Dr. Harshavardhan Hegde, Director Orthopaedics, the Nova Orthopaedic & Spine Hospital, addresses various questions you might have on that persistent back problem and its cure.

1. HealthLine
Q. I’ve had recurring back pain for
quite a while now. Is it time for me
to consider surgery?
A. Spine surgery is a solution for
patients whose lumbar (lower back)
pain has not responded favourably
to conservative, non-operative
treatments over a 6-12 month
period. Spine surgery is most
commonly suggested as a treatment
for conditions including degenerative
disc disease, spondylolisthesis, spinal
stenosis, scoliosis and fractured
discs. However, the decision
to undergo surgery should be
individualised to the patient and the
patient’s symptoms, along with their
level of function.
Q. What is Minimally
Invasive Spine Surgery (MISS)?
Is it successful?
A. Yes, MISS has been used
successfully for many years. It is
clear that MISS allows more rapid
recovery and return to work/sports.
There is less post-operative pain and
a shorter hospital stay. The scope,
complexity and procedures available
continue to evolve at a rapid rate.
Q. What is robotic-assisted spine
surgery? Is it a part of MISS?
A. MISS is the direction in which
much of the medical field is headed
and robotic surgery is the future. A
surgical robot is an operating room
machine completely controlled by
a skilled surgeon, who manipulates
mechanical arms from a console
near the patient’s bed.
Q. How does robotic-assisted spine
surgery work?
A. A surgeon operates several
precision-guided robotic arms that
hold and manipulate miniaturised
instruments that are inserted
through keyhole-sized incisions in
the patient. A small video camera,
inserted through another tiny
incision, provides surgeons with
a magnified 3D image of the
operating site. This expansive view
allows doctors to see and avoid
surrounding nerves and muscles.
The robotic arms, with their ability
to rotate 360 degrees, enable
surgical instruments to be moved
with greater precision, flexibility and
range of motion than in standard
minimally invasive laparoscopy.
Q. If I choose to undergo robotic
surgery, what can I expect?
A. The use of robotic equipment in
surgery means a more precise and
Recurring Back Pain
Myths, facts and frequently asked questions
Volume 1. Issue 1 The Neighbourhood Health Journal The Spine Special
Dr. Harshavardhan Hegde, Director
Orthopaedics, the Nova Orthopaedic
& Spine Hospital, addresses various
questions you might have on that
persistent back problem and its cure.

2. less disruptive procedure that takes
two to three hours, under general
anaesthesia. Patients typically
experience only minimal blood loss.
Depending on the condition being
treated, patients often only spend
one night in the hospital and are
usually discharged as soon as their
laboratory tests are acceptable,
pain is controlled, and are able to
retain liquids.
Q. After the robotic surgery, how
long will my pain last?
A. As compared to traditional
surgery patients undergoing robotic
surgery are discharged faster,
resulting in much less pain. In fact,
with robotic-assisted surgery, the
return to normal everyday activities
(except for lifting heavy objects and
strenuous exercise) can occur in as
little as two to three weeks.
Q. What are the benefits of robotic
spine surgery for me?
A. Patients typically experience
significantly less pain, blood loss
and recovery time as compared
to conventional open surgery,
which requires several days
of hospitalisation and several
months of recovery. A study in
the European Spine Journal by
Dr. Sven Kantelhardt proved
that using RenaissanceTM
:
Improved implant accuracy
by 70%
Reduced x-Ray dosage by 56%
Reduced complication rates
by 48%
Reduced need for re-operations
by 46%, and
Reduced average length of
hospital stay by 27%
Numerous additional peer-reviewed
publications and presentations
at leading scientific conferences
have validated the high accuracy,
usability, and clinical advantages of
Mazor Robotics technology.
Mazor Robotics technology
is available at over 30 spine
centers worldwide and the Nova
Orthopaedic & Spine Hospital
in New Delhi, where it has been
used for many successful spine
procedures till date.
The Nova Orthopaedic & Spine Hospital is
Delhi’s only hospital to have Mazor Robotics.
HealthLine
Expert Doctors at Nova Orthopaedic & Spine Hospital (NOSH)
Dr. Harshavardhan Hegde
Director
MS (Ortho); Fellow Klinikum Karlsbad, Germany;
Member, Girdlestone Orthopaedic Society, UK
Dr. Nitiraj Oberoi
MS, DNB, FRCS
Sr. Consultant – Joint Replacement and Arthroscopy
Dr. Rakesh Mattoo
MS (Ortho); Fellow, GSNU Hospital, S. Korea; Sr.
Consultant – Joint Replacement and Trauma Surgery
Dr. Alok Sharma
MS (Ortho), M. Ch (UK)
Joint Replacement and Trauma Surgery
Valid till February 28, 2014
Free Spine consultation
10% discount on Surgery Package*
20% discount on Diagnostics
(Radiology and Lab investigation)**
*Terms & conditions apply
**If advised by consultants
NOSH Spine Screening Packages
1. NOSH Basic Orthopaedic
Screening Package
2. NOSH Arthritis Screening Package
3. NOSH Advanced Orthopaedic
Screening Package
NOSH
Assessment
Programme
Dr. Mandeep Singh
D. Ortho, DNB (Ortho),
M.Ch (Ortho) Consultant – Orthopaedic and Spine
Spine Fellow – Germany
Dr. Manish Dalwani
MBBS, DNB (Ortho)
Consultant – Joint Replacement and Paediatric
Orthopaedic Surgeon
Dr. Akshay Kumar Saxena
MBBS, DNB (Ortho),
Dip, SICOT (Belgium)
Jr. Consultant Orthopaedics

