Operation to remove a hernia of the lumbar spine

Removal of a herniated lumbar spine - a description of the operation

A healthy musculoskeletal system is one of the main aspects of a full-fledged vital activity. The pathological lesion of this department is considered one of the serious diseases requiring urgent surgical intervention.

The main worrying symptom is increased pain in the lumbar region, which is almost impossible to eliminate with pain medication.

The course of the illness is complicated by the duration of the pain syndrome, which is supported by additional signs in the form of painful movement, numbness of limbs, problems with internal organs.

Therefore, the earlier a patient resorts to qualified care, the more favorable it is for a prognosis for a quick recovery.

It is not uncommon for a patient to follow exactly all the recommendations that the prescribing physician prescribed (medication therapy, physiotherapy, physiotherapy), but no positive results are observed and the pain does not subside.

On the contrary, the patient may experience complications in the form of paralysis of the legs and a painful syndrome that extends to the hip area.

Operation to remove a hernia of the lumbar spine

Indication for the operation

Herniation of the lumbar spine can lead to serious complications, which in the future will affect the quality of life. In this case, absolute indications for the surgical procedure are:

• erectile disfunction;
• problems with the normal functioning of the pelvic organs;
• atrophied muscles of the lower extremities;
• prolapse of the pulpous nucleus;
• increased pain syndrome over a long period of time, which is not eliminated with pain medication.

What is a herniated intervertebral disc

Features of surgical treatment

A patient suffering from a hernia of the lumbar region should be aware that the operation performed to remove her, does not guarantee a full one hundred percent recovery.

After surgical treatment, the clinical picture can not only change for the better, but also worsen complications and subsequent relapses.

A quick recovery will depend on the rehabilitation and fulfillment of all the prescriptions of the attending physician.

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When performing surgery, the patient should remember several aspects that will help successfully cure the ailment:

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1. Immediately before the operation, the patient must make an MRI mandatory and give a number of special tests.
2. The hernia of the lumbar department has its own peculiarities, therefore, to solve it, the doctor individually must choose the type of surgical treatment.
3. To prevent a possible complication in the form of infection, after the completion of the surgical procedure, antibiotic therapy is performed.
4. After the operation, the patient should remember a long period of rehabilitation, which can not be completed prematurely. It should include exercise therapy, the use of special corsets or other orthopedic adaptations, physiotherapy.

Operation with a Diascope

Types of surgical treatment

After the patient has undergone all necessary examinations and tests, the doctor decides on the choice of surgical treatment.

The choice of the method is based on the localization of the pathological process, additional complicating symptoms and the general condition of the patient at the time of the examination.

There are several radical methods that can eliminate the hernia of the lumbar spine.

Type of radical treatment

Endoscopic	This surgical procedure involves carrying out under local anesthesia. After anesthetizing the operated site, an endoscope is inserted through a small incision to the patient disk. In parallel, all the actions that are performed during the operation are displayed on the monitor. Among the advantages of the endoscopic method are the following: minimal trauma; rehabilitation that does not require a long time; minimal possible complications. The patient goes home after the surgery on the third day, and the physical working capacity is restored in a month and a half
Microsurgical	If for any reason it is impossible to apply the endoscopic method, then doctors use a microscopic method. The procedure is carried out with the aid of several incisions. Due to the operating microscope, an internal review of the patient site takes place. Main advantages: minimal risk of damage to nerve endings, which is important; the probability of an inflammatory process after surgery is minimized. The patient is discharged three days after surgery
The method of laser vaporization	A rather complicated procedure involving the introduction of a special thin needle is a diseased disk through which the flow of energy passes. Thus, the pressure inside the disk decreases due to the evaporation of the liquid present in it. This operation is indicated if the patient does not have sequestration with a hamstring of the diseased intervertebral disc. The advantages of laser vaporization are as follows: surgical intervention duration per hour; minimal possible complications; The absence of scars after the operation
Cold-plasma nucleoplasty	By means of a cold plasma, the hernial tissue is removed, which promotes the development of a hernia. Cold plasma is introduced into the area of ​​the lesion through a special thin needle. The destruction of hernial cells occurs due to low temperatures. This manipulation is one of the fastest operations, which takes no more than half an hour, while painful feelings, disturbing the patient for a long period of time, disappear instantly upon completion manipulation. Despite fast carrying out and high efficiency of a method, there is a unique minus - possible relapses
Hydrophlastics	If the patient is diagnosed with a hernia no more than six millimeters, the specialist recommends conducting hydroplastic. It is compulsory to perform this procedure if the painful syndrome begins to affect the lower limbs. The essence of the therapeutic manipulation is to lead into the cavity of the affected cannula disc, for this it is necessary to perform a small puncture. Then, using saline solution, the pathological cells of the hernia are washed out. It is significant that the method is slightly traumatic and is able to improve the cushioning of the intervertebral disc, which deteriorates significantly in the presence of hernial formation
Laser reconstruction	The operation involves inserting a needle with a laser LED into the diseased area. Thus, the hernial cells are dried. This operation is allowed if the hernia diameter does not exceed six millimeters. Pros of the method: no scarring after the intervention; minimal risk of complications; The therapeutic manipulation is not traumatic
Open surgery	The method is distinguished by the lack of use of devices that affect the diseased area. That is, the operation is performed directly by the surgeon. The peculiarity of such surgical treatment is that after it there are no relapses, since all hernial tissue is removed

