WHAT IS SPONDYLOLISTHESIS? Conversation between patient & Dr Raghava

 

in conversation with Dr Raghava Dutt Mulukutla, Orthopedic Surgeon and Chief of spine surgery

Q. Doctor I am suffering from back and leg pain and I am told that my vertebra has slipped forward.

A. You are suffering from a condition called spondylolisthesis. Here one of the vertebra slips forwards over the vertebra below.

Q. How does this happen?

A. There are a number of reasons for this. This could result from anomalies in the spine at birth, some in early childhood and some due to fractures and various diseases and conditions of spine.

The two most common varieties

1. the first variety, when the vertebra slips forwards between 4-6 years of age. This may cause back pain or leg pain during childhood or during adulthood. Sometimes due to extra weight of pregnancy, women come to doctors with back pain and this condition is then diagnosed

2. the second variety is one which is somewhat common in females at about the age of forty. This is due to degeneration (wear and tear) and is more common in women who are overweight.

Q. What are the treatment options for this condition

A. Most patients get better with physiotherapy and medication. Once the pain subsides it is important to start exercise programmes to strengthen back and abdominal muscle. Walking, sports, yoga, swimming all help.

Q. Do I require surgery?

A. Only if the pain does not subside with physiotherapy, restricted activity for a few weeks followed by exercises etc. Surgery is more beneficial in those who suffer from leg pain rather than back pain alone

Q. What is the type of surgery that is done?

A. In children and young adults sometimes repair of the defect in the vertebra .is done to prevent back pain.Mostly screws and rods are placed in the spine and the vertebra that has moved forwarded is brought back to its original position. Cages are also used to maintain the reduction and restore the height between the vertebrae. Fusion is routinely done .

Q. How long do I need to take rest? And what are the precautions to be taken after surgery

A. You will be out of bed 2nd or 3rd day after surgery. You need to stay in hospital for 4-5 days. You will be in ICU for a day. You will be given a brace to support your back for a few weeks.

Q. When can I get back to work?

A. You need 6 weeks time for light duties and 3 months for heavy work.

Q. Do I need to undergo lot of physiotherapy?

A. You hardly require any physio. A few months after surgery physios will teach you a set of exercises which are very easy to follow and can be done at home.

Q. How painful is the procedure?

A. The procedure is not that painful and you will be given adequate pain relief medication after surgery

Q. can I play games and sports after surgery?

A. Swimming, yoga ,sports are all beneficial. You will be told how to lift weights and also given a set of exercises to strengthen your back.

Q. Will surgery affect my married life?

A. Not at all . You can have a normal married life and women can have babies and undergo normal deliveries

 

BLOG – HEALTHY EATING by Dr Deepa Agarwal, Nutritionist/ Dietician

Every now and again many of us resolve to improving our health habits and promise ourselves to eating healthier. Follow these tips to treat yourself to healthy eating.

1. Don’t deprive yourself.

Aim to eat nutritious foods your body loves 80 percent of the time. Use that other 20 percent to treat yourself a bit.

2. Graze healthfully.

Tide yourself over between meals with healthier snacks. Whether your thing is sweet or savory, crunchy or chewy, there are plenty of options for snacking smart.

3. Eat fresh produce all year long.

Find out which fruits and veggies are in season even in the winter and stock up at the store and farmers’ markets. Eating fresh means eating the tastiest and most delicious produce around.

4. Indulge smarter.

Chocolate-dipped strawberries? Choco-Nut popcorn? Yes, please. Lower sugar doesn’t have to mean less deliciousness.

5. Understand emotional eating.

There is a link between how we feel and how we eat, particularly when it comes to stress.  Figuring out what kind of eater you are and whether you look to food to comfort you in times of anger, boredom, stress, or sadness will help you formulate a plan for making different decisions when faced with those emotions.

6. Make holidays, birthdays, and special occasions a little healthier.

Holidays and special occasions are always a good reason to enjoy delicious food. Luckily, there are plenty of ways to celebrate without going overboard.

7. Be mindful at meal times…

Staying tuned in to what you’re eating (as opposed to the phone or TV) is a great way to eat until you’re full, but not beyond. Being relaxed and mindful can also help you heed fullness cues.

8. …But don’t overthink it.

Recent research shows that the more time we take to think about whether or not we should eat something, the more likely we are to find a reason to justify eating it.  Checking in with yourself about your mood and are great habits to have, but remember to trust your gut.

9. Start the day right.

Studies suggest that eating a healthy breakfast is linked to sustained weight loss and weight management, particularly when that breakfast is nutritious and fiber-rich and high in protein.

10. Use the buddy system.

Having a partner with the same healthy-eating ambitions has been shown to help both people reach their goals.

What you eat can impact every aspect of your life from your mental health to your sleep and relationships. So go ahead and wholeheartedly commit to developing healthier eating habits this year. Set goals that are simple and tangible. Make time to meal plan to set yourself up for success. But above all else, believe in yourself. This is your year. You can do this!

