Lumbar disc surgery
All about lumbar disc surgery
Therefore, having a lumbar disc is not very strange; What differentiates it in different people is the protrusion of the disc. In this article, we want to give a complete explanation about the lumbar disc and its surgical method. Follow us to the end.
.Weakness with spasms in the legs and especially behind the knees
Numbness and feeling of weakness in the muscles
Feeling of localized back pain (may not occur for many people!)
Feeling of pain in the leg and side of the leg
Occurrence of movement disorders
Muscle burning
Pain in the buttock area
Legs falling asleep and tingling
Decreased sexual desire and urinary disorders in severe cases
Sciatica or radicular pain
We must say that the first symptoms of a lumbar disc occur with pain in the abdomen and back. Then, by weakening the disc, only one incident is enough for other symptoms such as pain in the legs, thighs, etc. to show themselves.
What are the causes of disc protrusion and rupture in the lumbar region?
Falling down suddenly
Bearing high pressure by the joints
.Bending forward frequently
Moving and lifting heavy objects
Arthritis of the spine
Abrasion of nuts
Being pregnant
Accidents and being hit
Prolonged sitting over many years
Repeated turning of the trunk to one side
Long drive
Inability to maintain muscle balance in some parts of the body
Usually, the highest incidence of this disease is related to people between 30 and 40 years old, but it does not mean that such a problem does not occur at younger ages.
Another type of disc, which is referred to as juvenile disc, occurs in the upper part of the lumbar vertebrae and is caused by blows experienced by a person at a younger age (approximately 20 years). In such a situation, over time, the water in the discs decreases and conditions for their fragility and cracking are provided. Therefore, with increasing age, the possibility of suffering from lumbar disc complications also increases.
How can you diagnose a herniated or ruptured disc in the back?
There are various ways to diagnose this problem, the most basic of which is physical examination by a specialist, in such a way that the doctor usually asks the patient to lie down and direct his leg vertically upwards. Another method is to examine the patient’s thumb and check his ability to walk on his toes and heels.
Also, using the SLR test can help the doctor diagnose. Other methods of diagnosing this disease include the following:
MRI: Imaging in this way is done by large magnets, radio frequencies and a computer.
Radiography: This method, known as X-ray, can image bones, organs and internal tissues.
- T. Scan or C. Oh you. T. Scan: CT scan is also an imaging method that provides us with more details of the body than X-ray. In fact, it can be said that this method is a combination of computer imaging and radiography.
Myelogram: In this diagnosis method, dye is injected into the spinal canal so that a clear image of the body structure can be obtained with X-ray.
Electromyography or electrical myography (EMG): This process measures muscle response or electrical activity in response to muscle nerve stimulation.
It should be noted that if you feel pain in the back area, do not act arbitrarily and to diagnose it, you must consult a neurologist.
Lumbar disc surgery
The majority of people who suffer from problems in the lumbar intervertebral disc can be cured without surgery, depending on the type and severity of the disease, different treatment methods are determined for them by the doctor.
Lumbar disc surgery is one of the ways to treat this disease, which is used in very severe cases and when the person does not respond to other treatment methods.
1-Laminectomy surgery
It is one of the oldest methods used to operate the lumbar disc. In this method, the surgeon first opens the spinal canal, which is covered by bones called lamina. Then he removes a part of the lamina as well as the ligamentum flavum in order to reach the nerve root. At this stage, the nerve root is pushed aside to be able to remove the disc from its back.
It is interesting to know that this method was performed without the use of a microscope for several years.
2- Microscopic surgery
This surgical method is also called microdiscectomy, which was used with the advent of the microscope. The process of this surgery is almost similar to the previous method. With the difference that in this method, a lumbar gap is created and the amount removed from the lamina bone is also less.
The use of a microscope in microdiscectomy surgery is that it helps to see the nerve root and disc more clearly.
3- Endoscopic surgery
Unlike the previous two methods, in this method, the patient’s spinal canal is not touched. Rather, a needle enters the disc through the intervertebral foramen. Then tubes enter the disc space, whose diameter gradually increases.