- Microsurgical removal of a herniated intervertebral disk in the lumbar spine

Possible complications

The main modern methods of surgical treatment are considered to be effective enough to eliminate lumbar hernia.

After all, medical statistics show relapses in only 5% of patients after the surgery.

But, at times operative treatment is not able to completely eliminate the problem and entails a number of consequences:

• the resumption of a hernia is one of the most common complications;
• after the intervention, pathological lesions of the nerve roots can be observed;
• after a certain method of surgical treatment there are scars and adhesions, which in the future not only discomfort, but also painful sensations;
• allergic reactions due to intolerance to the body of a drug;
• inflammatory process or purulent formation at the site of surgical manipulation.

Formation of a herniated intervertebral disc

How Rehabilitation Works

The result of recovery will depend directly on the rehabilitation period and following all the prescriptions. It is very important to follow the following recommendations:

1. Two weeks of the patient should be in complete tranquility, and avoid any physical exertion.
2. Minimize the sitting position to exclude a heavy load on the spine and discs.
3. Do not apply massage or other similar techniques.
4. For several months, use a medical corset.
5. Often change the position and posture of the body.
6. To restore the mobility of the spine, therapeutic exercise is shown.

A source: https://med-explorer.ru/ortopediya/lechenie-spiny/operaciya-po-udaleniyu-gryzhi-poyasnichnogo-otdela-pozvonochnika.html

Operation to remove a hernia of the lumbar spine

Hernia of the lumbosacral spine is a serious disease characterized by severe pain.

Unpleasant sensations can not pass for weeks, they practically do not give in to anesthetizing.

Any movement is difficult for the patient, in especially neglected cases paralysis of the extremities and disorders of the internal organs can occur. Under such conditions, it is not necessary to talk about normal vital activity at all.

When conservative methods of treatment fail, the operation becomes inevitable: for the patient this is the only way to solve the problem.

In what cases is surgical intervention prescribed

Treatment of intervertebral hernia can be carried out both conservative and surgical methods. The operation is appointed only if there is appropriate evidence for this.

The latter are divided into two types: absolute and relative. In the first case, you can not refuse the removal, otherwise it will lead to a fatal outcome.

Absolute indications include:

1. An unbearable pain lasting more than six months. It does not help to remove any medications;
2. The presence of serious complications from the internal organs (for example, urinary or fecal incontinence);
3. Paralysis, atrophy of limbs;
4. Lowering of the lumbar vertebrae.

There are also relative indications, in the presence of which the patient can refuse the help of a surgeon, if he believes that it is not needed, and wait:

1. Pain is present, but the patient is able to tolerate it;
2. There are limb disorders in the limbs, but they are insignificant, for example, foot paralysis;
3. Muscular tissue atrophied only partially;
4. The patient has undergone conservative treatment for the past three months, but it has not brought any results.

