Minimally Invasive Disc Nucleoplasty Surgery in India for herniated or slipped disc, chronic lower back pain, Sciatica

Disc Nucleoplasty in India

Intervertebral discs are cushion-like structures located between the bones that make up the spine. Under certain conditions, these discs can bulge and cause back pain. Disc Nucleoplasty is a minimally invasive procedure to reduce the pressure inside a disc to relieve pain. Because no incision is made, the recovery time is shorter than traditional open surgery methods. Intervertebral discs are cushions between the vertebrae that form the spine. The discs are the shock absorbers between the bones, providing stability and easing movement.

Nucleoplasty treats pain caused due to herniated discs. An experienced radiologist removes a small portion of disc the tissue using image guidance, to relieve pressure on the nerves. The treatment can alleviate pain and restore mobility. Nucleoplasty is a minimally invasive procedure, which makes smaller incision, has fewer risks of complication, and takes lesser recovery time as compared to traditional surgery. The innovative imaging technology plays a key role in planning and performing each procedure, and on-staff physicists and engineers ensure that the machines are upgraded eventually. 

Disc Nucleoplasty is a minimally invasive procedure wherein the doctor utilizes a small needle and advanced radiofrequency technology to reduce the herniated disc. This procedure quickly frees most patients from pain and discomfort.

Candidates for Disc Nucleoplasty :-

You are a candidate for disc nucleoplasty if:

·         If you are suffering from chronic back pain, back fatigue and rest, medications, medical interventions like steroid injections and physical therapy has not been of help.

·         If you suffer from disc herniation

·         If you suffer from contained spinal disc herniation, i.e, pain radiating down the leg or arm accompanied by back pain not improving with medication and physical therapy.

·         Inflammation and chronic pain, particularly in cases where the nerve roots are pinched or irritated.

How does the Disc Nucleoplasty procedure work?

The procedure is generally performed on an outpatient basis using a gentle, relaxing medicine and local anesthetic. The technique is as follows:

§  Cannula  insertion

After the doctor injects some anesthetic to numb the area where the incision is to be made, he inserts a thin needle known as a cannula through the back and into the herniated disc. He uses an X-ray imaging technique to guide the placement of the cannula.

§  Treating Disc Nucleus

A small radiofrequency probe is inserted into the disc through the cannula. The device sends pulses of radio waves to dissolve small portions of disc nucleus. Since the doctor removes enough disc material to reduce the pressure inside the disc, the spine regains stablilty.

§  Relieving from Herniation

The hollow created enables the disc to reabsorb the herniation. The surgeon uses heat to seal the disc.  

§  Post-surgery recovery

After the physician removes the treatment equipment, the insertion area is covered with a small bandage. Since no muscles or bone are cut during the procedure, recovery is fast. The patient may need a day’s bed rest after the procedure and some physical therapy, and is ready to return to normal daily activities within one to six weeks.

Benefits of Disc Nucleoplasty for herniated or slipped disc, chronic lower back pain, Sciatica

·         Minimally Invasive, Scarless , Minimal Pain & discomfort to the patient

·         Quick recovery and return back to active work life

·         Minimal Tissue trauma and no risk of complications that may result from open surgery

·         Quick Symptom relief within two weeks of undergoing the Nucleoplasty Surgery.

FAQ - Spine Surgery and Treatment in India

What is a herniated disc ?

The discs between the vertebrae act as shock absorbers. A herniated disc has a defect or weakness in the wall, similar to a blister in the sidewall of a tire, which can lead to pressure on sensitive nerve roots and pain receptors in the back.

When should I consider nucleoplasty?

Nucleoplasty candidates include men and women who have chronic back pain since at least past six weeks and debilitation due to disc herniation. They often have limited mobility and cannot perform routine daily activities, such as bathing, dressing and walking. Nucleoplasty is usually performed after conservative treatments like bed rest, brace, oral medications have failed. Most patients are elderly, but younger patients with osteoporosis, due to metabolic disorders or long-term steroid treatment, may also benefit from nucleoplasty.