Dr Deepa Agarwal, is Consultant Nutritionist at Udai Omni Hospital. She has an experience of 10 years having completed MSc and PhD in Clinical Nutrition.

To consult Dr Deepa Agarwal, please email enquiry@udaiomni.com

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Spine Surgery in hyderabad

BLOG – OH MY BACK! by Dr Raghav Dutt Mulukutla, Chief of Spine Surgery

If you are one of the few lucky ones who have not yet suffered from low back pain, do not be too happy. Second only to common cold, low back pain is increasing in incidence the world over.  Almost 80-90% of population  is affected by this problem in urban areas and  is the commonest cause of  absenteeism from work for people under 45 years of age in the Western World.

Most of us suffer for a few days to weeks and in some it becomes a chronic problem with umpteen visits to various specialists, homeopaths, ayurvedic  massage treatments, acupuncture, magneto therapy, reiki etc.

In India friends, neighbours, barbers, medical shop owners, grand mothers  are all specialists… they  have their own special remedies to offer and stories to tell. And of course that consultation with the foreign doctor – when I went to USA……… and the stories go on!

Who is at risk?

Almost 90%  have a mechanical reason for their back pain, and in 10% various diseases and disorders are responsible for low back pain. Many risk factors have been identified  :  lifting weights  beyond a workers physical capability, repeated bending and twisting in awkward positions , prolonged sitting especially in slouched position  is well known to produce low back pain. Obesity, cigarette smoking, lack of physical exercise, weak abdominal and back muscles  are some of the very potent factors  in causing low back pain.

What causes back pain?

The very fact that we are born as humans – our upright posture places tremendous stress and strain on the back.

  1. bad posture
  2. prolonged sitting : IT industry/ executives
  3. weak abdominal and back muscles
  4. weak bones ( osteoporosis )
  5. smoking
  6. driving 2 wheelers with bad shock absorbers
  7. over weight
  8. lack of exercises during and after pregnancy
  9. un-accustomed bending forwards and lifting weights

Let’s get to know some of the common conditions that cause low back pain:

The slipped disc: The human spine consists of individual bones called vertebrae separated by  discs-  which simply put  is a  jelly surrounded by fibrous tissue. When the discs get damaged or degenerated, it slips backwards and presses on the spinal cord and nerves causing pain in the lower  back or along the leg – known typically as sciatica.

Non surgical management: 

Over 90% of patients with slipped discs do not require surgery and get better with rest, physiotherapy and medication. You do not have to sleep on floor or hard beds. A firm bed is all that is required,  and rest for more than one week is not advisable. There is no need  for strict bed rest and you can move about  if pain permits.  Exercises should be commenced after the pain subsides and your physiotherapist would be the best person to teach you the exercises  to strength the back  and  abdominal muscles.

The surgery

Traditional surgeries such as laminectomy have no place in the management of disc prolapse. Surgeries such as Fenestration, Microscopic surgery or  Endoscopic microdiscectomy(Key hole surgery) offer the best results. The minimally invasive surgeries do not weaken the back muscles  and return to work is much quicker.

Spinal stenosis:

As we get older , the spinal canal  gets narrowed  due to arthritis and degeneration of tissues in the spine-resulting in pressure on the nerves. Typically  the patient may experience  low back pain, buttock pain and leg pain. Patients find it difficult to walk for long distances and have to rest after  walking for a few minutes. He/she can resume walking once the pain subsides. Majority of the patients get better with change in life styles, physiotherapy and epidural steroid injections in to the spinal canal. Modern surgical techniques once again give lasting relief  in those who do not get better  with non operative treatments.

Spondylolisthesis: This is slipping of one vertebra over the other, resulting in pressure on the nerves and again is responsible for back pain and sciatica. In those who do not get better with non operative measures, surgery offers good relief from pain.

Osteoporosis:  Again a common condition in women, is responsible for significant back pain and vertebral fractures. Exposure to sunlight, physical exercise, balanced diet,  go a long way in managing this problem. In those who suffer from fractures, minimally invasive procedures such as vertebroplasty – which is injection of synthetic material (bone cement) under local anaesthesia gives excellent results.

Other conditions: Curvature of spine (hunch back-scoliosis, TB, cancers and tumors and a variety of disorders can affect a human spine. Prompt consultation  and investigations would  help in diagnosis and treatment.

Who should be consulted for spine surgery?

Orthopaedic  surgeon or  Neuro surgeon? That is the doubt in almost everyone’s mind. Traditionally both operate on Spines.Today we have a sub-speciality  – Spine Surgery. Spine surgeons are specially trained to perform spine surgeries and it would not be too long  when Neuro surgeons would be operating only on Brain and Orthopaedic Surgeons on bone and joints and  Spine surgeons alone would be performing Spine surgeries.