Surgery to remove the intervertebral hernia in many cases is the only way to relieve a person of pain and return him to a full life.

What you need to know about surgical intervention

The decision that removal of the hernia of the spine is necessary, should be taken slowly and in a balanced manner. It is recommended to use conservative methods for at least one and a half months.

Only if medical treatment in combination with physiotherapy and physiotherapy exercises does not have any effect, the patient is assigned a surgical intervention.

Deciding on the operation, the patient must understand three important points:

1. The surgical way does not give a 100% guarantee of recovery;
2. The operation is followed by rehabilitation, in which he must actively participate;
3. Relapses and negative consequences are possible.

The operation to remove the hernia of the spine will be successful if several requirements are met:

1. Surgical intervention should be preceded by research on a computer (or magnetic resonance) tomograph, the surrender of all tests, consultation with other doctors, including an anesthesiologist;
2. Different types of operations are suitable for different types of hernia. Of great importance are factors such as size, position, etc .;
3. After the surgical treatment, antibacterial therapy is necessary: ​​only in this case complications can be avoided;
4. Rehabilitation of the patient does not end with the removal of stitches. For a long period after it, you need to wear special corsets, do the right physical exercises, go to a doctor for advice.

Many patients wonder about the cost of surgical removal of the lumbosacral spine. It is definitely impossible to answer this question.

The price is determined individually for each case and depends on the complexity of the situation, the need to install an implant, the characteristics of the rehabilitation period and much more.

It can vary from 15 000 to 200 000 rubles.

Removal of the intervertebral hernia: different types of operations

There are different types of surgical intervention, allowing you to remove the hernia of the spine. Each of them has both advantages and disadvantages.

The choice of a particular type is determined by various factors: the history of the disease, the characteristics of the diagnosis, the wishes of the patient himself and his financial capabilities.

1. Endoscopic operation This form of surgery allows you to get by with "little blood". Using an endoscope, the doctor makes a cut with a diameter of not more than 5 mm. Removal of a hernia and sequestrum is made by thin instruments, the enlarged image is broadcast on a special screen. The advantages of this procedure are obvious: it is bloodless, surrounding tissues are not damaged, the patient can be discharged the next day, and the recovery period lasts only three weeks.

   However, there are also disadvantages: with the help of endoscopic intervention, it is not possible to remove any kind of hernia, and the risk of relapse is 10% (this is quite a lot).

   Special anesthesia is required, which implies thorough preparation.

   If it is done incorrectly, the patient will have a complication in the form of headaches.

2. Laser discoplasty This operation can mean both the restoration of the damaged disc and the removal of the intervertebral hernia. This procedure is indicated only for diseases without complications. It has a number of advantages: a fast recovery period, low traumatism, a minimum of time in the hospital (about 2 days). The structure of the disc is practically unchanged, the mobility of the spine is preserved.

   Minus laser treatment - the limitation of its action. It is not used in the presence of inflammation, and for those patients who have already performed operations on the spine. The structure of the disk is not restored, so the result can not be called 100%.

1. LaminectomyThis is the removal of that part of the vertebra, to which the hernia presses the nerve root. It can be done both under general and under local anesthesia. The key advantages of the procedure are that it alleviates pain almost immediately and allows the patient to leave the hospital in three days.

   This operation to remove the hernia of the spine has also disadvantages: it implies a large incision (up to 10 cm), which heals for a long time and can bleed. In addition, there is a risk of damage to the nerve, which can lead to paralysis of the limbs.

2. MicrodiscectomyThis is the most modern type of surgical intervention to date. Using a powerful microscope and special tools, the doctor penetrates the lumbosacral region through a 3-4 cm incision and removes the core, leading to deformation of the disc. To restore the disc itself, laser irradiation is used. All manipulations must be done under general anesthesia.

   This removal of the intervertebral hernia has its advantages: a short period of rehabilitation, a quick discharge from the hospital and a momentary pain relief. Its disadvantages are high probability of relapses (up to 15%) and high cost (this procedure costs from 70 000 rubles).

