• Spondylolisthesis – slipping of one vertebrae forward in relation to other, which makes spine unstable and painful due to pinch of nerves causing pain – back pain , buttock pain , leg pain , numbness in legs while movement and walking.
• Spondylolisthesis is a condition where the space for nerve roots in spinal column gets narrow due to forward slip of one bone of spine over other . This slip of Spondylolisthesis leads to narrowing of channels where spinal cord and nerve roots travel resulting in spinal cord and nerve roots getting squeezed also known as “compression of nerve roots.

5 types of spondylolisthesis have been described in literature:-

• Lytic Spondylolisthesis
• Degenrative spondylolisthesis
• Pathological spondylolisthesis
• Iatrogenic spondylolisthesis
• Traumatic spondylolisthesis

However broacly they are described into two types –

• Developmental / congenital / inherited variant
• Acquired – DAEGENRATIION / TRAUMA/ INFECTION / FRACTURE

• Back pain, Leg pain, buttock pain, pain in legs, Numbness in legs, Heaviness in legs, Imbalance in walking, Difficulty in walking, Weakness in legs, Calf cramps are the common symptoms of Spondylolisthesis in the lumbar spine. All these symptoms increase with walking and are called as CLAUDICATION .
• Spondylolisthesis in the low back (lumbar spine) can cause pain or cramp in legs during standing or during the walk for a smaller distance. In severe cases of Spondylolisthesis, nerves to the bladder or bowel may be compressed, which can lead to partial or complete incontinence. The earliest symptom of this may be increased frequency of urination or urgency of urination and may progress to complete incontinence/inability to control urine. This is a surgical emergency and may need surgery at earliest .

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• Spine specialist may examine you clinically and may ask for investigations like X-Ray and MRI SCAN OR CT SCAN to diagnose in the presence of symptoms. MRI scan can show various grades of Spondylolisthesisand may also suggest if surgery is really needed in view of ongoing compression of nerves in the spinal canal.

• No. Surgery is not the only option of treatment in Spondylolisthesis. Surgery is required in a select group of patients with severe symptoms affecting daily living. Non-surgical treatment helps in most patients significantly.
• Nonsurgical treatment options to treat Spondylolisthesis include physiotherapy, exercises, medication and injection in spine. Meet your spine specialist to decide on which is the best treatment option for you. To treat Spondylolisthesisone of the best spine specialist in India is Dr. Vishal Kundnani, Mumbai who manages these problems with a scientific approach.
• These options of non-surgical management of slip disc are available at Spine Clinic Mumbai –best spine clinic in Mumbai for treatment of slip disc. Dr. Vishal Kundnani is one of the best spine consultants in Mumbai and is available on appointment in Mumbai on appointment for spine specialist.

Surgery is required in a select group of patients with severe symptoms affecting daily living. Nonsurgical treatment helps in most patients significantly.
The non-surgical treatment option is decided based on the duration and severity of symptoms in consultation with your spine surgeon / spinal surgeon the options available are

• Medicines – NSAIDS/ Muscle relaxant / Pregabalin / TCA,S /non opiod analgesics
• Hot fomentation
• Cold sponging
• Physical therapy
• TENS
• SWD
• However before one resorts to any option one should have advise of spine surgeon

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These options of non-surgical management of Spondylolisthesis are available at Spine Clinic Mumbai – one of the best spine clinics in Mumbai for treatment of Spondylolisthesis. Dr. Vishal Kundnani is one o the best spine consultant in Mumbai and is available on appointment in Mumbai on appointment for spine specialist. Dr. Vishal Kundnani is one of the best spines Specialist in Mumbai and best spinal consultation Goregaon, Kandiwali and Malad.

Surgery for Spondylolisthesis involves decompression and fusion – freeing the nerves of the compression from disc or facet joints in spine and to stabilise the instability (painful movement of bones causing nerve compression) in spine.

1. Two surgical techniques for Spondylolisthesis
   • Decompression: Tissue pressing against a nerve structure is trimmed , which makes more room in the spinal canal (for the spinal cord) or in the foramen (for the nerve roots).
   • Stabilization: to limit motion between vertebrae when instability is the cause of problem giving rise to pain and numbness / weakness.

