Disc Herniation Surgery

Disc Herniation: How and Why Does it Form?

Intervertebral discs are cushions separating vertebrae, acting as shock absorbers. They consist of a circular ring (the annulus fibrosus) surrounding a gelatinous nucleus (the nucleus pulposus).

A disc herniation occurs when, for various reasons, the nucleus pulposus's internal pressure is too high, the annulus fibrosus ruptures, and part of the nucleus herniates.

Herniation risk increases not only due to tissue aging but also conditions accelerating its degeneration (poor posture, strenuous work or sports, trauma, etc.).

What Does the Intervention to Treat Disc Herniation Involve?

Interventions reduce the impact on bone, muscle structures, and the annulus fibrosus. This intervention is indicated:

• After conservative therapies fail (medication, rehabilitation, osteopathy, ultrasound) and associated symptoms last over six weeks.
• After assessing progressive sensorimotor deficits.

Surgical treatment is essential for:

• Cauda equina syndrome, where compression affects a nerve bundle crucial for lower limb function.
• Sudden muscle paresis or severe motor deficits.

Procedure for Disc Herniation Surgery

Is Disc Herniation Surgery a Safe Procedure?

Disc herniation surgery is now a safe, short procedure (20-40 minutes), with minimal complications when performed by experienced surgeons. Thousands of patients undergo this surgery daily with excellent results. It involves removing herniated tissue compressing the nerve root or dural sac.

Previously, surgeons believed significant vertebral bone tissue removal was necessary. Now, minimal bone and ligament removal is possible, preserving lumbar spine stability and minimizing future lumbago or other complications.

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Disc Herniation Surgery Step by Step

A small skin incision is made posteriorly in the midline at the affected intervertebral space (a brilliance amplifier is sometimes used). Once the vertebral plane is reached, the surgeon destabilizes the spine and accesses the blocked nerve root.

Next, the dural sac is mobilized to highlight the conflict, and the root is delicately released. Once the herniation is identified, it's removed via microdiscectomy (always under a microscope).

Disc Herniation Surgery: Postoperative Follow-up

Radicular pain usually disappears immediately. Other symptom regression isn't always immediate and occurs gradually. Motility improves in the first few days, while sensory disorders recover last. Radicular pain disappears in over 95% of cases, while lumbar pain improvement is less favorable. Motor recovery is generally good. Pain 3-5 days post-surgery is usually due to temporary inflammation and regresses with corticotherapy. Cauda equina compression and motor deficit cases require separate consideration, with slower recovery.

Postoperative Monitoring and Rehabilitation

Post-surgery, the patient is monitored for area stabilization. This involves a program of examinations and diagnostic tests. Rehabilitation, starting 12-14 weeks post-operation, is crucial. Return to work is typically within 2-4 weeks.

Rehabilitation aims to:

• Accelerate symptom resolution, particularly pain.
• Promote functional recovery and professional reintegration.
• Avoid or limit symptom chronicity.
• Prevent complications and relapses.

Prevention of Disc Herniation

Prevention is essential. While disc herniations often have a genetic component, preventive measures help. Maintaining a healthy lifestyle is crucial.

This includes moderate and regular exercise, maintaining a normal weight, a balanced diet, and avoiding strenuous activities or heavy lifting. Good posture helps avoid spine changes leading to herniation.

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