Quite often there are people complaining of back pain. They say that pain occurs due to uneven physical exertion, a hard day or fatigue. But is this always the case? Unfortunately, there are frequent cases when such pain is the result of a hernia of the spine. When removal of a hernia of the spine is indicated, we will examine this article.
Symptoms
A hernia of the spine is extremely dangerous, as a result of which a person experiences constant, ongoing pain, damage is also caused to his internal organs. An incorrect diagnosis can aggravate this situation, therefore accurate diagnosis is extremely important.
What is a hernia of the lumbar spine, the symptoms and treatment of this pathology, we will consider below. From other diseases with similar symptoms, it can be determined by the following signs:
- strong, pronounced pain sensations occur that do not go away, despite medical treatment;
- the patient cannot hold feces and urine;
- paralysis of the lower extremities is possible;
- decreased sensitivity in them;
- after a course of treatment equal to three months, the patient's condition does not improve.
If any of these symptoms is present, you should immediately consult a doctor. It may be necessary to urgently remove a hernia of the spine. Moreover, much attention should be paid to the qualifications of a specialist. There are not rare cases when a doctor, due to inattention, lack of training, and unprofessionalism, makes the wrong diagnosis. And the most common misdiagnosis is sciatica. A mistake in the absence of treatment can lead to paralysis of a person.
This is how dangerous a hernia of the lumbar spine. The symptoms and treatment of it, of course, are interconnected.
Treatment methods
Well, the diagnosis is made. What next? What are the ways to treat hernia of the spine? Which ones are most effective? In fact, there are a lot of treatment methods. It could be:
- physiotherapy;
- drug treatment;
- methods of manual therapy;
- massage;
- wearing a special corset for the back;
- diet;
- folk methods;
- removal of a hernia of the spine.
The use of each of them is due to the individual characteristics of each patient and his general condition. But the best treatment is based on all methods not contraindicated, that is, comprehensive. And it is possible that due to this, the removal of a hernia of the spine is not required.
Indications for hernia removal surgery
Indications that an operation to remove a hernia of the spine can be performed can be relative and absolute. In the first case, it becomes mandatory. Moreover, the operation must be carried out as soon as possible.
And relative indications mean that the treatment carried out before this did not affect the shift towards recovery, and the operation is still necessary, but not so urgent. It is prescribed if, after two months of treatment, changes for the better did not follow.
The operation to remove a hernia of the spine can be carried out in various ways. We list them.
Discectomy
Discectomy is the most obsolete type of operation. It lies in the fact that an incision is made about eight centimeters on the skin of the back under general anesthesia. After which the affected spinal disc or, if possible, only part of it is completely removed through it.
The main disadvantage of this type of operation is that after it, the risk of inflammatory processes is extremely high. To prevent them, the patient should at least ten days be monitored in a hospital and undergo antibiotic therapy.
Judging by the reviews of specialists, the musculoskeletal functions of the spine after surgery come back to normal much more slowly than with other types of surgical intervention, due to the fact that quite extensive injuries are caused during it.
However, this operation has not only disadvantages. The advantages include a small percentage of relapse (3%). This is due to the fact that the affected disk, or part of it, is completely removed.
How much does spinal hernia surgery cost? Its price, judging by the reviews of patients, is low, and starts at 20,000 rubles.
Laminectomy
Laminectomy consists in the fact that a part of the vertebral arch is removed to the patient, to which the nerve ending is pressed with a hernia. As a result of this, according to experts, the patient’s rehabilitation is fast enough - within 3 days. In addition, due to the fact that the nerve is released, the patient almost immediately ceases to feel pain.
But there are risks. For example, the risk of infection is quite high. And, which is somewhat more dangerous, there is the possibility of nerve damage during surgery.
Endoscopy
Endoscopic removal of a hernia of the spine is carried out using an endoscope and extremely small instruments. This provides the opportunity to reduce the size of the cut to a minimum. It is equal to 5 mm. This type of operation is quite famous and popular due to a number of its advantages. First of all, this duration is no more than an hour. As a result, the muscles of the body are not harmed. They are moved apart using a special expander. Judging by the reviews of patients, the patient can go home the very next day. Recovery of the spine itself takes about three weeks.
But one should take into account the fact that this operation is not universal. It is not suitable for some types of hernia of the spine, and after it the risk of relapse is quite high (10%). And such an operation, unfortunately, is by no means cheap - its price in clinics reaches 130,000 rubles.