When is surgery necessary for patients with spine problems?

Surgery for conditions associated with disc disease is necessary when patients continue to be symptomatic despite all conservative treatments. Generally, patients try conservative treatments for between 2 and 6 months. If after this trial of conservative treatment patients continue to have severe pain, surgery is an excellent option. Surgery becomes "necessary" when patients develop signs and symptoms of progressive nerve damage ie, increasing muscle weakness or worsening nerve damage.

What are the benefits of getting Spine Surgery in India?

Spine Hospitals in India are equipped with the most advanced medical treatment. They have the most extensive Spine -diagnostic and imaging facilities including Asia’s most advanced MRI and X-rays technology. Personalized care and attention is provided with value added services besides results of world class standard at a very low cost affordable to all sections of society.

 Which is the Best Hospital in India for treatment of Spine?

India has not one but many better than the best hospitals for Spine r treatment. Mail us your medical report and we will find the hospital most suitable to treat your medical condition.

 Is it safe to get Spine Treatment and Surgery in India?

The medical fraternity in India is famed for excellence, and leads in Spine surgeries. Thousands of Spine operations are performed in India each year with maximum success rate, making the safety obvious.

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Latest and Advanced Treatment for Brain Tumour in India

 What are brain tumours?

A brain tumour is an abnormal growth of cells within the brain. It arises from glial cells of the brain, lymphatic tissues, nerves and meninges. Benign brain tumours grow slowly but they can compress adjacent parts of the brain. Malignant tumours grow rapidly and they invade adjacent structures of the brain. Brain tumours are graded according to the nature of cell growth. Grade I and II tumours are grouped as low-grade, whereas grade III and IV are grouped as high-grade tumours. Prognosis

is better in low-grade or benign tumours.

The following types of brain tumours are seen commonly:

In children: Juvenile pilocytic astrocytoma, craniopharyngioma, medulloblastoma, brainstem glioma and germ cell tumours.

In adults: Astrocytoma, oligodendroglioma, ependymoma, meningioma, vestibular schwannoma and lymphoma. Cancers from other parts of the body can also spread to brain.

What are the common symptoms of brain tumours?

* Headaches, usually in the morning

* Vomiting

* Convulsions or seizures

* Weakness in limbs

* Loss of balance while walking

* Altered speech or vision

* Altered behaviour

* Loss of orientation

* Memory lapses

How are brain tumours diagnosed?

* Imaging: CT scan or MRI scan of brain is commonly performed.

* Biopsy: A piece of tumour is removed for examination by open surgery or in stereotactic fashion using rigid frame to fix skull and localizing tumour under guidance of CT scan or MRI.

How is brain tumours treated?

 Brain tumours are treated by surgery, radiation therapy or chemotherapy, or a combination of these. The choice of treatment depends upon the age of the patient, type of tumour, its location, size and grade.

* Surgery: Maximum safe resection of the tumour or at least a biopsy is the standard goal of surgery.

* Radiation therapy: Radiation kills tumour cells with high energy X-rays, gamma rays or protons. It is usually started after surgery and given over 5-6 weeks.

* Chemotherapy: Chemotherapy is the use of drugs to kill cancer cells. It is given orally or through veins. It is given concomitantly with radiation therapy in high-grade tumours. It is also given in recurrent brain tumours after failure of initial treatment.

What are the advances in radiation therapy of brain tumours?

* 3-Dimensional Conformal Radiation Therapy (3D-CRT) and Intensity Modulated Radiation Therapy (IMRT):

CT scan and MRI are used to delineate the tumour and computers are used for radiation planning. Only the tumour and the high-risk region surrounding the tumour is radiated, avoiding radiation to

the normal structures in the brain.