3. At the Nova Orthopaedic & Spine Hospital (NOSH),
advanced medical technology has enabled doctors
to deliver precise treatments in the quickest possible
time. In the domain of spinal surgery, the surgeons
at NOSH are making the most of the high precision
Mazor Robotics RenaissanceTM
Surgical System to
treat complex spinal conditions with greater accuracy
and better results.
MAN AND MACHINE IN HARMONY
At NOSH, experienced surgeons are using this
state-of-the-art robotic-guided system to navigate
the delicate spinal cord and treat the most challenging
spinal cases painlessly.
“Surgical treatment of the spine requires planning
and precision, and each patient’s anatomy has unique
challenges. At NOSH, our doctors use pre-operative
advanced 3D planning so ware to create a unique
surgical blueprint, which is the ideal procedure for
each patient’s condition”, states Dr. Harshavardhan
Hegde, Director, NOSH.
ROBOTIC SYSTEM FOR PRECISION
“Though the word ‘robotics’ may be viewed sceptically,
it does not mean the surgery is performed entirely
by machines,” explains Dr. Hegde. “RenaissanceTM
is a specially designed surgical system that guides
and allows our surgeons to perform safer and more
accurate spine surgeries,” he elaborates.
The system guides the surgeon’s tools according
to the surgical blueprint and places the implants safely
in the pre-planned locations.
PROVEN ACCURACY
Clinical studies have validated that Mazor Robotics
technology better meets the challenges of deformities
and other intricate spinal cases. “We have leading
surgeons experienced and specially trained in using
the Robotic system. This state-of-the-art technology
enables our surgeons to more accurately plan and
place pedicle screws in complex spinal cases,” informs
Dr. Hegde.
Nova Dramatically Improves Spine Surgery Outcomes with
a State-of-the-art Robotic System
ADVANTAGES FOR PATIENTS
Personalised surgical treatment, according to a
patient’s unique blueprint
Minimally invasive procedures, allowing for
smaller incisions
Increased accuracy and lower clinical
complication rates
Reduced pain and recovery time
Highest levels of patient safety and care
NOVA ADVANTAGES
NOSH is India’s leading specialty hospital dedicated to
orthopaedics. Out of the top 30 hospitals worldwide to
use Mazor Robotics, NOSH is the only hospital to have
brought this advanced technology to Delhi. It provides
comprehensive spinal care services including:
Spinal evaluation and assessment
Work capacity evaluation and job analysis
Surgical care and rehabilitation
Insurance approved procedures
NOSH SPECIALISES IN
Spine stabilisation/fusion/instrumentation
Microsurgery
Hydro discectomy
Minimally invasive techniques for pain relief
Complex spine reconstruction
Spinal column tumours
Artificial disk surgery
HealthLine

4. www.novaorthopaedicandspine.com
SMS NOSH TO 54242 | TOLL-FREE: 1800 103 6682
A medical doctor herself, she was suffering from
almost 60% deformity of the spine. Dr. Hegde
and his team performed a successful spine
surgery on her. The Mazor Robotics technology
lent precision and helped the experts at Nova in
correcting the deformity by 95%. This was a life
changing surgery for her as she resumed normal
pain-free life within a couple of weeks. She can
now sit in her chair for hours and attend to her
patients without any discomfort.
The Recent Success Story at Nova
A erBefore
Patient’s Name: Shanti**
**Name has been changed to protect patient’s identity
R2, Nehru Enclave, Near Okhla Flyover on
the Outer Ring Road, New Delhi-110 019
Phone: 011 6629 7500
Low Back Pain Exercises
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