Various options of spine surgery include conventional open spine surgery and minimally invasive spine surgery or MIS surgery for spondylolisthesis. These options of surgical management of Spondylolisthesis are available at Spine Clinic Mumbai – Best Spine Clinic in Mumbai for treatment of slip disc and spinal stenosis. Dr. Vishal Kundnani is one of the best spine consultants in Mumbai and is available on appointment in Mumbai. Dr. Vishal Kundnani is one of the best spine specialist in Mumbai and best spinal minimal invasive spine surgeon in Goregaon, Kandivali and Malad.

Surgery for spinal stenosis is safe and simple. To remove the tissue that’s pressing on a nerve, the spine surgeon may perform one of the following:

1. Foraminotomy: If part of the disc or a bone spur (osteophyte) is pressing on a nerve root in its path (an exit called the foramen), a foraminotomy – widening of the path for nerve root- may be done. Otomy means “to make an opening.” So a foraminotomy is making the opening of the foramen larger, so the nerve can exit without being compressed.
2. Laminotomy: laminotomy makes a larger opening, this time in bony plate protecting the spinal canal and spinal cord. The lamina bony sheath over the nerves along with the nerve roots  may be pressing on your nerve,  which is removed  to  make more room for the nerves using a laminotomy.
3. Laminectomy: Sometimes, in severe cases and multilevel cases small opening in the bone may not be And what is needed is to remove all or part of the lamina, and this procedure is called a laminectomy.  This can often be done at many levels without any harmful effects.
4. Indirect decompression: is a variation of decompression surgery where pressure is relieved by spreading the bones apart instead of removing the bone. This can be done with different techniques and various instrumentation some examples are distraction laminoplasty with or without implants like interspinous process devices or interbody cages. Even artificial discs can accomplish some indirect decompression by restoring the height between adjacent vertebrae.

Various options of spine surgery include conventional open spine surgery and minimally invasive spine surgery or MIS surgery for spinal stenosis. These options of surgical management of slip disc and spinal stenosis are available at Spine Clinic Mumbai – Best Spine Clinic in Mumbai for treatment of slip disc and spinal stenosis. Dr. Vishal Kundnani is the best spine consultant in Mumbai and is available on appointment in Mumbai on appointment for spine specialist. Dr. Vishal Kundnani is the best spine specialist in Mumbai and best spinal consultantinGoregaon, Kandivali and Malad.

• Spinal Fusion surgery is a safe and simple surgery often performed by spinal surgeons for the unstable and painful spine to reduce pain. The instability in the spine can be due to various reasons. The simplest and most common reason of instability in the spine is SPONDYLOLISTHESIS (slip of one bone over another resulting in a pinch of nerves and causing back pain, leg pain, buttock pain, numbness in legs while walking).
• To Stabilise the instability in Spine the surgeon needs to reduce the movement at the unstable spinal bones. This is achieved by inserting implants in the spine after a dedicated and thorough discectomy. The surgeon removes part of or complete disc and puts the bone graft in disc space. this is then supplemented with spinal pedicle implants and cages in the disc space. This procedure is called spinal fusion surgery .
• Commonly performed for spinal instability due to spondylolisthesis, spinal tuberculosis, spinal stenosis, spinal trauma, and spinal tumors. Spinal fusion is performed for adjacent segment disease in the lumbar spine or thoracic spine.

Various options of Spinal Fusion surgery include conventional open spine surgery and minimally invasive spine surgery or MIS surgery for spinal fusion. These options of surgical management of spinal fusion are available at Spine Clinic Mumbai – Best Spine Clinic in Mumbai for treatment of Spinal Fusion. Dr. Vishal Kundnani is one of the Best Spine Consultant in Mumbai and is available on appointment in Mumbai. Dr. Vishal Kundnani is the best spine specialist in Mumbai and one of the best spinal surgeon in Goregaon, Kandivali and Malad.

• This is achieved by inserting implants in the spine after a detailed and dedicated discectomy between the bones in the spine . The surgeon removes part of or complete disc and puts the bone graft in disc space. this is then supplemented with spinal pedicle implants and cages in the disc space. This procedure is called spinal fusion surgery.
• Spinal fusion surgery requires putting/inserting Spinal implant (Pedicle screw and plates and cages ) in the spine after decompression surgery. The spinal implants are an extremely safe procedure. It is an extremely safe procedure.

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• Spinal fusion can be done in open conventional technique or Spinal Fusion is done with Minimal invasive technique. Minimal invasive spinal fusion surgery is extremely safe and simple and most efficient. The best technique to do spinal fusion is Minimal Invasive Spinal Fusion. Minimal invasive spinal fusion also called as minimal invasive transforaminal interbody fusion or MIS-TLIF or MIS TLIF is a extremely safe procedure with plenty of benefits of less pain , less blood loss, less infection, smaller incisions, early return to work, early discharge from hospital, no need of bed rest after surgery.

