The Gold Standard in Hernia Surgery: Microdiscectomy

What is disk structure? How does a hernia occur?

Disk structures; They are tissues in the cartilage structure that are firmly attached between the spinal bones and help mobility while connecting the vertebrae on the one hand. It consists of two parts, the inner nucleus (nucleus pulposus), and the outer annulus fibrosus, which surrounds this nucleus and resembles an onion structure. When it weakens due to age and injuries, the part that is exposed to tears is the outer annulus fibrosus. The inner soft core structure moves towards the injured and torn annulus fibrosus and causes overflow by compressing the nerve sac. The slipping, sagging and cambering of the disc into the tears is known as herniated disc. Lumbar hernia can compress or damage the nerve roots that go to the leg and provide urine and stool output. In this case, pain radiating to one or both legs,

What tests can be requested in lumbar hernia?

If low back or leg pain does not go away despite all conservative treatments and complaints continue for 4-6 weeks or longer, physicians may refer to diagnostic methods such as plain radiographs, MRI or computed tomography to determine the source of the pain.

Gold Standard Microdiscectomy (lumbar hernia surgery)

Microdiscectomy is the most common treatment method used in herniated disc surgery. It is applied to relieve the pressure on the nerve root and relieve pain by removing herniated disc parts.

How is microdiscectomy performed?

It is a surgical method that is mostly performed under general anesthesia (the patient is put to sleep with drugs and is unconscious). In microdiscectomy, a smaller skin incision (1.5-2 cm) is made and the operation is started. By using special retractors, very little muscle tissue is stripped. With the help of imaging methods (Scopy), a smaller bone window is opened. Since these procedures are performed using microsurgical instruments and methods under a special operating microscope, the possibility of nerve and nerve membrane damage is very low. The hernia tissue pressing on the nerve root is cleaned. There is no need to use any substance to replace the removed disc tissue. After the surgery, patients have the chance to return to their work or daily life more quickly.

In which patients can microdiscectomy be applied?

It can be applied with high success rates to all patients with lumbar hernia who received conservative treatments such as rest, physical therapy, analgesic-anti-inflammatory therapy and epidural injections, but did not respond to the treatments, developed drop foot or had a cauda equina picture.

What is foot drop? Is it an emergency?

Under normal conditions, we can move our feet up and down from our ankles, but the sudden inability to move our feet from the ankle up (to our face) is called drop foot. The patient walks by dragging his foot. If this is due to herniated disc, it means that we need to have an emergency operation. It is very important to have surgery within the first 8 hours. Otherwise, or if it is delayed, the probability of recovery of ankle strength will decrease.

What is the Cauda Equina painting? Do you need surgery urgently?

Complaints and findings in cauda equina syndrome due to herniated disc; It manifests as sciatica-style leg pain (pain radiating from the waist to the leg), severe loss of muscle strength, marked numbness or inability to feel pain, loss of urine and stool control (defects in the sphincters), and sexual dysfunctions. There is sudden numbness around the breech. When this picture occurs, the patient should be operated URGENTLY. If surgery is not performed, these findings will persist in the patient permanently.

How many days do patients stay in the hospital?

One day of hospitalization is sufficient, they can return to their homes and normal daily lives after one day. Generally, after 6 hours, patients can get up and walk around and eat. The patient is given training for lying down and getting up to protect the back health. 1 week of rest is usually sufficient after surgery. With the microdisketomy method, patients can start their business life more quickly.

Related topic: Lumbar Disc Disease (Herniated Disc)

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