Lumbar Hernia and Microdiscectomy
Low back pain and herniated disc are common health problems that affect the majority of the population.
The lumbar region is the area where the human spine is the most burdened and the most common disorders related to the movement system occur.
What is herniated disc?
Lumbar disc herniation is a disorder that occurs as a result of herniation between two vertebrae, which is defined as the disc that absorbs (absorbs) the load on the spine and ensures its equal distribution, towards the spinal cord and/or nerve roots.
Is Every Low Back Pain Caused by a Herniated disc?
Low back pain; It is among the most important health problems due to its high prevalence, the fact that it is among the three most frequent reasons for referral to a physician for outpatient treatment, too much expenditure on diagnosis and treatment, and labor losses caused by it. It is stated in various publications that the frequency of low back pain is 60-90%. It is stated that approximately 80% of adults have low back pain at some point in their lives. they usually recover within 4-6 weeks and return to their normal lives.
According to popular belief, a patient with low back pain thinks he has a herniated disc. This is a false belief. Low back pain can be due to herniated disc, lumbar spinal narrow canal (nerve compression), spinal cord tumor, spinal fractures, rheumatic diseases, inflammatory conditions or various diseases related to the musculoskeletal system. Therefore, it is more appropriate for the patient to seek the help of a specialist physician. The present complaint may be a problem that can be corrected with simple medical treatment or may require serious surgical intervention.
What Complaints Does the Patient with Lumbar Hernia Have?
Low back pain is usually the initial symptom. However, the patient usually complains of pain in the hip and radiating to one or both legs. These complaints can be very mild or severe enough to affect the person’s quality of life. It affects your social life. Depending on the nerve under pressure, the patient may complain of numbness, numbness, loss of strength in the thigh, leg or foot. In more serious spinal cord compressions, symptoms such as urinary/fecal incontinence may occur. If the low back pain does not go away on its own within a few days or if it has started to affect daily life negatively, then it is time to apply to the Cerebrospinal Cord and Neurosurgeon.
How to Diagnose?
Today, Magnetic Resonance (MR) imaging is the main option in the diagnosis of herniated disc. The patient’s lumbar disc herniation can be examined in detail in a detailed shot with high image quality. In addition, it can be used in radiological methods such as computed tomography, myelography (an examination performed by giving contrast material from the waist). However, MRI is the main choice in diagnosis because it is non-invasive, has high image quality and can be imaged in different planes.
The clinical findings and radiological findings of the patient are often sufficient for diagnosis. However, Electromyelography (EMG) examination can be performed in the differential diagnosis of Peripheral Nerve compression.
What is the Treatment?
Most of the lumbar hernias are not surgical in the first place. Some of the patients who receive medical treatment and rest benefit. However, medical (drug) treatment, rest, and physical therapy not responding; Surgical treatment may be necessary in patients with persistent low back and leg pain and diagnosed radiologically. A specialist physician’s evaluation is required in this regard. In addition, it is useful to consult a specialist without waiting for urinary incontinence, sudden loss of strength, which does not benefit from medical treatment with severe pain or requires emergency surgery.
What are Surgical Techniques?
Different surgical techniques have developed with the increasing technology and practical application in the surgery of lumbar disc herniation.
Which technique will be applied to which patient is decided as a result of the patient’s complaint, radiological findings and evaluation of the physician.
The basic surgical method is classical (simple) discectomy. Microdiscectomy; It is a technique performed under a microscope, which is performed through a smaller incision compared to simple discectomy, is less traumatic, and allows the patient to move early. With a small incision of 1-2 cm, a wide field of view is reached by making use of the magnification of the microscope.
Microdiscectomy
Since the procedure is performed in an area of 1-2 cm, the risk of blood loss and infection is reduced. Postoperative (post-operative) pain is less. The probability of recurrence of lumbar hernia is greatly reduced.
The length of stay in hospital is greatly reduced. He can walk 6 hours after the operation and can be discharged the next day. As a result, he can go to daily life faster. After a period of about 7-10 days, it is possible to return to daily life. This is how it prevents loss of work power.
Protection
Walking and swimming should be preferred as sports. Heavy loads should not be lifted. It is preferable to squat instead of bending over, and it is necessary to avoid slow turns. The waist should be kept straight. Sit with lumbar support. High-heeled shoes should be avoided.
