Spinal Disc Herniation (Slip Disc)

Spinal disc herniation, commonly known as a ‘slip disc’, occurs when the soft inner core of a spinal disc bulges or leaks out through a tear in the tougher outer layer. This herniated disc can press against nearby spinal nerves, causing pain, numbness, or weakness in the arms or legs depending on the disc’s location. It most commonly affects the cervical (neck) and lumbar (lower back) spine.

At Primax Hospital, our Neurosurgery team specializes in the diagnosis and minimally invasive treatment of disc herniations. Our goal is to relieve nerve compression, restore spinal function, and reduce the risk of recurrence through surgical or non-surgical interventions.

Causes and Risk Factors

– Age-related degeneration of spinal discs (disc dehydration and shrinkage).

– Sudden trauma or lifting heavy objects improperly.

– Repetitive spinal movements or bending and twisting motions.

– Sedentary lifestyle and poor posture.

– Obesity – increased stress on spinal structures.

– Smoking – accelerates disc degeneration.

– Genetic predisposition to disc disease.

Signs and Symptoms

– Localized back or neck pain.

– Radiating pain down arms (cervical) or legs (lumbar sciatica).

– Tingling, numbness, or ‘pins and needles’ sensation.

– Muscle weakness in the limbs.

– Difficulty walking, balance issues in severe cases.

– Pain worsening with movement, coughing, or sneezing.

– Loss of bladder or bowel control (in emergencies like cauda equina syndrome).

Diagnosis at Primax Hospital

– Detailed neurological and physical examination.

– X-rays – to rule out fractures or spinal alignment issues.

– MRI spine – gold standard for identifying disc herniation and nerve root compression.

– CT scan – especially in patients who cannot undergo MRI.

– Nerve conduction studies and EMG – to assess nerve damage in chronic cases.

Treatment and Management

– Initial conservative management with rest and activity modification.

– Physical therapy to improve spinal flexibility and muscle strength.

– Pain relief through NSAIDs, muscle relaxants, or nerve pain medications.

– Epidural steroid injections to reduce inflammation and nerve pain.

– Microscopic discectomy – minimally invasive removal of herniated disc portion.

– Endoscopic spine surgery – newer technique with smaller incisions.

– Spinal fusion – for recurrent or large herniations causing instability.

– Lifestyle changes and core strengthening to prevent recurrence.

Recovery and Rehabilitation

– Early mobilization with guided exercises post-surgery.

– Physical therapy to restore full range of motion and strength.

– Back care education for posture correction and injury prevention.

– Gradual return to daily activities and work.

– Pain and medication management during recovery period.

– Avoiding high-impact activities for several weeks post-operatively.

Prognosis and Long-Term Outlook

The prognosis for spinal disc herniation is excellent in most cases, especially with early diagnosis and proper treatment. Conservative therapy works well for many patients, while surgery provides lasting relief in those with severe or persistent symptoms. Long-term recovery depends on adherence to physical therapy, ergonomic modifications, and maintaining a healthy lifestyle.

Spinal Cord Compression

Spinal cord compression refers to pressure on the spinal cord that disrupts normal nerve signals. This condition can result from trauma, tumors, disc herniation, spinal stenosis, infections, or degenerative changes. If not addressed promptly, spinal cord compression may lead to permanent neurological deficits, including paralysis or loss of bowel and bladder control.

At Primax Hospital, our Neurosurgery team is equipped to diagnose and treat spinal cord compression with urgency and precision. We offer advanced imaging, microsurgical techniques, and minimally invasive procedures to relieve compression and protect neurological function.

Causes and Risk Factors

– Herniated or bulging spinal disc.

– Spinal tumors (primary or metastatic).

– Traumatic vertebral fractures.

– Spinal infections like epidural abscess or tuberculosis.

– Degenerative changes (e.g., spondylosis, ligament thickening).

– Spinal hematoma (bleeding around the cord).