* Stereotactic Radio-surgery (SRS) and Stereotactic Radiotherapy (SRT): Highly precise immobilization and image guidance system is used for treatment of selected brain tumours. High dose of radiation is delivered only to the tumour with very minimal spillage of dose to the rest of the sensitive brain structures. Stereotactic radiotherapy is preferred in children. Stereotactic radio-surgery delivering high-dose of radiation in single or a very few sessions is performed in adults with tumours such as metastatic residual glioma, meningioma and schwannoma. Novalis-Tx and Cyberknife are advanced machines to deliver such high-precision therapy.

* High-definition Rapid Arc: This is the latest software advancement in radiation planning technology. Radiation is delivered in continuous fashion moving the machine head and its small components simultaneously around the patient's head targeting the tumour by infinite small radiation beams. Radiation treatment with such a technique is highly precise and fast. This is preferred in children and elderly patients who cannot lie on treatment couches for long periods.

* Proton beam therapy: Proton therapy avoids spillage of radiation dose to the surrounding brain. It is preferred in children as well as in patients with recurrent tumours who have received radiation therapy earlier.

Advanced Epilepsy Treatment Options in India - Epilepsy Surgery in India

Epilepsy Surgery

Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain. About 50 million people worldwide have epilepsy, and nearly two out of every three new cases are discovered in developing countries. Epilepsy becomes more common as people age. Onset of new cases occur most frequently in infants and the elderly. As a consequence of brain surgery, epileptic seizures may occur in recovering patients.

Epilepsy is usually controlled, but not cured, with medication. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong – some forms are confined to particular stages of childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms but all involving episodic abnormal electrical activity in the brain.

Why is Epilepsy surgery required?

Epilepsy surgery has proven to be successful in reducing and even eliminating seizures in patients who did not respond well to the epilepsy medications. It is important to get the treatment for epilepsy, repeated seizures may result in:

• Irreparable Brain damage from repeated seizures
• Sudden death, a rare complication
• Injuries from falling / driving during various activities

Candidates for Epilepsy Surgery

It is very important that right candidates be chosen for the best results of the surgery. You are a good candidate for epilepsy surgery if:

• You have tried at least two anti-epileptic drugs (AEDs), and they have not stopped, or greatly reduced the number of seizures.
• There must be a specific cause for your epilepsy that can be removed with surgery, without harming your brain or you in any other way.
• Your surgeon must weigh the pros and cons and is confident that you would have a better quality of life after the surgery than without it.

Advanced EpilepsyTreatment Options in India

Till the time a person develops a second seizure, treatment for epilepsy will not begin. This is due to the reason that a person may have one seizure and never develops a second seizure. Medicines are successful in treating epilepsy. These medicines do not cure epilepsy, they prevent recurring of the seizures. These medicines changes the chemical or electrical transmissions in the brain in a particle way that decreases the chance of a seizure.

Vagus Nerve Stimulation (VNS) :

VNS therapy is recommended when medicines are unable to control epilepsy. During the surgical procedure, an electrical device is implanted underneath the skin. The lead of this device is wrapped around one of the nerves on the neck’s left side. This nerve is called as vagus nerve. This device continuously passes an electric dose to the nerve in order to stimulate it. This process reduces the severity and frequency of the seizures. If a person is feeling a warning seizure symptom then extra stimulation is given for preventing recurrence of the seizure.

Ketogenic Diet :  This is also considered as one of the treatment for epilepsy. Ketogenic diet is recommended for children as it involves eating a diet which is low in proteins and carbohydrates and high in fats. The chemical balance of the brain can be altered that also reduces the chance of having seizures. Ketogenic diet is not meant for adults as the diet can result in any other serious medical condition like heart disease, high blood pressure or strokes.

Advanced Surgical Procedures for Management of Epilepsy

Depending on the particular clinical situation, one of the following surgical procedures is chosen by the Medical team at our affiliate hospital. These operations either aim to resect the disease area of the brain, to disconnect it from other areas so as to relieve the seizures, or to lessen their impact.

