Surgical treatment of lumbar disc herniations

The spine   (or spine ) consists of 24 bones ( vertebrae ) stacked on top of each other.

Each vertebra is punctured at the back and all these holes form a canal (the spinal canal ).

The nerve fibers that transmit the movement orders sent by the brain to the different parts of the body circulate in this channel. In the lower back, at the level of the lumbar vertebrae , some of these fibers form what is called the ponytail . Over the years, the intervertebral disc   located between two vertebrae can be damaged.

If it overflows into the canal, it may compress a nerve where it comes out of the spine ( nerve root ) or the ponytail. It is called lumbar disc herniation. The compression of a nerve causes intense pain in the back, but also in the leg. If it is the sciatic nerve , you have pain in the back of the leg ( sciatica   or sciatica ). If it’s the crural nerve   which is compressed, the pains touch the front of the leg ( cruralgia ).

Sometimes the nerve does not transmit the information correctly.

You can not move parts of your body ( paralysis ), or you do not feel very well, as if you were anesthetized. If the nerves of the ponytail are affected, this can cause problems to urinate, impotence. This attack is called the horse tail syndrome . We must then intervene very quickly.Fortunately, it is extremely rare.

You are advised to rest and stay in bed for a while. Most often, medical treatment (drugs, physiotherapy …) is enough to suppress the pain attacks of sciatica or cruralgia.

If the pain persists, or you have signs of numbness or paralysis in certain areas of the body, your doctor may suggest an operation.

Depending on your case and the habits of your surgeon, he can operate in two ways:

– in a classic way, opening on your back for a few centimeters;

– by introducing fine instruments and a small camera by a few small openings. The doctor then operates by visualizing the inside of your body on a screen ( endoscopic technique ).

 During the operation, you sleep completely ( general anesthesia ).

The surgeon gently sets aside the nerve root to protect it.

If it accidentally hurts a nerve or the ponytail, this can cause insensitivity or paralysis.

He removes the hernia gradually, in several small pieces. If necessary to prevent the hernia from coming back quickly ( early recurrence ), the surgeon removes other pieces of the disc.

The operation usually lasts between 40 minutes to one hour.

Usually, the patient gets up the day after the operation. Sitting and standing positions are allowed from the first days, as long as you change positions regularly.

In general, you will return home four to five days after the procedure.

You return to work four to six weeks after the operation, or more if your profession requires a lot of physical effort.

Most often, sports activities are allowed after three months, but you have to be careful.

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