Dr. Vishal Kundnani – one of the Best Spine Surgeon in Mumbai, frequently performs a spinal fusion. Dr. Vishal Kundnani is the best spine specialist in Mumbai and one of the best minimal-invasive spine surgeon in Goregaon, Kandivali and Malad.

• Spinal fusion surgery done to bring the slipped bones together and making them stable and painless is called spinal fusion for spondylolisthesis. It’s especially helpful in cases where one or more vertebrae have slipped forward –
• SPONDYLOLISTHESIS – slipping of one vertebrae forward in relation to other
• Spinal fusion surgery for spondylolisthesis can be done in open conventioanl technqiue or with Minimal invasive spinal fusion suregry

• Minimal invasive spinal fusion surgery is extremely safe and simple and most efficient. The best technique to do spinal fusion is Minimal Invasive Spinal Fusion. Minimal invasive spinal fusion also called as minimal invasive transforaminal interbody fusion or MIS-TLIF or MIS TLIF is a extremely safe procedure with plenty of benefits of small incisions which heal very quickly, less muscle pain, less pain after surgery, less blood loss, less infection, smaller incisions, early return to work, early discharge from hospital, no need of bed rest after surgery.

• Minimaly invasive Spinal fusion surgery for spondylolisthesis is frequently performed by Dr. Vishal Kundnani – one of the Best Spine Surgeon in Mumbai. Best spinal surgeon in Mumbai to perform spinal fusion surgery is Dr. Vishal Kundnani. Dr. Vishal Kundnani is one of the best spine specialists in Mumbai and one of the best minimal-invasive spine surgeon in Goregaon, Kandivali and Malad.

• Yes. The spinal implants used for spinal fusion surgery are made of titanium, which is an inert, metal and extremely safe for the human body. When spinal implant, spine screw plate, screw plate in the spine is inserted in control by a trained spinal surgeon they don’t create any problem.
• To enhance safety Intraoperatively some Spinal surgeons use IITV (X-RAY) and navigation and robotics in spine surgery to make sure surgery is safe for patients.

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Meet your doctor and know momre about your problem , possible solutions and pro’s and con’s of all the solutions including surgery offered to you.

• After surgery is planned, plan your hospital stay and discuss discharge plan with the doctor.
• Maintain Good nutrition for healthy immune system.
• Eat a balanced diet and take a vitamin supplement, with the advice of your doctor in the weeks before your surgery.
• Weak muscles and low cardiovascular endurance prolong recovery from surgery. Talk to your doctor about how to start an exercise program that is right for your condition before and after spine surgery. Get your lungs and heart checked up by a physician, in consultation with your surgeon, to get surgical fitness.
• Back pain can make losing weight or weight maintenance a challenge. If you are overweight, it is a good idea to slim down before your surgery.
• Quit Smoking to prevent prolonged recovery and wound healing.
• Pain is always a cause for concern. To recover and remain pain-free, follow the treatment plan your doctor has outlined. Make sure you have regular check-ups, and tell your doctor if you are not getting better.

Minimal invasive spine surgery leads to fast recovery and makes patient walking after surgery within 24 hours. In fact in minimally invasive surgery and microendoscopic surgery and minimally invasive spinal fusion results in early return to work without any need of bed rest after surgery.
After surgery, the patient is mobilized out of bed within 24 hours, and pain medications are continued for 5 days. After the surgery, general do’s and don’ts instructions are given about. With Minimal, Invasive spine surgery patient can go home within 48 hrs and can resume job within 2 weeks however Contact sports is generally avoided for 6-10 weeks.

• One should follow.
• Follow your doctor’s treatment plan.
• Sit and stand properly and maintain posture.
• Learn to lift correctly.
• Exercise regularly (low impact aerobic exercise is especially good, but check with your doctor first).
• Attain and maintain a healthy body weight.
• Eat healthy foods (a well-balanced, low-fat diet rich in fruits and vegetables) and get enough calcium.
• Stop smoking.

Dr. Vishal Kundnani is one of the best minimal invasive spine surgeon for spinal fusion surgery and best microscopic / best Endoscopic Spine Surgeon in mumbai for spinal stenosis surgery.