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Herniated Disc Surgery

Herniated Disc Surgery

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Herniated Disc Surgery

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  1. Herniated Disc Surgery

  2. Anatomy Aherniateddiscmostoftenoccursinthelumbarregion(lowback).Thisisbecausethelumbarspinecarriesmostofthebody'sweight.Sometimestheherniationcanpressonanerve,causingpainthatspreadsorradiatestootherpartsofthebody.

  3. Definition • Veryfewpeoplewithherniatedorbulgingdiscsneedsurgery.However,ifyouhavetriedconservativetreatmentswithoutrelief,yourdoctormayrecommendherniated disc surgery.Surgerymaybenecessaryifyouareexperiencing: Muscleweaknessornumbness,lossofsensation Problemswalkingorstanding Difficultycontrollingyourbowelsorbladder Manytimes,onlytheportionofthediscthatisbulgingorherniatedisremoved.Inrarecases,itisnecessarytoremovetheentiredisc.Iftheentirediscisremoved,thebones(vertebrae)oneithersideofthedamageddiscmayneedtobepermanentlyjoinedorfusedtogethertoprovidestabilityforyourspine.

  4. Micro Discectomy Why It's Done AMicrodiscectomyisasurgicalprocedurethatisdonetotakethepressureoffthenervesorspinalcordbyremovingpartoralloftheherniateddisc. YourphysicianmightadviseMicrodiscectomyif: Nerveweaknesshasprogressedtothepointyouhavedifficultywalkingorstanding Aftersixweeksofnon-surgicaltreatment,suchasphysicaltherapy,yoursymptomsarenotimproving AfragmentofadiscbecomeslodgedinthespinalcordandiscompressinganerveThepainradiatingintoyourarms,chest,legsorbuttocksisnolongermanageable How Microdiscectomy Surgery Is Performed Amicrodiscectomyisperformedthroughasmall(1inchto11/2inch)incisioninthemidlineofthelowback. First,thebackmuscles(erectorspinae)areliftedoffthebonyarch(lamina)ofthespine.Sincethesebackmusclesrunvertically,theycanbemovedoutofthewayratherthancut. Thesurgeonisthenabletoenterthespinebyremovingamembraneoverthenerveroots(ligamentumflavum),anduseseitheroperatingglasses(loupes)oranoperatingmicroscopetovisualizethenerveroot. Often,asmallportionoftheinsidefacetjointisremovedbothtofacilitateaccesstothenerverootandtorelievepressureoverthenerve. Thenerverootisthengentlymovedtothesideandthediscmaterialisremovedfromunderthenerveroot.

  5. Risks MicroDiscectomyisconsideredtobeasafeoperation.Justlikeanysurgery,thereisariskofcomplicationsoccurring.Possiblecomplicationsincludethefollowing: • Bleeding • Infection • Spinalfluidleaking • Damagetonervesorbloodvesselsaroundandinthespine • Damagetotheprotectivelayeroftissuesthatsurroundthespine Results Discectomyhelpstorelievethesymptomsofaherniateddiscinmostpeoplewhohaveclearindicationsofnervecompression,suchaspainthatradiatesfromthebackintothearmsorlegs.Thissurgerymaynotprovidepermanentreliefhowever,becauseitdoesnotsolvetheunderlyingproblemthatinitiallycausedthedisctoherniate.Yourdoctormaymakesomerecommendationsthatwillhelpyouavoidinjuringyourspineagain,suchasaroutineprogramoflow-impactexerciseorweightreduction.Itmayalsoberecom-mendedthatyouavoidactivitiesthatrequirerepetitiveorextensivelifting,twistingorbending.

  6. Percutaneous Discectomy Anadvancedformofpercutaneousdiscectomydevelopedtodateusesaplasmatech-nologytoremovetissuefromthecenterofthedisc.Duringtheprocedure,aninstrumentisintroducedthroughaneedleandplacedintothecenterofthediscwhereaseriesofchannelsarecreatedtoremovetissuefromthenucleus. Tissueremovalfromthenucleusactstodecompressthediscandrelievethepressureexertedbythedisconthenearbynerveroot.Aspressureisrelieved,painisreduced,consistentwiththeclinicalresultsofearlierpercutaneousdiscectomyprocedures.Thereislittletissuetraumaandrecoverytimesmaybeimprovedinmanypatients.

  7. Laminotomy and Laminectomy Eachbackboneorvertebrahastwolaminae.Theselaminaearearch-shapedandarelocatedclosertotheinternalbodythantheoutsideofthebody.Otherpartsofthevertebraarelocatednearthelaminae:thefacetjointandthespinalprocess. Thelaminaearemadeofboneandtheyrarelycauseproblems.However,surgeryonthemcanbehelpfulinotherconditions.Spinalconditionsmaycauseseverepainifthespinalcordornearbynervesarecompressed.Operationsperformedonthelaminaecanhelptomakethespinalcolumnwider,whichrelievesthepressureandpain.Surgeryonthelaminaeisalsousedtohelptreatspinaldeformities. Whatisthe Difference Between Laminectomyand Laminotomy? Sometimesevendoctorsandnursesinterchangethesetwowords,butthereisadistinction.Inalaminectomy,thelaminaiscompletelyremoved.Onlyaportionofthelaminaisremovedinalaminotomy. Reasonsforalaminectomyorlaminotomy Themainreasonforeitheroftheseproceduresistoremovethepressurefromthenervesnearthespinalcordorfromthespinalcorditself. Eventhoughaportionofthevertebraisremoved,thespinalcordremainsprotectedinsidethespinalcolumnwhichconsistsofhardbackbones,evenwhenalaminectomyorlaminotomyisperformed.bepermanent.