Herniated Lumbar Discs
Disc Herniation, also known as ruptured disc, is a condition that commonly occurs in the lumbar spine (5 vertebrae bones making up the lower back). It is one of the most common causes of back pain as well as leg pain “sciatica” in some cases. Herniated discs can be very painful, however most cases respond very good to non-surgical treatment options. Surgery might be considered if non-surgical methods don’t help the patient. There are many techniques used for the operation, and the surgeon will decide which one is the best considering the unique features the case.
Your spine is made of 24 bones called vertebrae and intervertebral discs that are located between each vertebrae. Intervertebral discs are flexible discs that are composed of Annulus Fibrous (though, outer ring of the disk) and Nucleus Pulposus (soft center of the disk). Herniated disk occur when Nucleus Pulposus disrupt the shape of Annulus Fibrous due to wear and tear caused by age or a sudden injury.
Short Information
Before the Procedure
The surgeon will evaluate the overall health and medical history of the patient. The surgeon might temporarily change some medications the patient is using with other alternatives. Pre-surgical tests such as blood test and x-rays will be made several days prior to surgery. The surgeon will discuss about the patients lifestyle and perform physical examinations to find to cause of the problem.
During the Procedure
The surgeon will locate the affected vertebrae and disc with a device called fluoroscope. Next, an incision about 0,5-2 inches is made on the back over the affected vertebrae. The back muscles are retracted and the bone is exposed. The surgeon creates a small opening on the lamina part of the bone with a drill or other tool. Depending on the case, position and number of the laminotomy might change.
The surgeon retracts the protective sac of nerve root once the lamina is removed. Surgical tools and devices are used to locate the herniated disc. The ruptured portion of the disc is removed to decompress the nerve root. Other tissues such as bone or cysts that might apply pressure on the nerve root are also removed.
Once the disc is treated, the retractor that separated the muscles from the area is removed. To close the incision, muscle and skin tissues are sewn together with staples or sutures.
After the Procedure & Recovery
Once the anesthesia wears off, patient will be moved to a room where they can increase their levels of activity (walking, sitting etc.). Patients might be release from the hospital on the same day, or may need to stay at the hospital for 1-2 days. Pain mediations can be taken if needed. Bend the back, lifting heavy and strenuous activity such as housework or sex should be avoided for the first 2 weeks.
Walking short distances every 3-4 hours and increasing the walking time gradually is recommended during the healing period. The complete healing time depends on the cause of the disease and the general health of the patient. To avoid recurrence, patients should use proper lifting techniques, keep a good posture, a healthy weight and follow an appropriate exercise program during healing.