• Anteromedial Temporal Lobectomy
• Selective Amygdalohippocampectomy
• Electrocorticography guided Resections
• Multiple Subpial transections
• Quadrantic Resections
• Multilobar Resections
• Functional Hemispherotomy
• Vagal Nerve stimulation
• Radiosurgery (selected cases)

Epilepsy Surgery inIndia

Epilepsy is one of the most common neurologic diseases, present in about 4% of the world's population. The disease can be well controlled with medications alone, but many patients do not respond well to the epileptic medications and thus need surgery to control seizures.Epilepsy surgery is advised to people who have tried at least two epilepsy drugs without success and have seizures originating on the same place of the brain.

Epilepsy surgery removes or isolates the area of brain where seizures originate. If it is an area of the brain which cannot be removed, the surgeon makes incisions to prevent seizures from spreading to other parts of the brain.

Latest and Advanced Treatment options for Brain Tumour in India

 What are brain tumours?

A brain tumour is an abnormal growth of cells within the brain. It arises from glial cells of the brain, lymphatic tissues, nerves and meninges. Benign brain tumours grow slowly but they can compress adjacent parts of the brain. Malignant tumours grow rapidly and they invade adjacent structures of the brain. Brain tumours are graded according to the nature of cell growth. Grade I and II tumours are grouped as low-grade, whereas grade III and IV are grouped as high-grade tumours. Prognosis

is better in low-grade or benign tumours.

The following types of brain tumours are seen commonly:

In children: Juvenile pilocytic astrocytoma, craniopharyngioma, medulloblastoma,

brainstem glioma and germ cell tumours.

In adults: Astrocytoma, oligodendroglioma, ependymoma, meningioma, vestibular

schwannoma and lymphoma. Cancers from other parts of the body can also spread to brain.

What are the common symptoms of brain tumours?

* Headaches, usually in the morning

* Vomiting

* Convulsions or seizures

* Weakness in limbs

* Loss of balance while walking

* Altered speech or vision

* Altered behaviour

* Loss of orientation

* Memory lapses

How are brain tumours diagnosed?

* Imaging: CT scan or MRI scan of brain is commonly performed.

* Biopsy: A piece of tumour is removed for examination by open surgery or in stereotactic fashion using rigid frame to fix skull and localizing tumour under guidance of CT scan or MRI.

Howis brain tumours treated?

 Brain tumours are treated by surgery, radiation therapy or chemotherapy, or a combination of these. The choice of treatment depends upon the age of the patient, type of tumour, its location, size and grade.

Surgery: Maximum safe resection of the tumour or at least a biopsy is the standard goal of surgery.

Radiation therapy: Radiation kills tumour cells with high energy X-rays, gamma rays or protons. It is usually started after surgery and given over 5-6 weeks.

Chemotherapy: Chemotherapy is the use of drugs to kill cancer cells. It is given orally or through veins. It is given concomitantly with radiation therapy in high-grade tumours. It is also given in recurrent brain tumours after failure of initial treatment.

What are the advances in radiation therapy of brain tumours?

* 3-Dimensional Conformal Radiation Therapy (3D-CRT) and Intensity Modulated Radiation Therapy (IMRT):

CT scan and MRI are used to delineate the tumour and computers are used for radiation planning. Only the tumour and the high-risk region surrounding the tumour is radiated, avoiding radiation to

the normal structures in the brain.

* Stereotactic Radio-surgery (SRS) and Stereotactic Radiotherapy (SRT): Highly precise immobilization and image guidance system is used for treatment of selected brain tumours. High dose of radiation is delivered only to the tumour with very minimal spillage of dose to the rest of the sensitive brain structures. Stereotactic radiotherapy is preferred in children. Stereotactic radio-surgery delivering high-dose of radiation in single or a very few sessions is performed in adults with tumours such as metastatic residual glioma, meningioma and schwannoma. Novalis-Tx and Cyberknife are advanced machines to deliver such high-precision therapy.

