1. Dr. Dheeraj Bojwani
Your Medical Tour Consultant in India
Dr.DheerajBojwani Consultants
Website : www.dheerajbojwani.com

2. Spine Surgery India
Overview:
Back problems are one of the most common reasons to see a doctor. As per one study,
approximately 80% of people experience back pain during their lifetime. Though for the
vast majority of these people the pain will subside naturally without the need for surgery.
While the remaining still require a proper care and medication or spine surgery to get rid
of their back problems.
What is Spine Surgery?
Spine surgery is an invasive pain management procedure in which a specially trained doctor (the surgeon) uses instruments to
make incisions to repair damaged spinal tissues. Or in other words Spine surgery whether back or neck surgery, can be sum
up as an advanced treatment option for pain and disability caused by an identifiable lesion in the patient’s anatomy that has
not adequately improved with non-surgical treatments. Although spinal arthritis tends to be chronic, the symptoms are rarely
progressive and rarely require surgery on the painful spinal joints.
Types of Spine Surgery
There are different types of Spine surgeries, which include the following:
Discectomy: is a procedure to remove a portion of the disc that rests between each vertebrae. A herniated disc is the
most common reason for spine surgery. In this type of spine surgery, the herniated disc is removed and relieves the
pressure on the nerves.
Foraminotomy: is also a procedure used to relieve pressure on a nerve, but in this case, the nerve is being pinched by
more than just herniated disc. A foramenotomy removes a portion of bone and other tissue that may be compressing
the nerve as it exits the spinal column.
Spine Fusion: is a surgery that is done to eliminate motion between adjacent vertebrae. The spine fusion may be done
because to treat a problem such as spondylolisthesis (unstable spine), or it may be done because of the extent of
other surgery (such as a laminectomy).
Spinal Disc Replacement: is a new surgery that is still quite uncommon. Spine disc replacement is done to treat
specific types of back pain, while avoiding the problems associated with spine fusion surgery.
Anterior Cervical Corpectomy Spine Surgery: When the cervical disease encompasses more than just the disc space,
the spine surgeon may recommend removal of the vertebral body as well as the disc spaces at either end, to
completely decompress the cervical canal. This procedure is often done for multi-level cervical stenosis with spinal
cord compression caused by bone spur (osteophytes) growth.
Cervical Spine Surgery: is performed for variety of cervical spine problems. Generally, surgery may be performed for
degenerative disorders, trauma or instability. These conditions may produce pressure on the spinal cord or on the
nerves coming from the spine. The goal this surgery is to relieve pain, numbness, tingling and weakness, restore
nerve function and prevent spinal abnormal motion.
Lumbar Laminectomy: is a surgical procedure most often performed to treat leg pain related to herniated discs, spinal
stenosis, and other related conditions. The goal of a laminectomy is to relieve pressure on the spinal cord or spinal
nerve by widening the spinal canal. This is done by removing or trimming the lamina (roof) of the vertebrae to create
more space for the nerves.

3. Endoscopic Spine Surgery: is an operation on the lumbar spine
performed using a surgical endoscope and microsurgical techniques.
This type of surgery is performed by orthopedic surgeons and
neurosurgeons who are experts in diagnosing the causes of back and
neck pain and recognizing when a patient is likely to get better with
surgery
Vertebroplasty: is a procedure in which a special type of synthetic
cement material is injected inside the broken spine bone, giving
excellent results in pain relief with very low incidence of side effects.
This procedure can be safely done in osteoporotic fractures, painful
spine bones after spread of cancer, non cancerous painful tumors of
spine bones or to augment strength of weak spine bone prior to
insertion of screws to increase the holding power of the weak bones
for other surgical procedures.
Common Spinal Conditions
Facet joint osteoarthritis is a gradual process that breaks down cartilage between joints. The loss of cartilage causes
more friction between the joints, resulting in pain and stiffness. This disorder can also result in compression of nerves,
which causes pain as well.
Spinal stenosis is a narrowing of the spinal canal or neural passageways (foramina) that can place pressure on
nerves in the spinal cord. Stenosis is a gradual result of aging, and wear and tear on the spine.
Degenerative disc disease is a gradual process that affects the structural integrity of discs. As people age, disc
moisture decreases, resulting in discs that may shrink, wrinkle and even crack. These disc changes allow vertebral
structures to compress, resulting in less space for nerves to exit the spinal column. The compressed nerves may
swell and cause pain.
Spondylolisthesis is a condition where one vertebra slips over another, causing spine misalignment and instability. It
may be present at birth and develop over time, or be the result of physical activity or deteriorating spinal parts, such
as discs.
Disc herniation is a rupture of the disc where the inner core of the disc bulges out through the outer layer. If the
bulging disc presses on a spinal nerve, the pressure can cause pain. A common symptom of a herniated disc is
sciatica, the term used to describe pain that travels downward along the sciatic nerve from the buttock to the thigh
and leg. Herniated discs are also known as “slipped” or “ruptured” discs.
Osteoporosis is a disorder caused by bone mineral loss that results in fragile bones. This disorder can cause vertebral
compression fractures or a humped back.
In addition to these common conditions associated with back pain, there are many other possible causes of chronic pain,
including pregnancy, injury, infection and tumors. Pregnancy stresses the back and may contribute to pain that lasts several
months, but generally this pain subsides and is not indicative of a chronic condition. In any case, persistent pain requires that
the sufferer seek a more specific and definable problem after a wait-and-see period has elapsed.

