Disc surgery

Back pain is the harbinger of disc problems. First, one will try to counteract it with conservative medical therapy. Because the cause of lower back pain is not always a herniated disc. 23 intervertebral discs cushion the individual vertebrae of the spine against each other like shock absorbers. When standing, the entire weight of the upper body rests on the cartilage discs. That is why obesity is the most common cause of back problems. If conservative treatment is unsuccessful it usually becomes one Disc surgery devices.

What is a disc surgery?

During the disc operation, the surgeon will eliminate the herniated disc. In this way, the trapped nerve roots are relieved again.

The human intervertebral discs are built up like gel cushions, inside there is a gelatinous core. A robust fiber ring encloses and strengthens the individual intervertebral discs.

With increasing age, the cartilage mass loses its elasticity and it dries out increasingly. This can lead to cracking. The dilapidated, thinning cartilage tissue is less and less able to withstand the frictional forces between the vertebrae and the bones begin to rub against each other.

In the case of a herniated disc, the solid ring of fibers that surrounds the cartilage mass tears. The fixation of the inner, soft gelatinous mass is lost and it will bulge forward into the spinal canal.

Then, depending on the position of this bulge, unnatural pressure is exerted on the nerve fibers, which, depending on the intensity, can lead to impressive pain or even paralysis.

For the neurological diagnosis, the specialist will use magnetic resonance imaging, x-ray images or [[CT] images until a reliable clinical picture is obtained.

Herniated discs can be completely painless and go undetected. They can cause severe pain or even cause paralysis. Accordingly, the range of forms of therapy extends from medication and physiotherapy to surgery on the herniated disc by the surgeon.

Function, effect & goals

A Operation on the intervertebral discs becomes necessary when paralysis occurs, pain medication no longer works and the clinical picture in general worsens more and more. The operation is urgently indicated if cauda equina syndrome occurs, which manifests itself as numbness in the anal or genital area up to bladder and fecal incontinence.

During the disc operation, the surgeon will eliminate the herniated disc. In this way, the trapped nerve roots are relieved again. To do this, the surgeon uses microsurgical discectomy, in which relief of the spinal cord nerves is generated under the surgical microscope. With this procedure all herniated discs can be removed and it is of no interest in which direction the disc slipped. The operating doctor also determines exactly whether the spinal nerve has been correctly relieved.

The operation is performed under general anesthesia and in the prone position. In order to obtain the greatest possible distance between the individual vertebral arches and the necessary widening of the vertebral canal, the patient is in a kneeling position. The upper body lies on the operating table.

Schematic anatomical representation of the vertebrae and the intervertebral disc, as well as the pinched nerve. Click to enlarge.

Then the surgeon will make a small incision over the diseased area and gently push the back muscles to one side. Microscopes and filigree special instruments are used during the operation.

With their help, the ligamentum flavum - a ligament that connects the individual vertebral bodies - is partially incised. This gives the operating doctor the necessary clear view into the spinal canal. Only in rare cases does something need to be removed from the vertebral bone.

The bulging tissue of the affected intervertebral disc can now be separated. Parts of the intervertebral disc that had slipped into the spinal canal are also removed. During the entire operation, the spiral nerve will be kept under constant microscopic control.

If there are large defects on the fiber ring, they are sutured microsurgically. At the end of the intervertebral disc operation, the corresponding skin area is sutured again.

Risks, side effects & dangers

As with all surgical interventions, there are also Intervertebral disc operations Risks.

Rarely, there are injuries to the nerve that should be relieved. Impaired functions of the bladder and bowel, movement disorders of the legs and sexual disorders can result. Wound healing disorders and infections are also considered possible complications. The rare post-discectomy syndrome triggers pulling and tingling sensations in the legs, which can occasionally occur despite the optimal operation.

As a useful aftercare after the intervertebral disc operation, ligaments and muscles are strengthened through physiotherapy. If necessary, occupational therapists, nutritionists and psychotherapists are also used within rehabilitation.