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Discectomy and Microdiscectomy Treatment for Disc Herniation

Most adults complain of back pain at least once in their lives. Although herniated disc is most common in adults between the ages of 30 and 60, it can occur at almost any age. Risk factors that may lead to a herniated disc are important, rather than a group where herniated discs are particularly common. Medicana Bahçelievler Hospital Brain and Nerve Surgery Specialist Op. Dr. Selçuk Gözcü gave information about their approach to herniated discs and risk factors. Kiss. Dr. Gözcü made statements about ‘Discectomy and Microdiscectomy Treatment’ in herniated disc.
Saying that discectomy is the most common surgical treatment used for herniated discs, Op. Dr. Gözcü said, ”Intervertebral discs are substances that are located between the bones of the spine and connect the vertebrae, and are tightly adhered to the vertebrae. Ruptures occur when the outer surface of the disc, called ‘anulusfibrosus’, weakens due to age and injuries. Slipping, sagging and bulging of the disc is called herniation. A bulging disc can compress or damage the nerve root, resulting in pain reflected in one or both legs, loss of strength and numbness depending on the nerve root or nerve roots it affects. Discectomy is performed to remove herniated disc fragments and damaged parts, thus relieving pressure on the nerve root and relieving pain. “If there are symptoms such as loss of strength in the feet or legs or urinary incontinence, these are situations that require urgent surgery,” he said.

”The probability of nerve damage with microdiscectomy is quite low”

Stating that microdiscectomy is performed with a smaller skin incision (1.5-2 cm) than open hernia surgery, Op. Dr. Gözcü said, ”Muscle tissue is stripped very little, less bone is removed. Since microdiscectomy is performed using a microscope and microsurgical instruments, the possibility of nerve damage is very low. After surgery, the patient returns to work more quickly. Not all patients with a herniated disc are candidates for open discectomy. Most people can experience pain relief with conservative treatments such as rest, physical therapy, analgesic-anti-inflammatory use, and epidural injections. However, sometimes pain does not respond to such treatments and surgical interventions may be required. If lower back or leg pain does not respond to conservative treatments and persists for 4-6 weeks or longer, physicians may order diagnostic tests to identify the source of the pain. If the diagnosis of disc herniation is confirmed, open discectomy or microdiscectomy may be recommended. Some disc herniations can be removed endoscopically, through a smaller incision, under local anesthesia using special tools. However, open discectomy or microdiscectomy is still considered the ‘gold standard’ for the surgical treatment of disc herniation, as it can cause a lot of pain and weakness as a result of disc protrusion or rupture of the disc. “Open discectomy allows the surgeon to see and explore the surgical area in the best way,” he said.

Condition of patients after surgery

Informing patients about what awaits them after surgery, Op. Dr. Gözcü said, ”After the surgery, you may feel slight pain in the surgery area. Your doctor can arrange pain management to ease your post-operative period. You will learn deep breathing techniques and you will be asked to cough to remove any secretions from your lungs that may occur due to general anesthesia. “You can walk 6 hours after the anesthesia wears off,” he said.

”Do not drive without a doctor’s permission”

Op. warns against driving without a doctor’s permission. Dr. Gözcü said, ”In the first 4 weeks after surgery, some restrictions may be imposed, such as not sitting for long periods of time, not lifting objects weighing more than 5 kilograms, and not bending or stretching excessively. Also, you should not try to drive until your doctor gives permission. Walking is the first physical activity you will try. Walking will reduce the risk of tissue wounds in the surgery area and will also allow the spine to maintain its mobility. You may also be allowed to cycle and swim within a few weeks. Proper physical therapy can maximize your recovery. Those who work in professions that do not require physical exertion can return to work in 2-4 weeks or less. Those who work in professions that involve heavy lifting or controlling high-vibration machines may have to wait 6-8 weeks after surgery before they can return. “Physical therapy plays a big role in your recovery,” he said.

Success status of discectomy treatment

Evaluating the success of discectomy treatment, Op. Dr. Gözcü said, ”Medical studies have shown that there is an 80-90 percent success rate in cases requiring open discectomy treatment. This rate is slightly higher in microdiscectomy. According to studies, those with radicular pain (this is pain radiating down the legs) benefited more than those who had an open discectomy for lower back pain. To increase effectiveness, open discectomy is suitable for people who experience persistent, severe hip and leg pain or weakness. “If your back or leg pain is not at this level, open discectomy may not be a recommendable method for you, then you may be better with conservative treatments or less invasive therapies,” he said.

Source: zafergazetesi

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