lumbar hernia
lumbar hernia is a very common disorder in our society, which is quite painful and the consequences
can be severe. The condition called lumbar hernia
, which is located between the back vertebrae
and whose purpose is to absorb the load on the body and to provide flexibility to the spine
, in other words, due to the deterioration of the discs over time
, the spinal cord is bulging or tearing into or out of the canal
.
is a clinical condition resulting from Causes of occurrence are usually multifactorial. In other words,
traumas, irregular postures, inappropriate movements, age-related and
many factors can be counted. Generally, it is more common between the ages of 30-50
, but it can also be seen in the 20s and over the age of 50. ·
When a hernia occurs, it shows its clinic with pain. This pain is radiating to the buttocks, thighs, legs
. Before the pain starts, numbness and tingling may occur in the hips and thighs
. The first finding that can be called a precursor to the hernia may be a change in the way and habit of urination
. The pain is usually excruciating
. ) is the case. · Low back pain should not always be considered in favor of herniated disc. Because
it should not be forgotten that only 1% of low back pains are herniated disc. · The most important feature of the pain that occurs as a result of herniated disc
is the spread to the buttocks and legs. These
pains can cause the person to gain a psychologically limited sensitive structure
that affects their social life. And these events cause the patient to gain weight and the picture becomes more
may cause aggravation. When the lumbar hernia extends into the canal
, it puts pressure on the spinal cord. And this pressure manifests itself as pain
due to the damage it causes to the nerve over time, a decrease in strength and loss of function occur in the muscles of the nerve
and the areas it stimulates.
. · Lumbar hernias are usually L4 in the lumbar region. And it occurs between L5 vertebrae or
between L5-S1 vertebrae. However, hernias
may also occur in other regions, even in more than one region. · There may be many
causes of low back pain. There are not only discs
in the lumbar region. There are structures surrounding that area such as muscles, bones, ligaments, and it should be noted that a significant portion of low back pain
is called mechanical low back pain.
· However, when low back pain occurs, the most important concern in our society is the fear of having a herniated disc
and the desire and desire to confirm this with expensive methods such as imaging and MRI
. Considering that 1% of low back pain is hernia
, it can be seen that the rate of hernia is low. In addition, examination is very important in the determination of lumbar
hernia and it is the most important diagnostic tool
in distinguishing hernia. · When low back pain occurs, lumbar hernia
should not be suspected in cases where there is no pain spreading to the legs, numbness and tingling
and there is no loss of strength. · In addition, lumbar hernia gives symptoms as a result of the pressure exerted by the cambered hernia on the spinal cord
. · Examination is the most important
diagnostic tool in the diagnosis of lumbar hernia. When the findings obtained as a result of the examination are necessary, visual methods such as computerized tomography, MR, medicated waist
film are used to determine the effects of the size of the hernia
. Medicated lumbar film
is an interventional method used to detect the nerve under pressure
as a result of drug administration into the spinal canal. Although the arrival of MR reduces the usability of this method
, it is sometimes necessary. The physician decides whether this is necessary
. If a hernia pressing on the spinal cord
is detected as a result of the examination and the examination results
or the methods performed to support the examination results, the treatment to be applied varies depending on the person, the examination findings, the size of the hernia
, and the condition of the hernia in the canal. Medication and physical therapy
may be used in patients who have pain
but do not affect their social life, the localization and location of the hernia is suitable
and there is no loss of strength. But this should not be forgotten. Due to the progression of the hernia over time
, it is possible that the clinical condition will suddenly worsen
and strength and sensory losses in the foot and leg
may occur, and this
situation requires an urgent operation and a condition called caudo-equina syndrome in medicine
arises. may cause it to pop. · Surgery is an inevitable treatment method for patients whose social life is affected and who have loss of sensation, strength and
reflexes. Because no medical treatment or method
can cause this hernia to be taken back. · Unfortunately, one of the methods applied by patients with low back pain
in our country is to have waist pulling procedure performed by people who are not medically inclined
. Underlying this effort
generally lies the sense of seeking a remedy. The sense of remedy
is the product of an insufficiently informed society. · Unfortunately, undesirable and more complex events may occur in the face of waist pulling events
. While seeking a cure
, it is important to act within the knowledge and recommendations of your doctor
. The surgical procedure is a really scary situation. However, using alternative treatment methods
to avoid it, which has severe consequences and ultimately complicates the surgical procedure