– Congenital spinal canal narrowing.

Signs and Symptoms

– Back or neck pain localized to the compression site.

– Radiating pain along the arms or legs.

– Numbness or tingling in hands, fingers, feet, or legs.

– Weakness in limbs or difficulty walking.

– Loss of coordination and balance.

– Bowel or bladder dysfunction – urgency, retention, or incontinence.

– Sudden paralysis in severe or untreated cases.

Diagnosis at Primax Hospital

– Detailed neurological examination to assess motor and sensory function.

– MRI spine – gold standard to evaluate spinal cord, disc, and tumor involvement.

– CT scan – especially for bone-related compression or trauma cases.

– X-rays – to assess spinal alignment or fractures.

– Blood tests – to rule out infections or inflammatory causes.

– Biopsy – if tumor or infection is suspected.

Treatment and Management

– Emergency surgical decompression – to prevent permanent nerve damage.

– Laminectomy or laminoplasty – to relieve pressure on the cord.

– Microsurgical tumor excision – in case of compressive growths.

– Discectomy – for disc-related compression.

– Spinal stabilization or fusion – for unstable spine.

– Steroid therapy – to reduce inflammation and swelling.

– Antibiotics or antifungals – for infectious causes.

– Radiation or chemotherapy – for malignant spinal tumors.

Recovery and Rehabilitation

– Early mobilization and physical therapy post-surgery.

– Rehabilitation for gait training and muscle strengthening.

– Occupational therapy to regain independence in daily activities.

– Bladder and bowel management protocols.

– Counseling and psychological support.

– Close follow-up to assess neurological improvement or residual deficits.

Prognosis and Long-Term Outlook

The prognosis of spinal cord compression depends on the cause, duration of compression, and time to intervention. Early diagnosis and prompt surgical decompression significantly improve outcomes. Delayed treatment can lead to irreversible neurological damage. At Primax, our focus is on early detection, rapid intervention, and comprehensive post-operative care to restore neurological function and prevent recurrence.

Head Injuries and Trauma

Head injuries and traumatic brain injuries (TBIs) result from external forces causing damage to the brain, skull, or scalp. They may range from mild concussions to severe contusions, skull fractures, or intracranial hemorrhages. Common causes include road traffic accidents, falls, assaults, or sports injuries. Prompt diagnosis and treatment are critical, as delays can lead to life-threatening complications or permanent neurological deficits.

At Primax Hospital, our Neurosurgery and Emergency Medicine teams are available 24×7 to manage all forms of head trauma. Our advanced imaging, neuromonitoring, ICU support, and surgical expertise ensure that patients receive timely, evidence-based care in both acute and post-acute phases of injury.

Common Causes of Head Injuries

– Road traffic accidents – leading cause of TBIs in India.

– Falls – particularly in elderly or children.

– Assault or violence – blunt force injuries to the head.

– Sports-related trauma – especially in contact sports like football or boxing.

– Industrial accidents or construction site injuries.

– Penetrating trauma – such as gunshot or sharp object injuries.

Types of Head Injuries

– Concussion – mild TBI causing temporary confusion or memory loss.

– Contusion – bruising of brain tissue, often with swelling.

– Skull fracture – break in cranial bones, open or closed.

– Epidural hematoma – bleeding between skull and dura mater.

– Subdural hematoma – bleeding between dura and brain surface.

– Subarachnoid hemorrhage – bleeding into the space around the brain.

– Diffuse axonal injury – microscopic damage to brain fibers, common in high-speed trauma.

– Penetrating injuries – open head wounds from sharp or fast-moving objects.

Signs and Symptoms

– Loss of consciousness – brief or prolonged.

– Confusion, disorientation, or memory lapses.

– Headache, dizziness, or blurred vision.

– Nausea or vomiting – especially repeated episodes.

– Seizures or convulsions.

– Unequal pupil size or abnormal eye movement.

– Weakness or numbness in limbs.

