When a lumbar disc herniation develops, low back pain and pain in the lower back appear. This pain, in turn, radiates to other areas such as sciatica, spreading according to which root or nerve is compressed.
Although it generally improves after a more conservative treatment based on taking anti-inflammatories and analgesics, rest and injections, in some cases – between 5 and 10%, surgery is necessary.
In any case, surgery is the last resort to treat a herniated disc, something that is only recommended if, after 8 weeks of conservative treatment, the patient cannot tolerate the pain or loses strength and sphincter control. In the following FastlyHealarticle we will explain everything about the herniated disc operation: recovery and risks .
Herniated disc operation: different techniques
Depending on the condition and the specific case, the herniated disc operation can be done with different techniques. The 4 most used techniques are the following:
- Discectomy : it is the most used and the most effective for most patients, it consists of removing part or all of the herniated disc.
- Foraminotomy : it involves widening, using surgical methods, the opening of the back where the affected nerve root exits the spine.
- Laminectomy : it consists of, once reached the herniated disc and the nerve root, widening the space between the two sheets of the vertebrae that are juxtaposed. In this way, by expanding the space between the two, the nerve root is decompressed and symptoms are improved.
- Vertebral arthrodesis : by means of this technique, the fixation of two vertebrae is achieved, either by placing a bone graft or some plates. If there is only a herniated disc, it is not too common, it is usually performed in those patients who also have scoliosis .
How is the herniated disc operation
Whichever technique is used, the main objective of the herniated disc operation is to free the nerve root that is compressed by the disc, which causes the painful symptoms. For this, depending on the type of injury and the characteristics of each patient, one method or another will be used.
Herniated disc surgery should only be performed after all non-invasive healing or relief options have been exhausted. First, a conservative treatment should be chosen , with drugs and rest, to see if the patient can continue with his normal life. In the event that it lasts for a long time and at the risk of becoming chronic, the operation can already be considered.
The most effective option and with the best results is to perform a discectomy, that is, to remove the herniated disc. It consists of an incision that does not exceed 6 centimeters through which the hernia is removed and a resection of an area of the disc is associated to prevent it from occurring again. However, if the patient already suffered from lumbar pain and back problems before the hernia appeared, other techniques are usually chosen, especially vertebral arthrodesis.
Since the patient already had a previous history of lumbar pain before the appearance of the hernia, in addition to decompressing the nerve root, what is done in this operation is to fuse two vertebrae -with plates, bars or screws-, so that suppress movement and end pain. The success rate in this type of operation is around 80%, however, it can lead to the adjacent disc segments accelerating their degeneration.
Risks of herniated disc operation
Any operation, however simple and easy it may seem, always carries certain risks. These inescapable and somewhat unpredictable risks after any operation are mainly infection and bleeding .
Despite this, in the first intervertebral disc operations, the cases of hemorrhage or infection do not reach 1%, a very low rate. However, it should be noted that if the patient has already undergone an operation of this type or is an elderly person, these complications are more common. Like any surgery, the herniated disc operation depends on the general health of the patient, systemic diseases, heart, lung or metabolic problems can make the operation impossible or lead to serious complications.
The main risk associated with this type of operation is post-surgical fibrosis . When there is an injury or a cut, the body responds by repairing that tissue. With post-surgical fibrosis we refer to those cases that react with an excess of scarring, creating more fibrous tissue than recommended and necessary. The risk after a herniated disc operation is that excessive scarring can compress the nerve again, causing pain to the patient.
If the arthroplasia technique is used, one must be very careful with the nervous plexus and the large vessels located in front of the spine, as there is a risk of causing retrograde ejaculation .
Beyond this, the risk for the most important herniated disc operation is that the surgery does not give the expected results . In recent years, medical knowledge about this condition has improved greatly, and it has been observed that the greater the number of patients who undergo surgery, the higher the failure rate. Now we know that the filter to pass an operation must be very strict, operating only those essential cases.
Postoperative disc herniation
After the operation, the patient must remain hospitalized for 1 to 3 days, depending on his evolution and recovery. As a general rule, the next day you will be able to get out of bed and the goal is that by the time you are discharged you will be able to do it on your own and walk without help.
The following week, depending on the evolution of each patient, he should keep relative rest . Get up from the house and do small actions but without going back to the usual routine. When the doctor deems it appropriate, you will be able to go out, of course, you should not bend your hips for at least the first 4 weeks.
The rehabilitation exercises are an essential part of recovery after an operation of herniated disc, they depend largely on the success or failure of the intervention. Physiotherapists and other specialists will design a specific routine to strengthen and compensate for body changes that, if done correctly and with proper technique, gives satisfactory results in about 90% of cases. If you want to speed up recovery, in addition to physical therapy exercises, it is highly recommended to exercise in the pool to strengthen the muscles of the back without the spine having to overexert or carry weight.
It is important that you know that after a herniated disc operation, especially if you already had pain before the appearance of the hernia, the lumbar discomfort may not disappear completely. This is because the herniated disc appears when there is wear and tear and degeneration in the discs, a degeneration that even with surgery can not be stopped.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
If you want to read more articles similar to Herniated Disc Operation: Recovery and Risks , we recommend that you enter our Bones, Joints and Muscles category .
I am a Surgeon with a diploma in comprehensive ultrasound and surgical care residency, an area I am specializing in. During the exercise of my profession, I have realized the need for patients to know the diseases they suffer, and I can tell you that a large part of their complications is due to a lack of information. Being a health web writer allows me to transmit my experience, without borders, to all those readers eager for knowledge, educate them in the prevention of diseases and promote a healthy lifestyle.