* High-definition Rapid Arc: This is the latest software advancement in radiation planning technology. Radiation is delivered in continuous fashion moving the machine head and its small components simultaneously around the patient's head targeting the tumour by infinite small radiation beams. Radiation treatment with such a technique is highly precise and fast. This is preferred in children and elderly patients who cannot lie on treatment couches for long periods.

* Proton beam therapy: Proton therapy avoids spillage of radiation dose to the surrounding brain. It is preferred in children as well as in patients with recurrent tumours who have received radiation therapy earlier.

Brain Tumour Surgery and Treatment in India

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The First step is to email your Medical Reports to us for an opinion from leading doctors in India. We will send you an expert medical opinion and estimate for the cost of your treatment from at least three leading hospitals in India. Once you decide, we help you schedule appointments, apply for a medical Visa and make the arrangements for your stay.

MyMedOpinion has a team of dedicated doctors who personally attend to all your queries. We are the only facilitators that appoint a personal doctor to the patient from the time of enquiry till the time the patient fully recovers. Your personal doctor will stay in constant contact with you, your local doctor and your medical team in India throughout your stay, and will relay information back to your loved ones. From initial registration of interest, to returning the patient back to his or her home country after the procedure and recuperation, MyMedOpinion will ensure the whole process is as smooth and stress-free as possible for its patients. We believe that timely, affordable and quality medical treatment is every human beings right. We are dedicated to this cause and strive to deliver the benefit and pleasure of medical care to people across the globe.

Our mission at MyMedOpinion is simple. We want to help you to safely and successfully receive your medical procedure(s) at a world-class healthcare facility for a fraction of the cost elsewhere.

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Treatment Options Available in India for Cerebral Aneurysm | Cerebral Aneurysm Surgery in India

Cerebral Aneurysm Surgery in India

What is a Cerebral Aneurysm?

A cerebral (brain or intracranial) aneurysm is an area where a blood vessel in the brain weakens, resulting in a bulging or ballooning out of part of the vessel wall. Usually, aneurysms develop at the point where a blood vessel branches, because the “fork” is structurally more vulnerable. The disorder may result from congenital defects or from other conditions such as high blood pressure, atherosclerosis (the build-up of fatty deposits in the arteries), and less commonly, head trauma or infection.

Aneurysms are usually found at the base of the brain just inside the skull, in an area called the subarachnoid space. In fact, 90 percent of subarachnoid hemorrhages (SAHs) are attributed to ruptured cerebral aneurysms and the two terms are often used synonymously.

Aneurysms range in size, from quite small – about 1/8 inch – to nearly one inch. Aneurysms larger than one inch are called giant aneurysms, pose a particularly high risk, and are difficult to treat.

• Saccular or "berry" aneurysms, which are shaped like a small sac, are the most common type and often require intervention.
• Fusiform aneurysms are diffuse bulges of the vessel wall involving most of the entire circumference of the blood vessel itself. They may rupture or cause stroke-like symptoms when they compress the surrounding brain.
• Mycotic aneurysms are rare and result from an infection. The infection damages and weakens the blood vessel, thereby increasing the associated risk of rupture. This infection occurs most commonly as a complication of subacute bacterial endocarditis (a heart infection). Traumatic aneurysms occur when a cerebral blood vessel incurs trauma from a head injury. The damaged blood vessel weakens at the site of injury which may cause it to rupture.

Signs/Symptoms

People who suffer a ruptured brain aneurysm may have warning signs, including:

• Localized migraine-like headache
• Nausea and vomiting
• Stiff neck
• Blurred or double vision
• Sensitivity to light (photophobia)
• Loss of sensation

Many people with unruptured brain aneurysms have no symptoms. Others might experience some or all of the following symptoms, which may be possible signs of an aneurysm:

• Cranial nerve palsy
• Dilated pupils
• Double vision
• Pain above and behind eye
• Localized headache
• Progressive weakness or numbness

What are the treatment options available in India for Cerebral Aneurysm?