Postoperative complications

Lying on the operating table, the patient should understand that surgical intervention can have unpleasant consequences - various complications.

They can occur both during the operation and after it.

All adverse events that occur during surgical treatment are associated with insufficient qualification of medical personnel or poor-quality equipment. It can be:

1. Damage to the root of the nerve leading to paralysis of the limbs;
2. Damage to the hard shell of the spinal cord. In this case, rehabilitation will be associated with severe headaches. They will pass by themselves, when the shell will heal.

Adverse events in the post-operation period are associated with non-compliance with the prescriptions of the doctor. These include:

1. The onset of thromboembolism;
2. Allergic reactions to suture materials;
3. Local purulent formations: epiduritis, osteomyelitis;
4. Recurrent lumbar hernia;
5. The appearance of scars and adhesions, infringing the nerve endings (this leads to discomfort and pain).

For an operation to remove the intervertebral hernia did not cause complications and relapses, one should only apply to to qualified specialists, to fulfill all their instructions and recommendations, to do special gymnastics in the rehabilitation period.

• All means have been tried, and nothing has helped?
• Are you in constant pain?
• And now you are ready to take advantage of any opportunity that will give you the long-awaited well-being!

A source: http://lechuspinu.ru/gryzha/operaciya-po-udaleniyu-gryzhi-poyasnichnogo-otdela-pozvonochnika.html

Surgery to remove the hernia of the lumbar-sacral spine

The operation to remove the hernia of the lumbar spine can be carried out by various methods. Below we will consider some of the types of surgical intervention that are used in the treatment of the lumbosacral spine.

Types of surgical intervention

If there is an intervertebral hernia of the lumbar spine, the following types of surgical operations are used:

1. 1Nucleoplasty through the skin.
2. 2Discectomy with an endoscope.
3. 3Laminectomy is a classic operation using standard surgical equipment.
4. 4 Microcidectomy - is performed with the use of microsurgical instruments.
5. 5Cathering of the epidural.
6. 6 Laser operation.

The first two types of surgical intervention are minimally invasive. With a small surgical manipulation, the debris of the disc is removed and the spinal canal of the spine is released. Such operations are done with the help of a needle or with the use of a special apparatus - an endoscope.

The following two types of surgical intervention are traditional, with the use of standard equipment.

Epidural catheterization is performed without the use of surgical instruments and is something between conservative methods of treatment and surgery. With this method, the directed flow of medications is delivered to the affected areas of the vertebra.

Hernia of the lumbar region can be removed by electromagnetic radiation.For this, lasers are used. This technique is called laser vaporization. Laser can restore the integrity of disks.

Effective techniques of surgery

In most clinics to date, the following types of surgical intervention are used:

1. 1 Endoscopic microdiscectomy is made to a patient under local anesthesia. To carry it out, a special apparatus, an endoscope, is used. Its diameter is 4 mm. The patient is given a small cut (no more than, cm) in the area of ​​the hernia found on the spine. Then an endoscope is inserted into this hole, through which everything is projected onto the screen, and surgeons see the place of the future operation. Therefore, the removal of the lumbar hernia and all the remains of the core of the damaged disc is not particularly complicated. Often this type of operation is completed by laser treatment of the operated zone - this accelerates wound healing. This technique reduces the patient's incapacity for work several times. The patients are discharged for 1-3 days. Already on the second day the patient can engage in any activity, avoiding physical exertion. A person can start full-fledged activity after 1-2 months.
2. 2Nukleoplastika through the skin is considered a minimally invasive method of treatment. This reduces the protrusion of intervertebral discs. This operation is carried out in the event that the damage does not exceed 5 mm in size and the fibrous ring is not affected. Some part of the pulp core is removed, which ensures decompression. For this, a low-temperature plasma is applied to the hernia with a special device mounted in a thin needle. The temperature of the plasma cloud reaches 600 ° C. This technique is called coblation or cold plasma surgery. The procedure lasts about half an hour. The patient goes home 3 hours after such an operation.
3. Another method is the destruction of the facet nerve. When it is used, it affects the pain receptors of the intervertebral joints. This operation is good for arthrosis. A special blockade of nerve fibers is made. If everything is in order, then the faceted nerves are removed. To do this, use a special radio frequency device - a probe that "turns off" the nerve receptors. The operation is done under local anesthesia. The duration of the procedure is about half an hour, the radio-frequency probe works no more than 120 seconds. An hour after such surgery, the patient returns home.

