Herniated Disc Surgery

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Herniated Disc Surgery
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Anatomy
A herniated disc most often occurs in the lumbar
region (low back). This is because the lumbar
spine carries most of the body's weight.
Sometimes the herniation can press on a nerve,
causing pain that spreads or radiates to other
parts of the body.
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Definition

• Very few people with herniated or bulging discs
  need surgery. However, if you have tried
  conservative treatments without relief, your
  doctor may recommend herniated disc surgery.
  Surgery may be necessary if you are experiencing
• Muscle weakness or numbness, loss of
  sensation
• Problems walking or standing
• Difficulty controlling your bowels or
  bladder
• Many times, only the portion of the disc that is
  bulging or herniated is removed. In rare cases,
  it is necessary to remove the entire disc. If the
  entire disc is removed, the bones (vertebrae) on
  either side of the damaged disc may need to be
  permanently joined or fused together to provide
  stability for your spine.

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Micro Discectomy
Why It's Done A Microdiscectomy is a surgical
procedure that is done to take the pressure off
the nerves or spinal cord by removing part or all
of the herniated disc. Your physician might
advise Microdiscectomy if Nerve weakness has
progressed to the point you have difficulty
walking or standing After six weeks of
non-surgical treatment, such as physical therapy,
your symptoms are not improving A fragment of a
disc becomes lodged in the spinal cord and is
compressing a nerve The pain radiating into your
arms, chest, legs or buttocks is no longer
manageable
How Microdiscectomy Surgery Is Performed A
microdiscectomy is performed through a small (1
inch to 1 1/2 inch) incision in the midline of
the low back. First, the back muscles (erector
spinae) are lifted off the bony arch (lamina) of
the spine. Since these back muscles run
vertically, they can be moved out of the way
rather than cut. The surgeon is then able to
enter the spine by removing a membrane over the
nerve roots (ligamentum flavum), and uses either
operating glasses (loupes) or an operating
microscope to visualize the nerve root. Often, a
small portion of the inside facet joint is
removed both to facilitate access to the nerve
root and to relieve pressure over the nerve. The
nerve root is then gently moved to the side and
the disc material is removed from under the nerve
root.
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• Risks
• MicroDiscectomy is considered to be a safe
  operation. Just like any surgery, there is a risk
  of complications occurring. Possible
  complications include the following
• Bleeding
• Infection
• Spinal fluid leaking
• Damage to nerves or blood vessels around and in
  the spine
• Damage to the protective layer of tissues that
  surround the spine
• Results
• Discectomy helps to relieve the symptoms of a
  herniated disc in most people who have clear
  indications of nerve compression, such as pain
  that radiates from the back into the arms or
  legs. This surgery may not provide permanent
  relief however, because it does not solve the
  underlying problem that initially caused the disc
  to herniate. Your doctor may make some
  recommendations that will help you avoid injuring
  your spine again, such as a routine program of
  low-impact exercise or weight reduction. It may
  also be recom- mended that you avoid activities
  that require repetitive or extensive lifting,
  twisting or bending.

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Percutaneous Discectomy
An advanced form of percutaneous discectomy
developed to date uses a plasma tech- nology to
remove tissue from the center of the disc. During
the procedure, an instrument is introduced
through a needle and placed into the center of
the disc where a series of channels are created
to remove tissue from the nucleus. Tissue
removal from the nucleus acts to decompress the
disc and relieve the pressure exerted by the disc
on the nearby nerve root. As pressure is
relieved, pain is reduced, consistent with the
clinical results of earlier percutaneous
discectomy procedures. There is little tissue
trauma and recovery times may be improved in many
patients.
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Laminotomy and Laminectomy
Each back bone or vertebra has two laminae. These
laminae are arch-shaped and are located closer to
the internal body than the outside of the body.
Other parts of the vertebra are located near the
laminae the facet joint and the spinal
process. The laminae are made of bone and they
rarely cause problems. However, surgery on them
can be helpful in other conditions. Spinal
conditions may cause severe pain if the spinal
cord or nearby nerves are compressed. Operations
performed on the laminae can help to make the
spinal column wider, which relieves the pressure
and pain. Surgery on the laminae is also used to
help treat spinal deformities. What is the
Difference Between Laminectomy and
Laminotomy? Sometimes even doctors and nurses
interchange these two words, but there is a
distinction. In a laminectomy, the lamina is
completely removed. Only a portion of the lamina
is removed in a laminotomy. Reasons for a
laminectomy or laminotomy The main reason for
either of these procedures is to remove the
pressure from the nerves near the spinal cord or
from the spinal corditself. Even though a portion
of the vertebra is removed, the spinal cord
remains protected inside the spinal column which
consists of hard backbones, even when a
laminectomy or laminotomy is performed. be
permanent.