– Clear fluid drainage from nose or ears – CSF leak.

– Mood changes, agitation, or speech difficulties.

Diagnosis at Primax Hospital

– Primary neurological exam using Glasgow Coma Scale (GCS).

– Non-contrast CT scan of the brain – to detect bleeding, fractures, or swelling.

– MRI Brain – for subtle injuries like diffuse axonal damage or contusions.

– Skull X-rays – for detecting fractures.

– ICP monitoring – for severe TBIs at risk of brain swelling.

– Blood tests – to rule out clotting disorders or infections.

Treatment and Management

– Stabilization of airway, breathing, and circulation in emergency.

– Surgical evacuation of hematomas (EDH, SDH) to relieve pressure.

– Decompressive craniectomy – to relieve swelling in severe TBIs.

– Skull fracture repair – especially in depressed or open fractures.

– ICP monitoring and neurocritical care in ICU.

– Anticonvulsants for seizure prevention.

– Osmotic therapy (mannitol) or steroids (as per indication).

– Supportive care including fluids, nutrition, and prevention of complications.

Recovery and Rehabilitation

– Neuro-rehabilitation including physical, cognitive, and speech therapy.

– Psychiatric support for mood or behavioral changes.

– Nutritional care and caregiver counseling.

– Vocational rehabilitation for return to work.

– Follow-up imaging to monitor brain healing or hydrocephalus.

– Customized rehabilitation goals based on injury severity.

Prognosis and Long-Term Outlook

Recovery from head injuries depends on the severity, location, and timeliness of treatment. Mild TBIs like concussions often resolve fully, while moderate to severe injuries require prolonged rehab and monitoring. With immediate neurosurgical care, ICU support, and long-term neuro-rehabilitation at Primax Hospital, many patients achieve significant recovery and improved quality of life.

Hydrocephalus

Hydrocephalus is a neurological condition characterized by the abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain. This accumulation can cause increased intracranial pressure, leading to brain swelling, developmental delays, or life-threatening complications if left untreated. Hydrocephalus can affect individuals of all ages but is most commonly seen in infants and the elderly.

At Primax Hospital, our Neurosurgery team provides comprehensive care for hydrocephalus, including diagnosis, emergency management, and advanced surgical interventions like shunt placements or endoscopic procedures. Our multidisciplinary team ensures that patients receive timely treatment to relieve pressure and prevent brain damage.

Types and Causes of Hydrocephalus

– Congenital Hydrocephalus – present at birth due to abnormal brain development or genetic disorders.

– Acquired Hydrocephalus – caused by infections (like meningitis), hemorrhage, tumors, or trauma.

– Communicating Hydrocephalus – CSF flows between ventricles but isn’t absorbed properly.

– Non-communicating (Obstructive) Hydrocephalus – due to a blockage preventing CSF flow.

– Normal Pressure Hydrocephalus (NPH) – typically in elderly patients, presents with gait disturbance, memory problems, and urinary incontinence.

– Hydrocephalus ex-vacuo – due to brain atrophy, often secondary to stroke or degenerative disease.

Signs and Symptoms

Symptoms vary by age group. Common signs include:

**In Infants:**

– Enlarged head or bulging fontanel (soft spot).

– Vomiting, irritability, poor feeding.

– Sunsetting eyes (downward gaze).

– Seizures.

– Delayed developmental milestones.

**In Adults:**

– Headaches, often worse in the morning.

– Nausea or vomiting.

– Difficulty walking or balancing.

– Urinary urgency or incontinence.

– Memory loss or confusion.

– Blurred or double vision.

– Drowsiness or lethargy in advanced stages.

Diagnosis at Primax Hospital

– Clinical examination and neurological assessment.

– MRI Brain – to visualize enlarged ventricles and assess CSF flow.

– CT Scan – rapid diagnosis in emergency cases.

– Intracranial pressure (ICP) monitoring – to assess pressure levels.