At this stage, a narrow tube with a lens (endoscope) attached to its head enters the disc space and the disc is removed. Therefore, it can be said that the possibility of adhesion in this surgical method is very small.
4- Laser surgery
The most common use of this method is when the disc is not completely ruptured. The way it works is that the laser beam is directed to the disc space by a needle and with the help of an optical fiber. This burns the center of the disc and creates a microscopic hole inside the disc.
In this situation, the pressure inside the disc decreases and then by applying a negative pressure, the core of the disc can be pulled inward. These actions cause the disc to move away from the nerve root and ultimately improve the person’s disease.
5- Open surgery
Another type of surgery and the most common of them is open surgery, in which the damaged part is removed from the body and replaced with platinum or a special tool. This method is usually used in very serious situations.
What is the importance of lumbar disc treatment?
Timely action is very important for the treatment of lumbar disc. Because it may be possible to solve this problem in the early stages with simple surgeries or even without the need for surgery. But neglecting the symptoms and ignoring them can aggravate the disease and eventually cause movement disorders in the person.
In such a situation, a simple surgery is no longer the answer, and the patient must undergo more serious and extensive treatments, which are sometimes performed with the placement of platinum and a special tool in the human body.
Failure to treat lumbar disc on time can also cause the following cases.
Sexual disorders
Intestinal and bladder disorders
Abrasion of nuts
Destruction of disc and even vertebrae
Limping leg
Numbness of the legs
And …
Considering that the nerve, like the skin and many other parts of the body, is not able to regenerate and repair, therefore, it is necessary to take any problem and disorder in it seriously.
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Does lumbar disc surgery have complications?
One of the common people’s thoughts about dick surgery is that after the surgery, you cannot do many activities and in general, the normal routine of life will undergo drastic changes. In fact, it cannot be said that this belief is false or true; Because the severity of the disease can be different in different people and it is also different depending on the type of operation that is performed for them.
But we must say that today, with the advancement of technology and the arrival of new methods for disc surgery in medical science, the complications caused by this type of surgery have been minimized as much as possible, and it is possible to restore a person’s health with minimal restrictions.
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Prevention of complications
In order to prevent problems related to the disc and spine, it is recommended:
Keep your body weight in an ideal state.
Get help from the correct methods of lifting objects.
Strengthen your abdominal and back muscles and don’t forget to exercise.
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Pain after surgery
Immediately after surgery, you will have some pain in and around the area where the operation was performed. Accommodations will be given to you to ensure your comfort and help with your mobility. The main pain in your leg that you had before the operation usually goes away immediately after the operation, but if this does not happen, you should talk to your nurse or doctor.
A very small number of people will have difficulty urinating after the operation. This problem is usually temporary, but in rare cases, such as nerve damage, it may cause problems with proper leg or bladder function. It is important to talk to your doctor or nurse immediately if you have any problems.
It can take up to 6 weeks for the general pain and fatigue to completely go away after your operation.
Leg pain after lumbar disc surgery
A question that sometimes affects the minds of patients is about the possible causes of pain after lumbar disc surgery. There are several categories of these pains.
1- The first group are pains that occur the first few days after surgery and are similar to the pains before the surgery. These pains are due to the stretching of the root and are usually self-limiting.
2- The second group of pains is in the form of tingling and numbness in the way of the previous pains and usually scares the patients, but these pains are insignificant and normal, so they disappear gradually.
3- The third group is fatal and severe shooting pains that have not improved or have increased despite surgery, in which case there is a possibility of disc bleeding or recurrence and needs to be investigated.
4- The fourth category is new stabbing pains after a long period of operation, which suggests the possibility of adhesion, recurrence, or new discopathy.
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Rehabilitation after lumbar spine surgery
Your treatment team would like to get you up and moving as soon as possible, usually the day after surgery. This is because inactivity can increase your risk of developing a blood clot (DVT), and movement can speed up the healing process.
After your operation, a physical therapist will help you safely regain your strength and range of motion. He will teach you some simple exercises that you can do at home to help you recover.