There are two main types of treatment for a brain aneurysm:

• Preventative Treatment: where an aneurysm is treated to prevent it from rupturing
• Emergency Treatment: where an aneurysm is repaired after it ruptures

What are the surgical treatments available in India for Cerebral Aneurysms?

• Neurosurgical Clipping: Neurosurgical clipping is a procedure carried out under general anaesthetic (you're asleep throughout). A cut is made in your scalp and a small flap of bone is removed to reveal your brain underneath.When the aneurysm is located, the neurosurgeon (an expert in surgery of the brain and nervous system) will seal it shut using a tiny metal clip. After the bone flap has been replaced, the scalp is stitched together.
• Endovascular Coiling: Endovascular coiling involves inserting a catheter into an artery in your leg or groin. The tube is guided through the network of blood vessels into your head and finally into the aneurysm. Tiny platinum coils are then passed through the tube into the aneurysm. The coils block the flow of blood into the aneurysm. Over time this should seal the aneurysm off from the main artery to prevent it from rupturing

Treatment Options

The treatment of an aneurysm, like all medical decisions, should be agreed upon by both the physician and the patient. If the case is a medical emergency, in which the ruptured aneurysm has caused the patient to lose consciousness, this discussion may take place with the patient’s nearest relative or medical decision maker. The treating physician will discuss the risks and benefits of each available treatment option. He or she will usually recommend one treatment over another, based on the patient’s individual circumstances.

While the best method of securing the aneurysm should be made on an individual basis, in general, patients with a ruptured cerebral aneurysm should be treated as soon as possible. Surgical risks and outcomes depend on whether or not the aneurysm has ruptured, the size and location of the aneurysm, and the patient's age and overall health.

The following factors should be considered:

• Risk of hemorrhage — what is the chance of the aneurysm rupturing?
• Size, shape and location
• Age and health of patient
• Family history
• Risks of treatment

Nonsurgical Treatment

Observation is considered a reasonable option if the aneurysm is very small or in a location which is felt to present a low risk of growth or rupture. Repeated testing over time may be recommended and the risks of aneurysmal hemorrhage remain. In such cases, the risks are often considered to be lower than the risks associated with treatment. Because aneurysm rupture is fundamentally unpredictable, however, and because rupture of the very smallest aneurysms is well documented, the role of serial imaging remains undefined, and may provide a false sense of security.

Medical therapy is an option reserved for the treatment of unruptured aneurysms in patients with significant risk factors for surgery and general anesthesia. Patients with unruptured aneurysms who have high blood pressure may be prescribed an antihypertensive (blood pressure lowering) medication, and encouraged to follow a diet and exercise program in addition to smoking cessation. These are important factors that have been shown to have a significant effect on aneurysm formation, growth, and/or rupture.

Advantages

• Durability
• Direct visualization of the aneurysm (which may have very complex dimensions)
• Ability to decompress or deflate the aneurysm after clipping
• Ability to inspect other blood vessels in the area for smaller aneurysms
• In cases of SAH, the advantage of enabling evacuation of some of the clotted blood surrounding the aneurysm and the base of the brain
• Better option for convoluted arterial systems
• Better option for wide-neck aneurysms or those without defined openings

Post Treatment

For a patient with a ruptured cerebral aneurysm, surgical elimination of the aneurysm is only the beginning. Intensive care recovery for the next 10 to 14 days is the rule . At some time during that period (often immediately upon completion of surgery), cerebral angiography or a substitute study is done to document that the aneurysm has been eliminated. Patients who have been treated for an unruptured aneurysm usually have no complications related to vasospasm, swelling or hydrocephalus, and stay in intensive care for 1 to 2 days. Patients treated by coiling are often discharged from the hospital after 1 day, and those undergoing clipping, 3 to 5 days.

Outcome

Outcome and recovery after aneurysm rupture is variable. In general, those patients who presented in good neurological condition tend to have better recoveries.