Information on the Internet: Beware! Not all information on the net is accurate and current. Newer technologies that appear on the net, are like fashions that keep changing and  are industry driven.

Are spine surgeries safe?

Spine surgery is complicated and needs expertise. One need not worry too much about the complications and a well planned and well executed surgery in an understanding and cooperative patient gives excellent results.

Is there an age limit?

No! Today spine surgeries are performed in infants. Age certainly is no bar.

The second opinion?

When in doubt take a second opinion. But seeing too many doctors is quite confusing.

For a healthy back

  1. Correct your posture – do not slouch
  2. Get out of your chair every 20 minutes- stand or walk for a few minutes
  3. Getting out of chair is more important than buying expensive chairs
  4. Exercise regularly: yoga/walking/swimming/sports
  5. Quit tobacco

Dr.Raghava Dutt Mulukutla is  consultant orthopaedic and chief spine surgeon at Udai Omni Hospital. He has an experience of over 35 years, his expertise includes spinal deformity surgeries, scoliosis and back pain management.

To consult Dr Raghava Dutt Mulukutla, please email enquiry@udaiomni.com

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Video Sukhibhava – Dr Raghava Dutt Mulukutla addresses various issues related to relieving back pain in children and young adults.

 

Dr Raghava Dutt Mulukutla, Director and Chief Spine Surgeon at Udai Omni Hospital specializes in back pain and correction of spine as a result of  scoliosis and other spinal deformities. In this program, Dr Raghava Dutt addresses various issues related to relieving back pain in children and young adults. He advises parents that school going  children should  have proper support for the back and be  encouraged to have healthy food habits and lead an active lifestyle.

To consult Dr Raghava Dutt, please email enquiry@udaiomni.com

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Total-and-compartmental-300x180

BLOG – TOTAL KNEE REPLACEMENT versus PARTIAL KNEE REPLACEMENT by Dr Udai Prakash, Orthopaedic Consultant Hip and Knee specialist

If you have been recommended a knee replacement then you may be a candidate for a partial (uni compartmental) knee replacement.You may be a good candidate for a partial or uni compartmental knee replacement if your arthritis is confined to a single compartment of the knee.

Your knee is divided into three major compartments: The medial compartment (the inside part of the knee), the lateral compartment (the outside part), and the patella femoral compartment (the front of the knee between the kneecap and thigh bone).

Partial Knee Replacement

In a partial knee replacement, only the damaged compartment is replaced with metal and polyethylene (a surgical grade plastic). The healthy cartilage and bone in the rest of the knee is left alone.

Total Knee Replacement is also a highly successful procedure. More than 600,000 knee replacements are performed in the US annually and this number is set to reach 4 million by 2030. Similarly, in India it is thought that over 30,000 are being performed annually and this number is increasing by 15% annually.

Partial knee replacement numbers are much smaller as not all patients are suitable for this type of conservative surgery and not all knee surgeons are trained in performing this surgery.


Dr Udai Prakash, is chief joint replacement surgeon at Udai Omni. He has over 20 years of experience and specialises in primary and revision hip and knee surgery.

To consult Dr Udai Prakash, please email enquiry@udaiomni.com

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BLOG – WAYS TO GET RID OF YOUR BACK ACHE by Dr Raghava Dutt Mulukutla, Orthopaedic Consultant & Spine specialist

Top ways to get rid of your back ache


1. Reduce your weight

      • Cut off that fat from your diet
      • Less weight on your spine means less pain

2. Get out of that chair

      • Change the way you work, not your job
      • Get up every 20 minutes. Either just stand up or take a few steps

3. Exercise

      • Regular exercise tones up your back muscles
      • Healthy muscles take the stress and strain and protect your spine

4. Quit Smoking

      • Stop smoking. It damages your spine
      • Avoid all tobacco products

5. Consult a Physiotherapist

      • Core strengthening exercise programmes are very helpful
      • Get advise on how to sit/lift weights/posture etc.
      • Learn stretches

6. Use a desktop

      • Use large desk top monitors, and they should be at eye level
      • Do not use laptops and tablets at work places. Restrict their use

8. Have a healthy body & mind

      • Keep diabetes, cholesterol (lipid profile ), blood pressure, thyroid and other medical conditions in good control
      • Avoid excessive worry about back pain


9. Physical activity

      • Brisk walking/ swimming / yoga /sports are essential for a healthy back
      • Indulge in physical activity that you like and enjoy


10. If nothing works

 

      • See a spine surgeon

Dr. Raghava Dutt Mulukutla is Consultant Orthopaedic and Spine Surgeon. His expertise includes spinal deformity surgeries, scoliosis and back pain management. Here he advises on that lingering backache that one needs to get rid off.

To consult Dr Raghava Dutt Mulukutla, please email enquiry@udaiomni.com

Book an appointment

 

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