degenerated disc can be one or multiple depending on their state of deformity and irregularities. Also, the surgeons can decide the process to be anterior or posterior that primarily depends on the nature of the problem. Former involves reaching the disc by making an incision from the front moving aside the neck muscles, trachea, and esophagus whereas, the latter needs the surgeons to make precision in a way that they do not disturb spinal cord and spinal nerves. Selecting the Bone graft for Anterior Cervical Discectomy with Fusion is again the decision of surgeons as they do so keeping, in mind, nature of the problem and health aspects of their patient. They may prefer to take bone cells from the hip of the patient autograft bone or choose allograft bone. It is a bone graft that is in the bone bank that collects and preserves the organs of the people who are dead and have agreed to donate their organs. Another option comes in the form of bone graft substitutes made from plastics, ceramic, or bioresorbable compounds. The Allograft and Bone graft substitutes need the filling of shaved living bone tissues taken from the spine of the patient at the time of surgery. It is so because the former bone grafts are dead and have no protein and bone growing cells, whereas autograft bone is rich in protein and has living bone tissues. The only disadvantage of the latter is the patient has to bear the pain of hip surgery as well.

Posterior cervical microforaminotomy/discectomy is a surgical process of removing the herniated disc that exerts pressure on the neural structure of the spine that causes shooting pain and, uncomfortableness. The increased indent of the patients and doctors towards Posterior Cervical Microforaminotomy is because of the small incisions, less blood loss, reduced post-operative pain, and speedier recovery and other hosts of benefits it offers. The surgery begins with giving a person anesthesia then making a minor incision in the affected area through which tiny tube passes to separate muscles and tissues. Progressively series of the larger retraction tube pass through the incision that wide open the pathway and help in reaching the affected area of the spine. The process involves removing the disc fragments, bone spur, damaged tissues that compress the spine, and enlarging the size of affected neuroforamen. Neuroforamen is a passage through which spinal nerve roots exit the spinal canal . Disrupted disc narrows the passage, neuroforamen compressing the spinal nerve and causing pain. Like other neurosurgeries, this surgery also calls for doctors’ advice and guidance after the surgery before getting involved in any of the physical activity. Regaining the strength of the neck to perform the functions is essential that may require the patient to wear soft cervical collars, practice therapeutic sessions, and exercise.

A surgical procedure to enlarge the spinal canal. It is a surgical process of decompressing the pressure on spinal nerves and spinal cords. It becomes essential as the constant compression on the spinal nerves and cord can lead to permanent damaging of the soft tissues which, give rise to pain weakness, numbness, difficulty in walking, and disturbed bowel or bladder control. The process also facilitates the treatment of tumors, vascular malformations, and syringomyelia. However, the choice of cervical laminoplasty as a procedure for decompressing spinal nerve is purely a choice of surgeons. They opt for the surgery keeping, in mind, various medical aspects of their patients like age, the number of spinal segments involved, degree of calcification of bone spurs, and many other medical conditions. The procedure requires anesthesia before cutting the bone at the facet joint. Cut on both sides of the bone passes through the inner, middle, and outer layer that opens the lamina, spinal canal, and relieving the pressure on cords. A small metal piece or a bone helps in keeping the wedge open. If the surgeon feels, the need he may also enlarge the foramina that also relieve pressure on nerve roots. Post-surgery a few initial days demand all the precautions and medication details to be followed strictly. Follow-up with the doctor after four to six weeks is essential wherein the surgeon analyzes the rate of healing, motion, and balance of the spine. Depending on the outcomes, he further notifies the patient to restart the routine physical activity.