Laser treatment

The use of sources of coherent radiation - quantum generators (lasers) - is made as follows:

1. 1Laser vaporization can eliminate hernia by exposing the light beam to discs. In this case, the body of the hernia collapses and all remains of inflamed tissues evaporate. There is a decrease in pressure on the disk in a volume of 25-30%. This operation is used to treat patients aged 20 to 52 years at an early stage of the disease with a disc protrusion size not exceeding 6 mm. The procedure lasts from 20 to 30 minutes. The patient is in the hospital for about 2 hours. The laser along with the treatment also has a preventive effect: the disc is not displaced under the influence of light. And this prevents the further development of a hernia.
2. 2Laser reconstruction of disks is directly the opposite method of vaporization, since here the quantum generator is used not for tissue destruction, but for their reconstruction. Under the influence of light irradiation, the disk warms up, and the growth of cartilaginous structures is activated, which restores the disc itself. This process takes place from 3 months to 6 months, and after that cartilage cells fill all the cracks in the disk and restore it on their own. In this case, the patient's pain disappears, and the functioning of the spine normalizes. The former mobility returns to the person. The very procedure for introducing the laser beam into diseased regions is carried out by needle puncture. The operation and postoperative rehabilitation take 48-72 hours in the hospital. After that, the recovery of the disc takes nature. Usually in 9-12 months from a hernia there is also no trace. This operation is done separately or with the removal of a hernia to prevent relapse of the disease.

All the above surgical procedures for hernia in the lumbar region are used in modern medicine.

Practically 90% of patients recover completely.

A source: http://LechenieGryzhi.ru/operaciya-po-udaleniyu-gryzhi-poyasnichnogo-otdela-pozvonochnika/

Operation to remove a hernia of the lumbar spine

The intervertebral hernia is completely curable. The operation to remove it is the most extreme measure. Methods of surgical treatment are several, so it is worth talking about them in detail.

When an operation is needed

The intervertebral disc is a "padding" between the vertebrae, consisting of a fibrous ring (hard shell) and a pulpous core (liquid "filling" of the disc).

To damage the fibrous ring, a lot is not necessary - sometimes it is enough to bend down incorrectly. Through the crack, a pulpous nucleus emerges outward, pinching the nerve endings. This is the cause of pain and bulging disc.

This often happens with a hernia in the lumbar region. Modern surgical methods allow you to return to normal life without back pain in a couple of days.

Varieties of operations

Today, the following surgical methods cope with intervertebral hernia:

Laminectomy

The most applicable for diseases with complications in the form of osteophytes and with large neoplasms. The essence of the operation is to release the compressed fragments by splitting the disc (partial) or sequestering its arch. The price of a laminectomy starts from 25 thousand. R.

Endoscopy

Appointed in the following cases:

1. with rapidly progressing hernia and unstable condition of the patient;
2. with the root syndrome, which is actively progressing;
3. if the hernia is in the foramen lumbar region or posterolateral.

Contraindicated in tumors and infections, with medial protrusion and with a narrowed vertebral canal.

The endoscope is inserted through a hole a couple of centimeters, the instruments for operation are miniature. All this makes endoscopy minimally traumatic. The price in Russia is about 130 thousand. rubles, in Germany - from 5000 thousand. Euro.

Microdiscectomy

The gold standard for surgical treatment of hernias. It is prescribed if the hernia has produced many side effects, among which:

1. permanent lumbulgia;
2. weakness and atrophy of muscles;
3. sexual dysfunction;
4. constipation and impaired kidney function.