Sutures after surgery
You will have stitches after the operation to close any incisions made during the procedure. Deep sutures placed under the skin do not need to be pulled and will disappear. If absorbable surface sutures are used, they will not need to be pulled.
Non-absorbable sutures will be removed 5 to 10 days after surgery. Before you leave the hospital, your doctor will remove the stitches.
Your stitches may be covered with simple adhesive tape, such as a large Band-Aid. Be careful not to get this cover wet when washing. After your stitches are removed, you do not need to wear them and you can shower and bathe as usual.
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Marital relationship after lumbar disc surgery
There is a misconception that spinal surgeries affect sexual power! But what does science say about this?
In general, after lumbar disc surgery, it is better to have very little sexual intercourse for a month, but there is no change in the level of sexual desire or sexual pleasure. After one month, when the symptoms and pain are almost completely healed, patients can experience relaxed sexual intercourse with less vigor and gradually within the next two months, they will be completely back to normal.
But some patients have suffered from cauda equina syndrome or horse tail due to delay in surgical treatment and then referred. In this case, which is sometimes irreversible, the patient may experience sexual, urinary, or movement complications, sphincter, etc., and sometimes surgery will not be beneficial for them.
Exercise after lumbar disc surgery
Patients who have undergone lumbar disc surgery with the microsurgery method should usually start swimming and walking after one month of surgery. These patients can do other sports after three months. Our recommendation is that they benefit from walking, running and swimming, especially backstroke, but it is better to avoid weight lifting and martial arts and jumping as much as possible.
Due to the disease of the lumbar discs of these people, the chance of recurrence of discopathy increases with heavy sports. But with water sports or walking, spinal muscles are strengthened and therefore the recurrence rate is reduced. Note that sports restrictions are not caused by surgery; Rather, it is caused by disc disease that afflicts patients and surgery has been able to minimize that limitation.
Walking after lumbar disc surgery
As the recovery period begins after back surgery, the patient should follow the doctor’s instructions at home and in the hospital. One of the things prescribed by the doctor is rehabilitation exercises that focus on returning the person to a normal state. Following these instructions will have an effect on the speed of recovery. Exercise causes the release of endorphin hormones in the body, and by increasing blood circulation, it raises a person’s mood during the recovery period.
The doctor and physiotherapist advise the patient to start walking as soon as possible and gradually increase it. In addition to preventing muscle atrophy, walking also helps prevent blood clots and constipation. Patients should walk as much as possible but not push themselves. During hospitalization, the patient is encouraged to start walking if able.
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The cause of lumbar disc recurrence after surgery
- Disc height
Patients with lumbar disc had higher preoperative disc height (19.1±4.6 mm) than non-diseased individuals (15.0±3.3 mm).
- Cigarettes
Due to the importance of ossification in the spinal surgery site, smoking should be avoided. Smokers had an 18.5% higher recurrence rate than non-smokers.
- Gender
According to the research, the risk of lumbar disc recurrence is strongly related to male gender. Other studies have not shown a relationship between gender and secondary incidence.
- Employment
Lifting heavy objects as part of the job has a lot to do with lumbar disc recurrence. In contrast, manual workers were not significantly at risk compared to non-manual workers. Surgeons should advise their patients to limit their strenuous manual work to prevent lumbar disc recurrence.
Driving after surgery
Before driving again, you must stop using any sedatives that make you drowsy. You should be comfortable with your driving position and be able to stop in an emergency situation without any pain (you can practice this before you start driving). Most people feel ready to drive after 2 to 6 weeks, this time depends on the size of the operation.
Call your doctor or the hospital where you had the procedure for advice in the following cases:
..the presence of liquid discharge or redness at the wound site
Your stitches coming out
Getting your clothes wet with blood
Having a fever of 38 degrees or higher
Increased pain, numbness, or weakness in your legs, back, or hips
You cannot move your legs
Not being able to control your stool or urine
Have a severe headache
Have sudden shortness of breath (it can be a sign of pulmonary embolism, pneumonia or other cardiovascular problems)