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Institute for Bone, Joint Replacement, Orthopedics Spine & Sports Medicine >> Treatment Offered >> Spine Surgery

Spine Surgery

Spine Surgery is a surgical speciality which is dedicated to the restoration and preservation of spine function by managing various spinal disorders. It includes both non-operative and complex operative treatment modalities. Spine Surgery is a unique sub-specialty of orthopedic and neurosurgical surgery.The department's spine specialists offer a gamut of spinal surgeries with an aim to relieve pain, stabilization of spine and decompression of spinal cord/nerves.

At BLK Centre for Orthopaedics, Joint Reconstruction & Spine Surgery, the emphasis is always on early rehabilitation. In the case of disc operations, patients are discharged from the hospital on the same day after the microsurgery. Patients who undergo Minimal Access Fusion Surgery are discharged from the hospital a day after the surgical procedure. Results of these surgeries are at par with global standards.

 What is our spine made of ?

  • Our spine is made of a number of vertebral bones which are attached to each other with ligaments
  • There is a cushion like structure called ‘Disc’ between two vertebral bones that acts as a shock absorber and provides mobility to the spinal column
  • Spinal column houses a very important structure within the spinal canal called spinal cord, which is a link between our brain and rest of the body
  • There are lot of muscles around the spinal column that stabilizes our back, neck and also help in our movements

What causes back / neck pain?

Any fault within the numerous structures that form the spinal column can lead to back / neck pain. Additionally, many abdominal organs when inflamed can cause referred pain in the back

It is therefore important to thoroughly investigate and ascertain the underlying reason for back or neck pain.

What is disc prolapse?

Disc is a kind of cushion between two vertebral bones. It has a soft center and an outer hard shell. If the disc ruptures, the soft inner material can come out and press the nerve leading to leg or arm pain depending on whether disc prolapse occurred in lower back or neck.

9 out of 10 patients suffering from disc prolapse get better with rest and medication. However, 1 out of 10 patients, who is unable to settle or has significant weakness in arm or leg because of disc prolapse may need surgery to remove the material pressing on the nerve.

What is discectomy / microdiscectomy?

Discectomy is a surgical procedure for treating disc prolapse. A portion of the disc along with a small amount of bone is removed. It is done with the help of a microscope through a small incision. Because of the use of minimally invasive techniques, patient can be discharged from the hospital quickly and the recovery is even faster.

What is decompression?

Decompression is a standard procedure to release compressed nerves. The material, usually bone, is removed to release the nerve, thus decompressing them. Whenever suitable, such procedures are conducted through ‘Minimally Invasive Key Hole Approach’. In other cases, open surgery is recommended.

What is spinal fusion?

Spinal fusion is a surgery done to join together two bones (vertebrae) of spine resulting in zero movement between them. This leads to relief of pain from spinal segment. In certain selected cases, such procedures are conducted through ‘Minimally Invasive Key Hole Techniques’ (MITLIF). When required, open techniques are also used.

What is vertebroplasty / kyphoplasty?

Osteoporosis can lead to spontaneous fracture of back bone: ‘Vertebral Compression Fracture’ (V.C.F.)

This can cause significant pain which can be very disabling at times.

Most of these fractures can be managed by bracing, pain killer drugs and medicines for Osteoporosis. However if pain does not subside, or in certain fracture patterns as seen on X-ray and C.T. Scan, it is now possible to insert bone cement into the fractured vertebral bone (vertebroplasty / kyphoplasty).

This is done under local anaesthesia while the patient is awake. Patient can be relieved of pain and can walk soon after the procedure.

What do you plan to achieve from spine surgery?

  • To relieve your leg pain by removing whatever is pressing on the nerve i.e. disc, bone or scar tissue
  • To achieve fusion for relief of back pain or to stabilize unstable segment of spine
  • To relieve pressure on spinal cord or nerves in case it is leading to weakness in arms or legs
  • Improve quality of life and return to work / sport as soon as possible

How to prepare for spinal surgery?

Normally, you are admitted to the hospital one day before your operation. The operation will take place the next morning. You are usually in the hospital for 1-5 nights after your operation, depending on the type of surgery e.g. you may be discharged after a day or so following micro-surgery for slip disc, or may have to stay longer for major decompression and / or fusion surgery.

What is the operation procedure?

Operation is usually done under general anaesthesia except vertebroplasty or kyphoplasty (injecting bone cement in osteoporotic spine fracture).

  • Microdiscectomy for slip disc: size of the incision may be 2 cm or above depending on patient’s weight
  • Minimally Invasive Fusion (decompression and stabilization): There may be 4-6 small stab incisions and one 3-4 cm incision
  • Open decompression and stabilization – incision length may be 8 cm or above
  • When you wake up following your operation you can expect (any or all) the following:

  • You will be lying flat on your back with a dressing over the wound
  • A drip for fluids may be attached to your arm until you start eating and drinking
  • A wound drain may be attached to your back to minimize bruising and swelling
  • Pain control may be administered via a drip in the arm or in the tablet form
  • Occasionally, a catheter may be fitted to assist you in urination

How to manage pain?


