Gurgaon, August 2, 2008: Dr. Harshavardhan Hegde, Consultant and Head, Department of Orthopedics and Spine Surgery at Artemis Health Institute, Gurgaon performed a 4 level disc replacement surgery on a 54 year American patient. Dr. Hegde in an 8 hour long surgery replaced two lumbar discs (lower back) and two cervical discs (neck).
The patient was suffering from disc degeneration for the last 10 years and when he came to know about Dr Harshvardhan Hegde from a patient who had been treated by him earlier. One option was to have a fusion surgery and the other was to have disc replacement surgery which is more complicated but has a faster recovery. He chose the latter. The patient was walking on the first postoperative day and is hoping to be discharged from the hospital in five days. The cost for the surgery in India too was a big relief for him. It cost him USD 25,000 US dollars for a 4 level disc replacement at Artemis Health Institute, while in America he was given a budget of around 2,50,000 US dollars.
Cervical disc replacement is a procedure where an artificial cervical disc is inserted between two cervical vertebrae after an intervertebral disc has been surgically removed in the process of decompressing the spinal cord or/and a nerve root. The intent of the device is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following such a disc removal, which necessarily eliminates motion at the operated disc space in the neck.
Lumbar disc replacement is a procedure where an artificial disc is inserted between two lumbar vertebrae after an intervertebral disc has been surgically removed in the process of decompressing the spinal cord or/and a nerve root. The intent of the device is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following such a disc removal, which necessarily eliminates motion at the operated disc space in the neck.
The advantages of the artificial cervical and lumbar disc over a fusion include:
Dr Hegde says, "A 2 level disc replacement surgery is a rarely done procedure in India due to the complications involved as it is requires a lot of precision. A 4 level disc replacement surgery is a big milestone for the Indian spinal & orthopedics society as it is the first surgery of its kind to be performed in Asia".
Degenerative disc disease is fairly common, and it is estimated that at least 30% of people aged 30-50 years old will have some degree of disc space degeneration, although not all will have pain or ever receive a formal diagnosis. In fact, after a patient reaches 60, some level of disc degeneration is deemed to be a normal finding, not the exception.
Dr. Hegde further adds that, It has become a very common problem in India and what is more worrying is the alarming increase in neck, leg and arm pain in the computer professionals in the country, due to extended working hours in wrong posture. They need to change the posture and redesign the office workstation ergonomically. Those who are prone to neck pain need to consult a spine surgeon for the same, as it is gripping more and more of the younger population. Also people who are heavy smokers and have a sedentary lifestyle are prone to suffer from this problem.
Disc degeneration can affect anyone above the age of around 20yrs. Usually, younger people have these problems more related to ergonomics and prolonged working hours. In older population, it can be a degenerative process wherein multifactor causes like repetitive injury, genetic, wear and tear in the body and above that, smoking and sedentary lifestyle contributes to it.
What is disc degeneration? The process of degeneration of the inter-vertebral discs causes many problems in the spine. Everything you do during the day while being upright tests the spine's ability to support your body weight. Minor injuries to the disc may occur and not cause pain at the time of the injury. These repeated daily stresses and minor injuries could add up over time and begin to affect the discs in your spine. The disc eventually begins to suffer from the wear and tear-it begins to degenerate. This means the disc becomes compressed into the adjacent spinal canal where it can press on nerves or the spinal cord.
Pain symptoms can vary, but generally are:
To correct this problem an artificial disc replacement surgery is performed, the goal is to remove the damaged, painful disc, and replace this with a metal and metal/plastic implant. The implant is designed to move like a normal disc. Disc replacement surgery would most typically be done for patients that have not responded to non-surgical treatment options and are significantly affecting the individuals' quality of life and ability to function.
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