Kyphosis which is commonly known as ‘Hunchback’ or ’roundback,’ is a spinal deformity resulting from the outward growth of the spine. The spine in the human body has curves that make it possible for the human being to stand , sit, walk erectly. If the spinal curves happen to be too large or too small due to any biological reasons, it causes problems in our standing, sitting positions, and our body appears abnormal. The range of curvature of the thoracic spine ranges between 20 and 45 degrees. Curves beyond this range become a cause of the problem and in medical terms referred to as Kyphosis. It can affect the person of any age, but the medical history shows more chances of ailment developing at the time of adolescence when bone growth is at its peak. Postural kyphosis leads to the development of a round and smooth curve that is the cause of poor posture or slouching. Scheuermann’s Kyphosis is more severe in nature and condition than the former. Vertebrae have a triangular shape than a rectangular shape due to which they wedge together towards front of the spine causing, a sharp rigid curve. Congenital Kyphosis develops in the womb when either, the bone does not form as they should or, vertebrate gets fused. The situation worsens with the time as the child grows. It requires surgeries at a young age to stop the growth of curves, and it also leads to the development of many other dysfunctionalities in the womb. Treatment includes non-surgical procedures like medications, physical therapies, bracing, and exercises. The surgical procedure for treatment is the spinal fusion that involves initially realigning the curved vertebrate, filling the gaps with bone grafts that fuse with time, and grow into one single bone.

Osteoporosis is a bone disease. It occurs when bones of the body become weak on one side, and also starts losing the bone as well there is marked deficiency in the ability of the body to make bone. As a result, the bones become brittle fragile to the extent that they can break, fracture at sneezing, or cough. The microscopic view of the bone structure deeply affected by Osteoporosis helps in understanding the damage it does to the bone structure of the human body. The healthy bone structure of the human body looks like a honeycomb tight, intact and, healthy contrary to it, the bone structure affected with Osteoporosis shows large holes, pores between bones, that are loosely packed, and fragile enough to break at a jolt or tremble. The problem is more common amongst the old age group, or in other words, after a person reaches the forties. One should take guidance from the doctor about bone mass, density, and structure to avoid the severe consequences of suffering from Osteoporosis. Target areas of bone-breaking and fracture are hip, spine, and wrist other, bones are at equal risk. If it affects the vertebrate in the spine, it can lead to a shortening of height and lead to stoop or hunch. Osteoporosis is a silent disease that gives very few symptoms and keeps on progressing with time. It becomes prominent at the last stage, severely affecting the health of a person. It is advisable to consult ortho surgeons and doctors from time to time for better information and keep a check on bone’s health

An another surgical procedure that surgeons opt for when it comes to treating the cervical pathology. The surgery is beneficial when it comes to relieving the neck, spinal pain from compressed nerve root or spinal cord. The procedure begins by giving anaesthesia to the patient, followed by making an incision in front of the neck. Removal of bone spurs, Disc fragments that exert pressure on the nerve root or spinal cord relieve the pain that person experiences before surgery. Image monitoring helps the surgeons to fill the disc space with the artificial disc shape to decompress the pressure on the surrounding nerves. Spinal disc mechanism is no less than a wonder that we are born with, restoring the same with the artificial disc is not less than a challenge. Efforts and attempts aim for restoring the natural biomechanics in the artificial disc. However, a replica of biomechanics functioning like natural spinal disc poses problems, and there still exists the challenge of long-term surviving disc designs, shape, and size. There are a wide range of artificial disc designs based on the material of disc metal-on-metal, metal-on-polymer composite, ceramic-on-polymer composite, based on motion constrained, semi-constrained, unconstrained, or biomimetic disc shapes. Unconstrained devices suffer from the disadvantage of increasing loads on the adjoining joints. Constrained devices reduce the load on joints, but they have a fixed rotational axis that requires precise placement. Ceramic materials come with many advantages. The only demerit is if there occurs manufacturing error, it can cause fractures and deformities. Metals come with the problem of wear and tear and corrosion. Neurosurgeons have many choices when it comes to selecting the disc design, although the efficiency of one over others remains unanswered

Lumbar fusion is an attempt by the neurosurgeons to eliminate the pain that originates due to spinal deformities, spinal weakness, or instability or, a person is suffering from the herniated disc problem. The process involves grafting a bone natural or synthetic within two vertebrae. The natural bone graft is usually taken from the patient’s hip or manufactured known as a synthetic bone graft substitute. The process begins with an incision made at a suitable position that facilitates the surgeon to have access to the spine from the front. Natural bone graft requires an incision at the body part selected for taking bone. The bone graft material fills the gap between the vertebrate. Metal rods, screws, and other artificial material facilitates holding vertebrate intact by the time grafting heals. Healing time for the surgery is long, and it does require strict precautionary measures for a long time. Resuming physical activity and exercises demands doctors advice and consent to avoid any further complications. .