– CSF tap test – especially for Normal Pressure Hydrocephalus.

– Neuropsychological tests – for cognitive assessment in adults.

Treatment and Management

– Ventriculoperitoneal (VP) Shunt Surgery – a tube diverts CSF from brain to abdomen.

– Endoscopic Third Ventriculostomy (ETV) – creates a bypass channel for CSF inside the brain.

– External Ventricular Drain (EVD) – temporary CSF drainage in ICU settings.

– Shunt revision – required if blockages, infections, or malfunction occur.

– Antibiotics – for hydrocephalus due to infections like meningitis.

– Post-operative imaging and pressure monitoring.

– Rehabilitation for motor or cognitive recovery.

Recovery and Rehabilitation

– Physical therapy for improving gait and motor coordination.

– Occupational therapy for regaining daily functional independence.

– Cognitive rehabilitation for memory or attention issues.

– Routine follow-ups to monitor shunt function or recurrence.

– Nutritional and psychosocial support especially for children and elderly.

– Parental education and long-term care guidance for pediatric cases.

Prognosis and Long-Term Outlook

With early diagnosis and proper surgical intervention, the outlook for patients with hydrocephalus can be excellent. While some patients may need lifelong shunt management and follow-up, many lead normal and productive lives. At Primax Hospital, our multidisciplinary approach and long-term care support ensure the best possible recovery and quality of life.

Brain Hemorrhage / Intracranial Bleeds

Trigeminal Neuralgia

Trigeminal Neuralgia is a chronic pain condition affecting the trigeminal nerve, which carries sensation from the face to the brain. It is characterized by sudden, severe, electric shock-like facial pain that can be triggered by mild stimulation such as brushing teeth, speaking, or even a breeze. The condition can significantly impact quality of life and is considered one of the most painful disorders known.

At Primax Hospital, our Neurosurgery and Neurology teams provide advanced diagnostic and treatment options for trigeminal neuralgia, including both medical management and surgical interventions like microvascular decompression or radiofrequency ablation.

Causes and Risk Factors

– Compression of the trigeminal nerve by an artery or vein (vascular loop).

– Multiple sclerosis – due to demyelination of the trigeminal nerve.

– Tumors pressing on the trigeminal nerve.

– Post-traumatic nerve injury or facial trauma.

– Idiopathic – no identifiable cause in some patients.

– Age – more common in people over 50 years.

– Women are more frequently affected than men.

Signs and Symptoms

– Sudden, intense facial pain – typically one-sided.

– Pain episodes last from a few seconds to two minutes.

– Sharp, stabbing, or electric shock-like sensation.

– Triggered by touch, chewing, talking, or brushing teeth.

– Pain typically affects the jaw, cheek, teeth, or lips.

– Periods of remission that may last weeks or months.

– Over time, episodes may become more frequent and severe.

Diagnosis at Primax Hospital

– Detailed neurological and pain history assessment.

– MRI Brain – to rule out multiple sclerosis, tumors, or vascular compression.

– High-resolution MRI with contrast for trigeminal nerve imaging.

– Neurophysiological tests to evaluate nerve function.

– Trial of pain medications to assess response.

– Exclusion of dental, ENT, or ophthalmic causes of facial pain.

Treatment and Pain Management

– Medications – first-line treatment includes anticonvulsants like carbamazepine or oxcarbazepine.

– Muscle relaxants (e.g., baclofen) for resistant cases.

– Surgical microvascular decompression – relieves pressure from blood vessels compressing the nerve.

– Radiofrequency ablation – selectively destroys nerve fibers transmitting pain.

– Balloon compression or glycerol injection – minimally invasive options for pain relief.

– Gamma Knife radiosurgery – focused radiation to damage the pain-conducting nerve fibers.

– Lifestyle support and stress management – to reduce flare-ups.

Recovery and Follow-Up

– Post-surgical monitoring for recurrence or facial numbness.

– Pain assessment and adjustment of medications.