During surgery, the surgeon removes a piece of bone tissue of the vertebra, located above the nerve, or part of the intervertebral disc itself, which helps stop the squeezing. Carried out as follows:

1. First, a special crochet lifts the muscle, which straightens the back;
2. above the nerve roots, the membrane is removed, so that access to the spinal column is possible;
3. The surgeon can also remove a small part of the inner surface of the facet joint;
4. The nerve root is shifted to one side and the tissues of the intervertebral disc are removed from under it.

It is considered the most effective method of fighting protrusions. The price in Russia is from 20 thousand. R.

Laser removal

Also called "drying". A damaged disc is irradiated here by a laser, which reduces the hernia. Suitable for young patients (up to 50-52 years). The price in Germany is from 5000 euros, in Russia - up to 80 thousand. R.

It is also possible laser reconstruction, in which the disk heats up and activates the metabolic processes in it. Thanks to this, new cartilaginous cells fill the cracks in the disc.

It is performed by puncture with a special needle.

Destruction of the facet nerve

The most effective if you have facet syndrome and arthrosis of intervertebral discs. With it, pain receptors are inactivated. A radio frequency probe is used for the test. It is brought to the nerve and inactivation of pain receptors is carried out there. The cost of the operation - from 17 thousand. R.

How to prepare for an operation

Preparing for an operation to remove a hernia does not represent anything complicated:

• in the first place, you should undergo MRI of the spine (or CT);
• to pass tests of urine and blood;
• before the operation can not be 8 hours there;
• need an examination and anesthesia survey.

Complications

With modern surgical methods of removing hernias, they rarely occur. Nevertheless, sometimes there are some phenomena:

• Sometimes the shell of the spinal cord breaks or the cerebrospinal brain substance flows. The risk of such complications is up to 2%. They do not bring any particular harm, they do not affect the outcome of the operations, but if this happens, you need to spend a day or two in bed rest and lying on your back after the operation to heal the rupture;
• damage to the nerve root;
• infection;
• incontinence of feces or urine.

Rehabilitation after surgery

The main task after the operation is to restore the muscular corset of the back. In the first 14 days you need to eliminate all pain and swelling. The first day may require bed rest. Further, medications that relieve pain are used. Perhaps you will be prescribed an orthopedic corset.

Next, physiotherapy (ultrasound, electrotherapy and laser) will be needed. In addition, in two weeks after the operation will need a therapeutic massage.

All this is necessary to quickly restore blood circulation in the spine and to improve the elasticity of the back muscles and increase their tone.

In 20 days after the operation, you can start physical therapy (appointed as a doctor, the task is the same as in physiotherapy and massage). In a month you can practice special simulators. During the restoration it is forbidden:

• move without corset;
• to raise more than two kg (for three months);
• Tilt to the sides or forward, twist, do sharp movements with a large amplitude;
• engage in osteopathic treatment;
• two weeks can not sit.

Surgery to remove a hernia is the most extreme measure. But if all other methods do not save you from pain, it is necessary.

About the operation you can learn from this video.

How is the operation to remove the lumbar spine? Link to the main publication

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Surgery to remove the lumbar intervertebral hernia

The operation to remove the intervertebral hernia of the lumbar region, is indicated with the risk of rupture of the spinal disc. As a consequence, a hernia is formed.

This pathology is widespread, because the human spine column is the largest share of possible loads. Pains sometimes pester the patient for weeks and are almost not stopped by medications.

What kind of quality of life can you say in such circumstances? If traditional medicine is ineffective, doctors raise the question of surgery: for the patient this is the only way to solve the problem.

And rehabilitation after removal of the intervertebral hernia is important not less than the operation itself.

Indication for the operation

Intervertebral hernia therapy provides both medicamental and surgical possibilities. Surgical intervention is carried out only with the necessary indications: absolute and relative.

Absolute readings

This is the case when you can not refuse the operation - the refusal is fraught with a fatal outcome. Absolute indications include severe pain, persecuting the patient for six months or more. They are not able to absorb even potent painkillers.

