LUMBAR DISC HERNIATION (HERNIA) AND CURRENT TREATMENT METHODS

What is Herniated Disc?

The spine is made up of interconnected bone structures called vertebrae. The disc is connective tissue that acts as a pillow between the vertebrae. The outer layer consists of solid tissue called anulus fibrosus and the inner layer consists of soft tissue called nucleus pulposus. The outer layer deteriorates and the soft layer overflows inside is called the herniated disc. The herniated disc can cause low back pain, pressing the nerves that come out of the spine, causing pain in the legs, numbness or even weakness in the feet, and in later stages, such as incontinence and paralysis of the feet. There are many other causes of low back and leg pain other than herniated disc. Therefore, differential diagnosis is important.

Treatment Methods

First stage

• Short term rest
• Pain relievers to control pain
•Physiotheraphy
• Exercises
• Epidural steroid injection
treatments are applied.
The purpose of non-surgical treatments is to improve physical condition and increase overall body functionality to reduce nerve and disc injuries and protect the spine. In most of these patients, it can be accomplished with an organized program that includes multiple treatment methods. The purpose of non-surgical treatments is to improve physical condition and increase overall body functionality to reduce nerve and disc injuries and protect the spine. In most of these patients, it can be accomplished with an organized program that includes multiple treatment methods. Epidural injections may be recommended if you have severe leg pain. These are corticosteroid injections into the spaces around the spinal nerves. The same procedure can be repeated several times after the first injection. The purpose of these injections is to reduce inflammation of the nerve and disc.

Epiduroscopic (Closed Surgery) Methods

This method is generally applied to nerve root and disc around the initial hernia in order to reduce leg pain or to reduce adhesions around the nerve in patients who have previously had surgery. It is applied with an endoscope with a 1 cm incision about 3-5 cm above the bone, known as the tail-end bone.

Surgical treatment

The purpose of the surgery is to eliminate the pressure of the herniated disc on the nerve, which causes pain and weakness in the leg. The most common method is discectomy or partial discectomy where only the herniated disc part is cleaned. Depending on the condition of the hernia, endoscopic, microscopic or open surgical methods can be chosen.
Postoperative

If you are suffering from leg pain rather than low back pain, you can get good results from surgery. Your chance of getting rid of leg pain after surgery is approximately 90%. Usually, no postoperative complications are seen. Infection, bleeding, nerve injury, nerve sheath rupture may occur with a 3-5% probability.

When Should I Have Emergency Surgery

Sometimes the hernia can put pressure on the nerve going to the leg, causing significant loss of strength in the leg and foot. In this case, urgent surgery is required. Rarely, large hernias can press the nerves that provide control of the intestine and bladder (bladder), causing conditions such as loss of sensation and incontinence in the groin or sexual area. In such a situation, emergency surgery is required.

NOTE: This article contains excerpts from the brochure prepared by the Turkish Neurosurgical Society Spinal and Peripheral Nerve Surgery Teaching and Training group, including general practices, to inform patients.