and surgical procedure. As a result, it should not be forgotten that there is a situation
that may reduce the benefit rate. · The aim of physical therapy programs is to strengthen the waist and abdominal muscles
and to increase the flexibility of tense nerves. However, it should not be forgotten that
should be done in place and on time. Because it should be known that the purpose
is definitely not to retract the hernia. The most important problem of patients with low-grade hernia
is that the discomforting pains occur with various positions and movements
and the possibility of having a really larger hernia in the future
is ultimately surgical. are in the candidate group for treatment. Physics
treatment programs can be applied to alleviate the pain of the patients in this group
and to stop the progression of the hernia. Physical therapy programs are also used for patients who have loss of strength before the surgery
to regain their old strength after the surgery
. . There are various
methods applied when a herniated disc is detected. These are the destruction of the disc with laser, removal of the disc with endoscopic methods
and open surgery. The first two groups of patients mentioned are both advantageous methods in terms of returning to active life after the procedure
and reducing the complications of post-procedure wound
infection
. ), an important problem is that recurrent hernia events can be seen more frequently
after these procedures, and the patients who can be applied for this group of procedures are selected patients
. That is, these methods cannot be applied to all herniated disc patients,
The patient’s age, clinic, weight, The current state of the spine, the location of the hernia should be suitable for this
hernia. Open surgery, on the other hand, is a superior method with low recurrence rates
as it allows the hernia to be seen directly
and evacuated almost completely. Likewise, the biggest fear of herniated disc patients is the same
fear of suffering, and this is a situation that disrupts their psychology. Today, patients are mobilized on the 1st day after the surgical
procedure. · It is a fact that there are some prejudices about the surgical procedure among the public
. Are these the definitive solution
? Is there a risk of stroke? Or if my hernia recurs. The developing brain and nerve
has succeeded in minimizing the problems that may arise in his surgeries
thanks to the technological developments he has taken behind his surgery. Considering that there are 5 hernia
regions in the waist region, there is always the possibility of hernia in other disc regions
that have not undergone hernia surgery. It should be known that the operation to be performed is performed only on the existing
hernia area and does not prevent other hernias. There may be complications after all
surgeries, as well as complications after herniated disc
surgeries. Paralysis, which is one of them
, can be a concept that can be thought of as theoretical
, but it is quite practical in practice. It is a rare complication. However, the fact that it is rare
does not mean that it will not happen. The benefit of lumbar hernia surgery
is compatible with the clinic of the person. In patients whose strength losses are not severe
, the rate of benefiting from the surgery is quite high. However, it is necessary to accept that nearly complete strength losses
that occur in patients who avoid surgery despite a long
loss of strength, are difficult to recover.
This loss of strength is not the result of the failure of the surgery, but the result of the patient not having the necessary procedure
done at the required time. · One of the mistakes made in our society is to reveal the failures of the procedures
, not the success rates, but not to take into account the structure of the patient when talking about them
. · It should not be forgotten that the purpose of medicine
is to use science to improve people’s quality of life and save life
. Doctors are the people who offer and use this information. · After the surgical procedure
, numbness and tingling may remain in the hips and legs. Such
complaints generally disappear 6-12 months after the operation. · A few months after the surgical procedure
, sometimes there is a recurrence of pain. This recurrence is due to adhesions
formed during the operation of the surgical field rather than the recurrence of hernia
. These adhesions are tried to be opened through physical therapy programs
. The aim is to increase the flexibility
ability of adhesions in that region. However, if the complaints do not decrease despite all the efforts
, a second operation may be required. However, recently it has been determined that some substances used during the operation
reduce the formation of these adhesions
. · After hernia surgery, the hernia may recur in the previously operated field
, although it is very rare. The reason for this may be a hernia that was not evacuated sufficiently before
. · It should not be forgotten that cases of herniated disc
are relieved to a great extent after surgery. · Patients who have had herniated disc surgery
have to protect themselves. And with various exercises, they have to strengthen their abdominal and waist
muscles and not gain weight. · If there is weight in patients whose hernia is not at the surgical level
but who suffers from pain, it should not be forgotten that reducing their weight to a weight appropriate for their height
may provide close to 50% relief in their complaints.
OP DR GÖKALP KARAARSLAN