4. Am I the candidate for Spine Surgery?
Surgery should always be the last resort when it comes to treating spinal conditions in the neck and back. However, if you have
tried all the non-operative treatments without improvement or worsening over a 6-12 month period, then you become the
candidate for a spine surgery for certain specific conditions such as spinal stenosis, sciatica, spondylolisthesis or degenerative
scoliosis. Your decision for surgery should be individualized to the patient and the patient’s symptoms, along with their level of
function.
Preparing for the Spine Surgery
This is the most critical step towards. The surgeon's medical assistant or nurse provides the patient with a written list of
instructions to follow before surgery. Instructions include how to prepare the home for post-operative care, planning for the
patient's transportation needs, special information about taking current medications, to leave valuables at home, a reminder not
to eat or drink anything the evening before surgery, and what time to report to the surgical facility. t the surgical facility, the
patient checks in and is escorted to a pre-surgical area where the patient is prepared for surgery. Here the patient changes into
a hospital gown. The patient's pre-surgical nurse verifies the patient's name, type of surgery to be performed, and reviews their
medical history including allergies. An intravenous line (IV) is started. Different types of necessary medications are injected
through the IV into the patient's bloodstream. Light sedating medication may be given to the patient through the IV. Some
patients become so relaxed that they do not remember being taken to the operating room.
How long is the recovery?
Most patients are able to get up out of bed and start walking shortly after surgery, usually on the same or following day. For the
first 6 weeks, the activity level is limited to walking and normal daily activities. Most patients are encouraged to avoid heavy
lifting, frequent bending, twisting or turning or climbing during the first 6 week period. After 6 weeks, patients begin a physical
therapy and exercise program to achieve rapid recovery and strength. By 3 months a gradual increase in normal activities as
well as the institution of low impact sporting activities can be started. At 6 weeks, all activities are begun, including sports.
Benefits of Spine Surgery
Its an easy way to get rid of your back pain
Pain free life
Almost nil postoperative pain
Risk factor
Potential risks associated with spine surgery include anesthesia complications, blood clots, allergic reactions and adverse
effects due to undiagnosed medical problems, such as silent heart disease. Spinal nerves are extremely sensitive. One or more
can be damaged during any spine surgery procedure. A spinal fusion might not bond well at the operated levels, which may
ask for surgery operation.

5. Spine Surgery in India
Besides, the cost factor, the other factors which drives the international patients is the quality which is delivered. It is often goes
par with international benchmark as practiced in the developed nations like the US or UK. India has a rich medical
infrastructure; with most of the hospitals catering various medical services happen to a top class modern treatment centres
abreast with state-of-art technologies as witnessed in the developed nations. Whereas coming down to India isn’t a big deal,
Indian government has no stringent rules applied for medical tourists, so getting a visa for your Spine surgery in India.
Moreover, since India happens had a British rule in the past, hence English is widely spoken, so it becomes easy for a foreign
patient to interact.
Indian spinal surgeons are the most competent in performing various surgeries, as they have ample of experience of handling
cases regardless of its complexity. Most of them are accredited from prestigious foreign universalities. They have a good
success rate and are world renowned medical professionals known to cater service both India and abroad. Most of them are
qualified and trained in developed nations like the US or UK from prestigious universities who have the history of producing
skilled surgeons. Spine Surgery in India is available at world class hospitals in the following cities:
Mumbai Hyderabad Kerala
Delhi Pune Goa
Bangalore Nagpur Jaipur
Chennai Gurgaon Chandigarh
These places deliver a patient world class spine surgery at tailor made packages which suits all his or her needs and
requirements. The special feature of these places are there is no patient wait list, however, the Indians follow the concept of the
preference given to the urgent medical treatments. So in nutshell, Spine Surgery in India not only helps the foreign patient in
their back pains related treatments by packaging their medical trip to India but it also offers a full complement of surgical as well
as physiotherapy services for you and that too combined with your post - discharge recuperative holidays, which helps to
recover fast.
Cost of Spine Surgery in India
Cost is the most prominent benefit for which the foreign patients avail Spine surgery in India. The exorbitant cost difference,
which comes to around 40-70% less as compared to any developed nations like US and UK, as indicated below. Here is the
cost comparison of surgery in India and other countries.
Procedure USA ($) Thailand ($) UK($) India ($)
Complex Spine Surgery with Implants 13,500 13,000 13,000 7,500
Spinal Fusion 62,000 70,000 65,000 5,500
Simple Spine Surgery 15,000 15,000 13,000 2,100
Knee Replacement 40,000 10,000 13,000 6,500

