Dr. Yogesh Kumar B is a dedicated Spine Surgeon for F.O.R. Ortho Hospital, kolathur, Chennai. He completed his MS Orthopaedics at KMC Manipal.

He then pursued his career in spine surgery by completing Clinical Spine Fellowship for 2 years at Manipal Hospital, Bangalore. He got training in Microscopic Spine surgeries, Day care spine surgeries, Interventional Pain Management and Complex Revision Spine Surgeries as well at Manipal Hospital.

He got trained in minimally invasive spine surgery in AO spine Asia Pacific Spine fellowship at Park Neuroscience Institute, Kolkata.

He further went on to do the prestigious clinical fellowship in Paediatric spinal deformity (Scoliosis and Kyphosis) at Nemours dupont Hospital for Children, Delaware and Shriners Children’s Hospital, Philadelphia, USA.

He has visited Texas Scottish rite hospital for children, the centre of excellence in scoliosis spine surgery in Dallas, USA. He was selected as AO International Spine Fellow at National University Hospital (NUH), Singapore.

He has practiced safe spine surgery for the last 8 years. He has performed more than 1500 spinal surgeries independently in this time frame successfully.

The Speciality Orthopaedic Spine

BACK PAIN / NECK PAIN UNDERSTAND AND KEEP IT SIMPLE

Over 70% of the population suffering with lower back pain and neck pain during their lives. Surprisingly it is the second most common reason why people consult a doctor, next to the common cold.

WHAT ARE COMMON CAUSES OF BACK PAIN?

Mostly linked to a general cause—such as muscle strain, injury, or veruse that will spontaneously resolve and upper back pain from Vitamin D deficiency.

10% to 20% can be attributed to a specific condition of the spine such as Herniated Disc, Degenerative Disc Disease, Spondylolisthesis and Spinal Stenosis.

Uncommon causes of pain include infection, cancer, fractures, aneurysms, and/or internal organ problems.

WHAT CAUSES NECK PAIN? (Divided into 3 Categories

Mechanical pain (from joint or disc) is called degenerative disc disease and is the most common reason for neck pain.

Radicular pain (coming from Spinal nerve root) is usually sharp, electrical pain that goes down the upper extremity in a particular nerve pattern associated with numbness or weakness.

Myelopathic pain (coming from the spinal cord) associated with weakness in the hands and legs, loss of balance and in-coordination and decreased control of your bowels and bladder.

WHEN DO MOST PEOPLE DEVELOP SIGNIFICANT SPINE PROBLEMS?

The usual age of onset is between 30 and 50 years of age.

The most likely reason is that the degenerative process has begun, and individuals are still active enough to stress their bodies and place somewhat degenerative discs at risk for injury. This leads to increased stress on the discs predisposing them to injury.

Fortunately, it is often self-limiting as adolescents learn good body mechanics and participate in proper strengthening and conditioning for their spine and overall body.

DOES SMOKING CAUSE SPINE PROBLEMS?

Smoking has direct link with back & neck pain because of its role in causation and acceleration of disc degeneration – Hence quit smoking.

In patients who undergo surgery, the overall success rate is much lower in smokers when all other factors are equal.

IS BED REST A GOOD TREATMENT FOR NECK AND BACK PAIN?

Recent studies show that bed rest is counterproductive and often detrimental in treating neck and back pain.

Bed rest > 5 days delays recovery by way of worsening the psychological component of pain.

Lumbar Belts / Neck Collars > 7 days are proven to be BAD as they cause wasting of trunk muscles. Analgesics such as Paracetamol can be taken on-demand basis only.

WHEN DO WE NEED MRI / SURGERY? (Indications for MRI and Surgery are the same)

MRI is oversensitive and non-specific tool. It is very tempting tool to both the doctor and the patient. Once the MRI is done, it is very difficult to stop as findings in the report are usually too exaggerated. We need to treat the patient and not the MRI. If the patient deserves surgery clinically, then MRI becomes gold standard investigation to direct surgery to the exact pathology.

Absolute indications (Surgeon sells surgery) – irrespective of duration of symptoms, time is money, delay causes increased damage – cry of the dying nerves

1. Gross weakness of limbs

2. Bowel and / or Bladder involvement

Relative indication (Patient buys surgery) – as pain is subjective

3. Functionally disabling pain > 3 months (functional disability is the gap between the expectations and abilities of a person – very highly individualized

SPINE SURGERY IS DANGEROUS AND AFTER SPINE SURGERY, ONE CAN NEVER LEAD A NORMAL LIFE

The use of modern scans, an improved understanding of spinal pathology, better surgical instruments and well-trained surgeons have improved the results of spine surgery.

In the past, three to six months of bed rest following spine surgery was the norm. Nowadays, the duration of stay in hospital for spine surgeries varies from one to seven days and most patients are able to sit, stand and walk prior to discharge.

The aim of surgery is to restore the patient to functional normalcy

Prevention of Back/Neck pain:

Spine consists of 33 bones and every two bones are connected with each other by three joints (bearings). For these joints, movement is life. Flexible spine resists injury/damage while the stiff spine breaks with the smallest of jerks. The permanent solution is to keep all the joints (bearings) in the spine mobile every day and get back the flexibility by gradual stretching in the form of Yoga.

Yoga has been proven scientifically to be the best way to cure chronic back/neck pain (Williams K et al Spine 2009; 34: 2066-76). Thus it targets both (physical and psychological) components of back/neck pain. Start on Yoga once pain subsides and continue for the rest of life.

It is a way of life and not an exercise.