– Counseling support for anxiety or depression due to chronic pain.

– Nutritional counseling if chewing becomes difficult.

– Facial exercises to relieve muscle tension.

– Long-term monitoring in cases of multiple sclerosis or tumor-related neuralgia.

Prognosis and Long-Term Outlook

Trigeminal Neuralgia is a manageable condition with the right combination of medications and interventions. While some patients respond well to medical therapy alone, others may require surgical procedures for long-term relief. At Primax Hospital, our specialized team ensures individualized treatment plans to restore comfort, reduce flare-ups, and improve the overall quality of life for each patient.

Cervical and Lumbar Spondylosis

Cervical and lumbar spondylosis refer to degenerative changes affecting the cervical (neck) and lumbar (lower back) regions of the spine. These changes involve wear and tear of the spinal discs, vertebrae, ligaments, and facet joints due to aging or repetitive stress. Spondylosis can cause pain, stiffness, and nerve compression, significantly affecting mobility and daily activities.

At Primax Hospital, we provide comprehensive care for spondylosis, including advanced imaging, non-surgical pain relief methods, and surgical options when required. Our multidisciplinary spine team ensures precise diagnosis, personalized therapy, and long-term spine health for every patient.

Causes and Risk Factors

– Age-related degeneration of intervertebral discs and joints.

– Loss of disc hydration and elasticity over time.

– Repetitive spinal movements or heavy lifting.

– Poor posture or sedentary lifestyle.

– Spinal injuries or trauma.

– Genetic predisposition to disc degeneration.

– Smoking – accelerates disc wear and tear.

Signs and Symptoms

**Cervical Spondylosis:**

– Neck pain and stiffness, especially in the morning.

– Pain radiating to shoulders or arms.

– Tingling or numbness in the arms and hands.

– Reduced neck flexibility or motion.

– Headaches originating from the neck.

– Muscle weakness or grip weakness.

– In severe cases, gait instability due to spinal cord involvement.

**Lumbar Spondylosis:**

– Lower back pain, especially after prolonged sitting or standing.

– Stiffness and reduced flexibility in the lower back.

– Pain radiating to the buttocks or legs (sciatica).

– Numbness or tingling in the legs or feet.

– Difficulty in walking or standing for long periods.

– Muscle weakness in the lower limbs.

– Bladder or bowel dysfunction in advanced cases.

Diagnosis at Primax Hospital

– Physical examination and spine movement assessment.

– X-rays – to detect bony growths (osteophytes), disc space narrowing.

– MRI Spine – to assess nerve root compression or disc herniation.

– CT Scan – useful for evaluating bone structures.

– Nerve conduction studies – if neurological symptoms are present.

– Blood tests – to rule out inflammatory or infectious causes of back pain.

Treatment and Pain Management

– Physical therapy – core strengthening, posture correction, and flexibility exercises.

– Pain relievers such as NSAIDs or muscle relaxants.

– Heat or cold therapy – to reduce inflammation and spasms.

– Lifestyle modifications – ergonomic adjustments, weight management.

– Cervical or lumbar traction – for decompression.

– Epidural steroid injections – for nerve-related pain.

– Surgical options like laminectomy, foraminotomy, or spinal fusion for severe cases with neurological deficits.

Recovery and Rehabilitation

– Individualized physiotherapy plan to restore strength and flexibility.

– Occupational therapy to assist with posture and movement training.

– Regular follow-up to monitor symptoms and adjust therapy.

– Pain management counseling and behavior therapy if needed.

– Preventive strategies to avoid recurrence – like proper lifting techniques.

– Nutritional guidance to support bone health.

Prognosis and Long-Term Outlook

Most cases of cervical and lumbar spondylosis can be managed conservatively with excellent results. Surgery is only required in patients with persistent symptoms, neurological complications, or spinal instability. At Primax Hospital, our team provides evidence-based care tailored to individual needs, enabling long-term spinal health and pain-free mobility.