Microdisectomy
Microdisectomy is an operation based on neurosurgery. It is performed using the latest tools and a powerful microscope. An incision of 3-4 cm is made on the back of the patient. It should be made in the area of the nerve, which is compressed by a hernia. A disc hernia is removed, as a result of which the nerve is released. Now this operation, according to experts, is one of the most frequently used.
As a result of it, the pain syndrome disappears almost immediately. The patient may leave the medical institution the very next day. He will be able to return to work (while, of course, not active yet) in a month. It will be possible to start active in one and a half to two months.
Such an operation, as a rule, is recommended for those who have several hernias. Since using it you can remove them within one intervention.
Unfortunately, the relapse rate reaches 10-15%. And the operation is quite expensive.
Laser removal
Laser removal of a hernia of the spine - laser discoplasty - consists in the fact that with the help of a beam of small power the disk is heated to a certain temperature, which contributes to its recovery. The use of such an operation is not recommended without prior consultation with a doctor, without passing an analysis. Moreover, laser surgery is not universal. She, according to experts, is not suitable for all types of hernias.
After this operation, complications are likely, so the patient needs to undergo antibacterial therapy.
Possible complications
What complications can arise after spinal surgery? They are divided into intraoperative and postoperative. The first occur during the surgery itself:
- This may damage the nerve. Since it is located next to the hernia, it is quite easy to damage it, especially if a discectomy is performed. In this case, after the operation, some problems with sensitivity in the legs may occur, muscle weakness appears.
- The dura mater may be damaged . If the surgeon noticed damage during surgery, he will suture the gap. Otherwise, after the operation, the patient will have a severe headache, since the cerebrospinal fluid will leak from the spinal canal, which will provoke changes in intracranial pressure. The hard shell will heal on its own, but it will take some time (about 2 weeks).
Postoperative complications may also occur. They are divided into 2 types:
- The early ones. They are manifested by purulent-septic complications (epiduritis, osteomyelitis, pneumonia, sepsis) and thromboembolic complications (pulmonary embolism, venous thrombosis of the lower extremities).
- Late postoperative complications are manifested by relapse of the intervertebral hernia. Unfortunately, this type of complication is quite common, on average up to 30%. Scars and adhesions that pinch the nerve are also possible, which leads to pain.
Subject to all the rules of rehabilitation, it is possible to avoid late postoperative complications.
Rehabilitation after removal of a hernia of the spine
After some time has passed after the surgery and the stitches are removed, the treatment of the patient will still not be completed. A new stage of actions will begin, quite a large one, and the results of the operation will depend on it to some extent:
- The patient needs to regularly engage in physical therapy, observe the regimen of the day, wear a special corset for the back. However, you can not engage in physical activity immediately after the operation. At first, you even need to get up with caution, avoiding unnecessary, sudden movements.
- For a month, it is not recommended to sit so that the hernia does not form again, and there is no compression of the vertebral discs. You can’t walk and stand for the first time either. Every hour or two you need to rest your back, lie for 15 minutes.
- Weight lifting is not allowed.
- Moreover, recovery measures apply to the bed. Need a special, hard orthopedic mattress.
- You can go to the shower only three days after the operation, but it is not recommended to take a bath in the first month after removing the stitches.
- Do not ignore scheduled examinations by a doctor.
It must be remembered that relapse does not necessarily occur immediately after surgery. It can also appear after a long time after it.
How to do gymnastics?
Gymnastics is very important after removal of a hernia of the spine. It consists of the following exercises:
- Slow rises of legs bent at the knees in a supine position.
- Raising the pelvis on legs bent at the knees, lying on the back.
- The legs are bent in a supine position. Slowly make turns of the legs in one direction and the other. Try to get your knees on the floor.
- Kneeling, leaning on your hands, slowly stretch one straight leg back, hold for 30 seconds and change the leg.
- Lying on his stomach, alternately raise and hold his legs.
Reviews and consequences of hernia surgery
According to numerous patient reviews, the described operations, as a rule, go well. Complications are rare. The recovery period takes about six months, after which you can again fully live and work.
According to experts, if all the precautions are followed and all the recommendations of the doctor are followed, then the consequences of removing a hernia of the spine will be minimal. Of course, a lot depends on the quality of the operation, since there is a likelihood of relapse. But more often than not, everything ends happily.