Surgical intervention is indicated with sequestered hernia (the last stage of its development). In this phase of the pathology, the dropped hernia squeezes the roots of the nerves, causing acute pain. From the waist region, it moves in the leg. Without surgery, the sequestered hernia can provoke paralysis.

Absolute indications are loss of susceptibility of the lower extremities.

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This symptom of a lumbar hernia indicates paresis - damage to the fibers of the nerves, leading to disturbances in the activity of the nervous system.

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Without radical measures paresis after a month after the appearance of the first signs will cause irreversible muscle atrophy.

Obligatory operation requires a hernia of considerable size, compressing the end of the nerve roots. This is the syndrome of the horse's tail - so dubbed such a medical condition. It negatively affects the processes of urination and emptying of the intestine, men suffer from erectile dysfunction.

Relative readings

With relative indications for surgery, the patient may find it unnecessary. This is possible if the patient recognizes the pain symptoms tolerant, and the muscles atrophy slightly. The operation can be postponed with small negative changes in the performance of the limbs.

Ineffective drug therapy for three months is also referred to relative indications. Nevertheless, the removal of the intervertebral hernia of the lumbar region is often the only chance to protect the patient from painful pains and improve the quality of his life.

Types of surgical intervention

The method of carrying out the operation, the specialist determines, based on the capacity of the medical institution, the medical indications and preferences of the patient. In the treatment of the intervertebral lumbar hernia, several radical methods are used:

• endoscopy;
• microsurgery;
• laser vaporization;
• laser reconstruction of the disk;
• epidural catheterization;
• destruction of the facet nerve;
• cold-plasma nucleoplasty;
• hydroplastic;
• open-type operations.

Endoscopic operations

The operation to remove the intervertebral hernia of the lumbar region by the endoscopy method (discectomy) is performed with the use of local anesthesia. To the vertebral disc through a small incision (not more than, cm) an endoscope is inserted.

With it, you make the necessary manipulations, which you can observe on the monitor. Advantages of the method: small traumatism, insignificant risk of postoperative complications, rapid recovery.

After the operation, the patient is discharged after 1-3 days.

Microsurgery

If there is no possibility of an operative intervention with the use of an endoscope, microsurgical surgery is used. Carry out several incisions.

Overview of the internal cavity provides an operating microscope, located outside the patient's body.

A big plus of the method is the minimal risk of harm to the nerve endings.

The use of micro-tools reduces the likelihood of inflammation and pain symptoms. After 2-3 days, the patient can do the usual things.

Laser vaporization

Such an operation is indicated with protrusion of the spinal disc, but in the absence of sequestration, that is, in the second stage of hernia development. A needle is placed in the vertebral disc, a metered energy flow is started through it.

The internal disk liquid evaporates, the pressure decreases. Elimination of the roots of the nerves is eliminated, the number of receptors decreases.

Advantages of the method are a short operation (not exceeding an hour), absence of cosmetic defects and injuries.

Laser reconstruction of the disk

During the reconstruction, a needle with a laser light guide is injected into the affected area. The radiation emitted by it reduces the volumes of the spinal disc and the pressure inside it, the hernial cells "dry up".

The operation is indicated if there are no sequesters (before reaching the last stage of the disease) and the hernia did not exceed 6 mm.

Advantages of laser reconstruction - minimal probability of complications, absence of scars.

Epidural catheterization

The procedure combines surgical intervention and medication. At its carrying out do not use surgical tools. A directional flow of medicinal products is delivered to the area of ​​the vertebral lesion.

Destruction of the facet nerve

Radiofrequency destruction is performed under local anesthesia and X-ray control. In the zone of the intervertebral joints, needles are injected, and current is supplied.

Heating and destruction of nerves takes two minutes. Then, through the needles, anti-inflammatory agent and anesthetic come to the lesions.

Already an hour after such a blockade the patient can return home.

Cold-plasma nucleoplasty

Herniated cells are removed by cold plasma. It is fed into the affected area with a special needle. Pain symptoms after the procedure are immediate, the operation itself lasts from 15 to 30 minutes. The procedure is comfortable for the patient and highly effective, but can provoke relapses.