6. ABOUT INDIA
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign,
democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely
medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the
travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and
Chandigarh offers best medical tourism service.
Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things,
including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice
of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start
exploring this great city.
Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous
growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past
few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.
Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its
endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly
compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has
much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore
is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'.
Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as
one of the most charming cities in India,
Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll
instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good
jumping-off point for a series of trips into the far eastern corner of Maharashtra.
Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala
– better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to
rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National
Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the
planet.
Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi
is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed
burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.
Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of
factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international
standards and many more have made Pune one of the top destinations for medical tourism.
Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and
colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in
India.
Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil
Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers
in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest,
including robotic surgery.

7. Patients Testimonial:
Mr. Ricky Sablet, Florida – USA
Spine Surgery in India
Hello, I am Ricky Sablet from America. Heaven! What an experience of flying thousands of Km for my Spinal decompression
surgery in India, my God! its hard to express, the kind of feelings I have, especially, the joy of getting rid of my medical ailments.
I am really obliged to my medical consultant- Dheeraj Bojwani Group, who expedited my entire Spinal decompression surgery in
India. Indeed, they came as an angel in our life and with this treatment arranged in India, set an example of pain healer for
many patients waiting to come for the same. Otherwise, my health was in bad shape, and every passing day seemed adding
more problems. I was constantly seen with a back pain bugging me a lot, hampering my life. The symptoms typically improve
during the day and worsened late in the day. I immediately consulted the doctor, wherein after listening to my symptoms, he did
some physical tests and other tests including the blood test and X-ray, confirmed that I have problems and now would require
Spinal decompression surgery. Unfortunately, I was unable to get any place which seemed affordable to me, and moreover,
there was a huge rush which was seen at my home town. This compelled me to search for my Spinal decompression surgery
in India, along with other countries like Thailand etc. After spending a comprehensive time over the internet, I found Spinal
decompression surgery in India pretty practical, moreover, the packages that were offered for this treatment by a medical
consultant- Dheeraj Bojwani group was within my reach. I immediately called them up to discuss the possibility of having my
Spinal decompression surgery in India. The executive at the other end was kind and pretty professional; she collected my
medical reports and gave me a call after discussing with their panel of medical experts. She then explained me at length about
the Spinal decompression surgery in India. I was convinced and soon was in India for my Spinal decompression surgery.
Ms. Debbie Walker, USA
Laser Spine Surgery in India
I am Debbie, I learnt about dheerajbojwani website through research on the internet for Endoscopic Laser Spine surgery in
Bangalore. I had many questions and concerns - all of which were answered promptly and with professionalism. Upon arrival
in India for Endoscopic laser spine surgery I was greeted with a pleasant smile which put me to rest I felt I am at the right
place. They took care and they always were there for me and made me feel at home. Endoscopic laser spine surgeons of
Bangalore hospital were real very professional and superb! They are awesome who understand the meaning of giving care to
their patients. I am absolutely pain free now and can do all the things I couldn’t do before my laser spine surgery. I was never
treated so well at a hospital, anywhere in the world, the services provided were exceptional. The veteran Endoscopic laser
Spine surgeons of Bangalore hospital played a vital role in giving me my quality of life back and the best part of it is all this
costed me peanuts. People should know the option to come to India for treatment is real and its one to be seriously
considered."
Thank you
Debbie
USA

8. Knee Replacement Surgery in India
Knee replacement surgery also known as knee arthroplasty is procedure to replace the
weight-bearing surfaces of the knee joint to relieve the pain and disability of
osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis
and psoriatic arthritis. The procedure has been proven to help individuals return back to
moderately challenging activities such as golf, bicycling, and swimming. Total knees
are not designed for jogging, or sports like tennis and skiing (although there certainly
are people with total knee replacements that participate in such sports). Knee
replacement is a routine surgery performed on over 600,000 people worldwide each
year. Over 90% of people who have had Total Knee Replacement experience an
improvement in knee pain and function.
Knee Replacement Surgery Candidates
A person would be considered a candidate for knee replacement if there is:
• Daily pain
• The pain is severe enough to restrict work, recreation and ordinary activities of daily living
• Significant stiffness in the knee
• Significant instability (constant giving way) of the knee
• Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee
• Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis
Success Rate of Knee Replacement Surgery:
Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be
the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans
back on their feet and allowed them to enjoy their golden years.
Knee Replacement Surgery Preparations:
• If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery.
• If you drink, don't have any alcohol for at least 48 hours before surgery.
• Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to
strengthen your upper body will help you cope with crutches or a walker after surgery.
• Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery.
This examination will assess your health and your risk for anesthesia. The results of this examination should be
forwarded to your orthopaedic surgeon, along with a surgical clearance.
• Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and
answer any last-minute questions.
• You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray.
• Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to
stop taking certain medications or your surgeon may recommend substitute medications until your surgery.
Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.