In the early stages of lumbar hernia development, non-surgical treatment methods called conservative treatment are applied. At this stage, the patient is given painkillers, muscle relaxants and anti-inflammatory drugs, firm bed rest is recommended, physical therapy can be performed, and laser treatment can be used. Again, some different interventions such as skin (percutaneous) closed surgery can be performed. Exercise can be given in the appropriate period and psychotherapy can be done if necessary.
It is useful to see the treatment of herniated disc as a team effort. Neurosurgery (brain-spinal cord-nerve surgery), neurology, anesthesia, physical therapy and rehabilitation specialist doctors, dieticians, psychologists, nurses and physiotherapists should be included in this team. If necessary, the opinions of specialist doctors in some other branches should also be consulted.
In principle, surgical intervention, that is, herniated disc surgery is the last resort. However, if the disease has progressed and some conditions have been met in the examination (which are the criteria that are generally accepted in the international neurosurgery community and are in the classical books), then the decision for surgery is made. The main factors in deciding on surgical treatment are: recurrent pain, urinary and stool problems, loss of strength in the legs and/or feet, and weakening and thinning of the muscles, which seriously reduce the efficiency and quality of the patient’s social and work life and do not respond to rest-drug therapy.
It is a method in which the line is anesthetized from the waist down in order to reduce the risk of patients undergoing surgery in some concomitant conditions such as advanced age (over 80), severe cardiovascular disease, respiratory disease, pregnancy, allergy to anesthesia drugs, liver disease. It can be operated under spinal anesthesia or epidural anesthesia, that is, under local anesthesia, that is, without anesthetizing the patients. During this anesthesia, the patient does not feel any pain and can talk to the surgeon. In this type of surgery; It is possible to get up early and be discharged on the same day, thus avoiding the risk of hospital infection.
If symptoms such as inability to urinate or urinary incontinence, numbness around the anus and genitals, paralysis in the leg suddenly occur in a patient with a herniated disc, emergency hernia surgery should be performed on that person. In such a patient, even hours are important. Even in the middle of the night, the pressure on the nerve elements should be removed as soon as possible by entering the operation immediately.