Immediate pain after your operation can be managed with a combination of non-steroidal anti-inflammatory drugs (NSAID’s) and pain killers.

These will be prescribed to you for one week following your discharge from the hospital. It is important to take your medication regularly to gain maximum benefit, and not just when you are experiencing pain. As your pain level becomes less, you should gradually reduce your dose of prescribed medication, beginning with your pain killers, as this will help reduce a flare up of symptoms.


Ice packs applied to your back can be especially useful in reducing pain during the first few days after surgery. Be careful not to apply the ice directly to the skin as it can cause an ‘ice burn’

What is the recovery process?

BLK spine team has developed a comprehensive recovery and rehabilitation program for a faster healing process.


A physiotherapist will see you the day after operation. You will be assessed and shown the best way to get in and out of bed and will be encouraged to attain mobility as soon as possible.

General Advice

  • Transferring from lying to sitting / standing position: While moving from lying to sitting position, do not sit up using your abdominal muscles. If you can, roll onto your side, try to maintain a natural position of the spine. Bring your uppermost arm across your body, placing your hand on the bed. Push through both arms to help sit up as your legs are lowered to the floor. Try to gently contract your abdominal muscles during the movement
  • Lying down: Spend short and regular periods of time lying on your bed in any position you find comfortable
  • Sitting: Sitting can be a stressful position for your back. You should gradually build up the length of sitting time to approximately 30 minutes. On discharge from hospital, you may find perching on a high stool or chair more comfortable. You can use a lumber roll, or a small rolled up towel to support the curve of your lower back
  • Wound dressing: Your wound will be covered by skin staples and a dressing. This dressing will need to stay dry until the wound has healed. The dressing can usually be taken off after 10 days by when you will be required to come to the hospital for a follow-up visit.

Are there likely to be any complications?

In BLK Hospital, Success rate of surgery is more than 90%. Prior to surgery, your consultant will discuss potential risk and complications of your surgery.

Possible complications of spinal surgery:

  • Further disc prolapse: It is possible that more disc material can prolapse out in the future causing back or leg symptoms
  • Nerve scarring: Scar tissue will form in the area following the operation as part of the normal healing process. If this is excessive, it can constrict the nerve and prevent it from moving normally. This can cause possible leg pain
  • Back pain: Back pain sometimes occurs after surgery due to the cutting of muscle and removal of disc material. This is common in the first few weeks, however, it usually settles over time. Occasionally, back pain can become constant and severe
  • Nerve damage: Nerve damage may occur especially if the disc prolapse is large or the spinal canal is narrow. If the nerve is accidentally cut during the surgery there will be permanent weakness of those muscles and altered sensation in the area of the leg the nerve supplies. Nerve or Dural tear can lead to CSF leak also
  • Haematoma: There is occasional bleeding in the spinal canal or within the wound causing blood clot. This usually settles independently but it may be necessary to evacuate it surgically
  • Infection: To minimize the risk of infection you are given antibiotics in operation theatre. Infection can occur in the operative wound but one can also get infection of the disc, which is rare but more serious
  • Deep vein thrombosis (DVT blood clot in the leg): There is a small risk following surgery of developing DVT. This is minimized by early mobilization

What are the various activity levels, post surgery?

  • Mobility: Gradually increase the frequency and distance you walk. Take regular short walks around the house. As soon as you feel you are able to walk longer distances, go for a walk few times a day. Build the routine slowly
  • Lifting, twisting and bending: During the first 6 weeks avoid lifting, twisting and bending as much as possible. If you are bending and lifting, make sure the object you are moving is as close to your body as possible. Bend both your knees and try to keep your back straight. Always ensure you tighten your abdominal and buttock muscles while bending and lifting
  • Return to work: Post operation, your return to work will depend on the nature of your job. Normally, you can return to work after 4-6 weeks. If you are in a less than active job, you can return to work after 4 weeks, and after 6 weeks if your job involves physical activities. After microsurgery for slip disc, many patients return to work much earlier if the job is sedentary. For more extensive spinal fusion surgery, return to work may be delayed a little more
  • Driving: Do not drive until after your first outpatient appointment as your doctor needs to review your back first. You can be seated as a passenger as long as the journey is short and you can sit comfortably for that period of time. Usually you can start driving after 4-6 weeks
  • Sports and other activities: Participation in any activity or sport would require the advise of your consultant and therapist– on when you can resume them and how you can gradually build up your fitness. 

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