What are the causes of lumbar hernia?
First of all, defining lumbar hernia will make it easier for us to understand its causes. It occurs as a result of the displacement of the elastic cartilage tissue called “disc” between the 5 lumbar vertebrae in the lower part of our spine, due to overloads and/or deterioration of its structure, from its location to the spinal canal and the nerves coming to the leg. Old age is the leading cause of deterioration of the structure of cartilage tissue, degenerative rheumatic diseases and some infections are other causes.
Among the causes of overload; obesity (excess weight), some professions (workers in heavy jobs such as housewives, porters, workers, those who do desk work by sitting for a long time, those who work by standing constantly such as waiters, teachers, managers under intense stress), reverse and sudden waist movements countable. The mechanisms described in lumbar hernia are also valid for neck hernias. So the reasons are similar.
What are the symptoms of neck hernia?
Neck pain; Pain in one or both shoulders, arms, forearms and hands, pain in the back and scapula, numbness in the arms and/or hands, loss of strength, spasms and/or loss of strength in the legs in advanced stages, difficulty in walking and balancing, and even in the neck. may present with paralysis.
What are the classical treatment methods for waist and neck hernias?
Not every low back and neck pain means a hernia. Approximately 95% of hernias can be treated with non-surgical methods. Among these methods; rest and medication (painkillers and muscle relaxants), weight loss, recommending a full orthopedic bed, walking, swimming, exercise, and physical therapy.
What are the disadvantages of classical surgeries?
The most valid surgical technique today is the “microsurgical discectomy” method. As the name suggests, a microscope is used. In addition, there should be a device called a scope, which is used for distance determination in the operating room, and instruments for microsurgery. If we indicate the advantages of the microsurgical technique, the disadvantages of other methods will be self-explanatory.
In microsurgical technique, it is entered from a very small place (approximately 1 cm). Thus, there is less tissue damage, wound healing is fast and close to perfection. There is no problem of dressing and stitching. The patient can stand up very quickly and can return to normal home and work life in a short time.
Hernia recurrence (under 2%) and the risk of infection at the wound site (approximately 0.5%) are low. Most importantly, undesirable conditions (complications) related to surgery are clearly low (under 0.5%) in microsurgical technique, which means a very comfortable and safe operation for the patient.
What are the advantages of back surgery without anesthesia?
Back surgery without anesthesia (with epidural anesthesia) is unfortunately still performed by very few surgeons, but I sincerely believe that its importance will be understood and become more widespread in the near future.
In this method, an anesthesiologist friend of ours inserts a thin, hair-like catheter with a special needle from a suitable region of the waist, between the bone and the spinal cord, and provides the lumbar region to be operated with numbness by administering some drugs from there.
But most importantly, mobility is maintained in the patient’s legs. The advantage of back surgery performed with this method, for the doctor; The ability to establish one-to-one communication with the patient, which allows the control of foot and/or leg movements during surgery.
At the slightest contact with the nerve to the leg, the patient states that there is pain or electricity in the leg, so that the possibility of damaging the nerve is reduced to almost zero.
Advantages for the patient; The feeling of confidence and relief given by knowing that the doctor has performed the surgery, listening to music, being able to chat, even making phone calls, reading magazines and newspapers, are beneficial for diseases in which general anesthesia (narcosis) is risky (heart diseases, asthma, diabetes, high blood pressure, kidney failure, etc.). ) provides a safer surgery in overweight patients.
Eating and drinking is free immediately after the operation. The patient can be walked within 2 hours and can be discharged on the same day.
Side effects of epidural anesthesia technique are almost never seen. It is quite safe, and in terms of its construction, it is carried out in a short time like 10 minutes, without any discomfort to the patient.
CONCLUSION:
Patients with low back problems who have been recommended surgery should be afraid of being late rather than having surgery. They should consult their physician as soon as possible, who will perform the safe and comfortable surgery performed with microsurgical technique, preferably under epidural anesthesia.
Opr. Dr. Candan HUNDEMİR
Neurosurgery Specialist
