Ask The Orthopaedic Expert

Dr Neeraj Adkar

Dr Neeraj Adkar is a DNB, D Orthopaedic with Fellowships in Joint Replacement Surgery as well as Arthroscopy and Sports Medicine, bringing solid and stable expertise to his field.

I am a 32-year-old man. I have back pain which has been moving towards my leg for the past six months. I have been suggested surgery but I think I am too young to undergo spine surgery. What’s your opinion?

Age is never a factor to consider surgery. The decision of whether to undergo surgery is based on symptoms, clinical examination, diagnostics, and the patient’s medical condition.

One of my close family members underwent spine surgery a while back and has been bedridden since then. Now I have been recommended one for prolonged lower back pain. Will I be bedridden too?

Unlike joint replacement or other elective surgeries, timing is crucial in spine surgery. The longer the duration of symptoms, the lesser the chances of a good prognosis or outcome. Thus, if diagnosed and treated in time, spine surgery can yield good results. With recent advances of good imagining techniques like MRI and the introduction of minimally Invasive Spine Surgery, well-timed surgery is definitely going to be a successful one.

I went to a spine clinic for my back pain, after I was recommended spine surgery. The doctor said I would be absolutely fine without surgery, but with some conservative treatment. What is your take?

Within the first four to six weeks, 80% to 90% of the people with spine ailments can be treated conservatively, without surgery. The human body is equipped for self-healing. It is a misbelief that an external manipulation in the form of vibrations, massage or physio is a prerequisite. Sometimes, resting also does wonders. Unfortunately, if the symptoms persist beyond four to six weeks, and the patient has increasing pain, then it is an indication for further intervention. We at Saishree follow a protocol-based treatment of medicines and physio for the initial period, followed by interventional spinal blocks if needed. If the treatments don’t work, we have to opt for surgery.

I recently underwent spine surgery. My spouse and I want to plan for a child. When is it safe for me to get physical?

Approximately, it takes four to six weeks after spine surgery to engage in physical activity. It depends on which type of spine surgery you have undergone and which technique was used to perform the surgery. If it is a plain decompression surgery, done by open or microscopic approach, the time period is extended. For an endoscopy or biportal approach, which is done by minimally invasive approaches, the time period is lesser.

My father had undergone microscopic surgery. My younger brother now needs surgery. I have heard about endoscopy as an advanced technique, but I am unable to decide which technique is better.

Microscopic surgery and endoscopic surgery are way different. Microscopic surgery involves an external microscope which is used as an additional magnification tool. In endoscopic surgery, an actual endoscope is inserted inside the body using puncture holes. The camera is inside the body and the surgery is performed looking at the screen. Secondly, microscopic surgery is an air medium surgery, whereas in endoscopic surgery, the constant flow of irrigation makes sure that there is least amount of collateral damage to the normal tissue, as normal saline is continuously flowing in and out. Patients who have undergone endoscopy recover faster. If you are a suitable candidate, I would recommend endoscopic spine surgery.

Why do doctors make patients do an MRI when they have back pain? Can an X-ray suffice?

MRI and X-rays both have their own merits. X-ray provides a clear picture of the bone outline, whereas MRI is related to soft-tissue injury or problem diagnosis. Through X-ray, we can know how the vertebrates are placed. But in an MRI, we can actually see the spinal cord. We can see if there is an injury, inflammation, or infection. A combination of both gives the doctor in-depth knowledge about the patient’s condition. Both should be done to support the clinical findings of the doctor.

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Originally Appeared Here

Kids deal with adult orthopaedic problems- The New Indian Express

Express News Service

BENGALURU: While orthopaedic issues are common among adults, doctors are noticing a new trend with children in the age group of 9-14 years complaining of orthopaedic problems.

Doctors pointed out that there is easily a 50 per cent increase in paediatric orthopaedic issues like pain in the neck, shoulder, upper back and limbs. The reason is lack of activity and improper posture while attending online classes. 

In one case, a 14-year-old boy had severe back pain and consulted a doctor at Fortis Hospitals, Rajajinagar. The doctor prescribed painkillers, and when the pain persisted, he was advised physiotherapy. After 30 days of physiotherapy, his condition improved and he was asked to take up indoor games to stay active, and prescribed calcium and Vitamin D tablets for three months.

Dr Vinay Kumaraswamy, Consultant – Orthopedics & Joint Replacement Surgery, Fortis Hospitals, who treated the patient, said, “I have never come across children coming in with back pain or neck pain. Usually such complaints are among adults, often software engineers who work long hours. Now cases are increasing in the paediatric age group, as due to the pandemic, there is lack of activity among children. The body does not get Vitamin D as they are unable to go out and play under the sun. Many sit on the floor to attend online classes, instead a table and chair will correct their posture. The use of mobile phones strains their necks and eyes.”