Hydrophlastics

The procedure is indicated if the hernia does not exceed 6 mm, and the pain is given to the lower extremities. A special cannula is inserted through the puncture into the spinal disc, the nucleotome (the rector) is inserted into the hernia to herniate.

The nucleotide under high pressure is injected with saline solution, washing out the hernial tissues. Advantages of the method are low traumaticity, prevention of necrosis of the intervertebral disc, improvement of the quality of its depreciation properties.

Operation of an open type

Operative interventions of an open type do not involve the use of assistive devices affecting the affected area.

Their dignity is the ability to completely eliminate hernial cells and a minimal possibility of relapse. The removal of a fragment of the body of the vertebra and a small part of the disc is called a laminectomy.

The operation reduces blood pressure and restores blood circulation. The cut thus reaches 10 cm.

Discectomy consists in the removal of the intervertebral disc and certain elements of the vertebra, pressing on the vessels and nervous structures.

To restore the structure of the vertebral segment, the removed fragments are replaced with natural or artificial implants.

Open operations are characterized by long recovery periods.

Possible consequences and complications

Any surgical intervention in the human body does not pass without a trace. The removal of the intervertebral hernia of the lumbar region can cause complications - both during the operation and after it.

Without suturing, surgical complications can provoke nerve damage, manifested by migraines, paresis, paralysis.

The main complication after removal of the lumbar hernia is a relapse of pathology and pain symptoms.

Often complications in the postoperative period cause the patient's non-compliance with medical recommendations.

As a result, there may be manifestations of thromboembolism and allergic reactions to suture materials, local purulent formations (osteomyelitis, epiduritis) and relapses.

To the pain and discomfort lead postoperative scars and adhesions, which jam the nerve endings. After minimally invasive methods of operative treatment, the pain passes quickly, rehabilitation is short.

Rehabilitation Features

The recovery period includes several stages. Postoperative takes two weeks, late - up to two months. Supportive therapy will have to be carried out for life.

Rehabilitation is designed to relieve the patient of pain, which provokes residual neurological reactions. Rehabilitation measures normalize biomechanical and physical parameters, restore mobility of limbs, mobilize muscle tone.

An experienced rehabilitation physician should help the patient achieve these results.

To achieve the greatest effect after the operation, physiotherapy and medication should be shown: first anesthetics, a little later - to prevent the manifestation of complications. Well-established in the post-operative rehabilitation stage is sanatorium treatment.

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The choice of the rehabilitation program is influenced by physiological factors (age, duration of the disease before the operation, the presence of other diseases) and the type of surgical intervention performed.

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From the type of operation, the duration depends directly: after minimally invasive manipulation, the patient is restored in the shortest possible time, and after laminectomy the process of fusion of vertebrae can stretch out for half a year.

Postoperative period

At least two weeks after the operation, the patient should carefully monitor his health and wear a corset. You can not sit - the patient is moved only on a gurney.

Do not self-medicate and lift items weighing more than 3 kg. The body needs to be supported by a sufficient number of proteins, animal fats, essential microelements.

At this stage, the pernicious habits of the patient can interfere with the recovery of the body.

Limitations of the late stage of rehabilitation

Two weeks after the operation, certain restrictions for the patient persist. He is not recommended for a long time to be without movement. At the same time shaking and falling are unacceptable. In order not to slip on the street, you need to take care of the presence of stable shoes.

You can not lift objects weighing more than 5-8 kg (more precisely, the limitations of the load will determine the doctor). Every four hours the patient should lie down for at least 20 minutes.

And under no circumstances should we forget about the corset, it should be worn at least four hours a day.

With the preservation of pain symptoms in the postoperative period, the patient is prescribed analgesics.

Electrophoresis, laser therapy, physiotherapy and massage are highly effective.

Operation is not to be feared - it will change for the better a life filled with pain.

And compliance with all the proposed restorative recommendations by the doctor will allow you not to limit yourself in performing the usual work and prevent the development of relapses.

A source: http://MedOperacii.ru/skelet/operacii-po-udaleniyu-mezhpozvonochnoj-gryzhi-poyasnichnogo-otdela/.html