Dr Jayanth S Sampath, Senior Consultant Paediatric Orthopaedic Surgeon, Rainbow Children’s Hospital, said he has been seeing 3 to 4 children a week with neck pain, lower back pain and general body pain.

“Due to lack of activity and exposure to sunlight, prolonged sitting for online classes, we are seeing ‘adult symptoms’ in children. Weight gain is also a significant issue due to lack of activity. We encourage children to perform stretching exercises for all lower limb joints, avoid sitting for more than an hour at a time, restrict use of portable electronic devices, correct Vitamin D deficiency, and take up whatever physical activities are possible in this situation,” he said.

Dr Prashanth Inna, Consultant – Paediatric Orthopaedic Surgery, Manipal Hospitals, Old Airport Road, said children’s agility has also come down. “Earlier, children would come in with minor injuries, but now with agility going down, they are reporting bad injuries,” Dr Prashanth said. If children remain like this for a few more months, their condition can get chronic, doctors warn.

Originally Appeared Here

Ultimate Knee Replacement Experience Comes To Waterbury Hospital

Press release from Waterbury Health:

Aug. 17, 2021

The American Academy of Orthopedic Surgeons estimates knee replacement surgeries are expected to increase a staggering 180% between now and 2030 in United States. In Connecticut alone, an estimated 22 percent of adults over 25 are at high risk for osteoarthritis and may need surgical intervention.

A great number of patients are unaware of robotics-assisted procedures and recent advancements that have been made in the field of orthopedics.

“I tell the majority of my patients to forget everything they thought they knew about knee surgery,” said Dr. William Flynn, orthopedic surgeon at Waterbury Hospital. “Within the last few years, the advancements in robotics-assisted knee surgery alone have been a game changer for my patients.”

A recent survey conducted by global implant maker, Smith+Nephew and Kantar showed procedure fears and recovery time were the biggest concerns patients had about moving forward, but they expressed near unanimous interest in discussing robotics-assisted knee surgery with their physician.

Waterbury Hospital reached a significant milestone last month when Dr. William Flynn performed the first total knee replacement surgery using the CORI Surgical System.

Waterbury Hospital orthopedic surgeons have already performed several total knee replacement surgeries using the CORI Surgical System.

For more information on the procedure call the Waterbury Hospital Joint Replacement Center at 203-689-0080 or go to:

About Waterbury HEALTH

Waterbury HEALTH, which includes Waterbury Hospital, Alliance Medical Group, Cardiology Associates of Greater Waterbury, VNA Health at Home and Access Rehab Centers, Greater Waterbury Imaging Center, offers comprehensive healthcare services including primary care, emergency and acute care, and home healthcare. Serving Waterbury and 11 surrounding communities in Western Connecticut, Waterbury HEALTH is a member of Prospect Medical Holdings, Inc., a national family of hospitals and healthcare networks.

About the CORITM Surgical System Robot

Robotics-assisted knee replacement surgery using the CORITM Surgical System combined with the features and benefits of Smith+Nephew’s implant portfolio can lead to the following patient benefits:

· Quicker, smoother recovery

· Regain function faster and return home sooner

· A unique plan: We use 3D digital modeling to get a surgical plan customized to the patients’ unique anatomy. This means our surgeon can perform the procedure more accurately than traditional knee replacement surgery.

· A natural fit: Using these technologies patients can keep more of their natural bone and ligaments, including the ACL. That helps maintain more of a natural rhythm and step.

· A wide selection: Our surgeon is able to choose from the widest selection of implants available, so implants can be precision-matched to feel more like a patient’s own knee.

This press release was produced by Waterbury Health. The views expressed here are the author’s own.

Originally Appeared Here

Morton Hospital adds new GI and orthopedic providers

TAUNTON — Morton Hospital and Steward Medical Group (SMG) have recently expanded their specialist teams.

Amber Lippa, PA, has joined the Steward Digestive Disease Center of Taunton, conveniently located in Suite 2200 of the Thayer Building at Morton Hospital. She joins gastroenterology specialist Dr. Alexis Pappas, and they specialize in treating a wide range of GI issues. For more information or to request an appointment, call 508-828-7740.

Veronica Walczak, PA, has joined SMG Orthopedics & Sports Medicine at Northwoods, located at 2007 Bay Street, Suite 100. The office includes Dr. Marc Adams, Dr. Christopher Nacca and Dr. Matthew Werger, who specialize in psychiatry, orthopedics surgery sports medicine, and arthroscopic joint surgery. They are now accepting new patients. To request an appointment, call 774-409-2009.

Veronica Walczak, PA, has joined SMG Orthopedics & Sports Medicine at Northwoods.

To learn more about providers at Morton Hospital or to request an appointment online, visit

Originally Appeared Here