Lumbar Disc Herniation Surgery (Lumbal Disc Herniation)

What is Lumbal Disc Herniation?

A herniated disc is a disorder that develops due to dysfunction of the five vertebrae in the lumbar region of our spine and the discs between them. The lumbar spine is responsible for supporting a large portion of the body weight and is therefore subject to high amounts of stress and pressure. A herniated disc is a tear or protrusion that occurs as a result of damage to the discs between the vertebrae. This tear or bulge can put pressure on the nerve roots extending to the legs or the spinal cord, causing symptoms such as lower back and leg pain.

The vertebrae act as a shield to protect the spinal cord from external factors. However, as a result of excessive strain on the discs in the lumbar region or exposure to trauma (such as lifting something heavy, remaining immobile for a long time, being hit, carrying excessive weight, or giving birth frequently), the structure of these discs may deteriorate and lead to a herniated disc.

Surgical intervention can play a key role in quickly and effectively relieving the symptoms of a herniated disc. Especially in patients who experience loss of sensation or movement as a result of nerve pressure, surgical treatment can improve the patient’s quality of life by supporting faster recovery of the nerves.

What Causes a Herniated Disc?

Regardless of the exact cause of a herniated disc, various factors are known to contribute to the development of this condition. Both genetic and environmental factors can increase the risk of a herniated disc. Although herniated disc becomes more common with age, it can also be observed in young individuals. Structural weaknesses or ruptures in the discs can lead to the extrusion of the disc contents and herniation. The main factors contributing to the formation of a herniated disc are:

Aging: Over time, discs can lose water content and become more fragile. This can cause discs to rupture or weaken more easily.

Being Overweight: Excess weight puts an extra load on the spine. This increases the pressure on the discs, increasing the risk of herniation.

Physical Activities: Lifting heavy loads can cause sudden and severe stress on the discs, especially if the correct technique is not used. This can lead to disc ruptures or weakening.

Genetic Factors: Family history may affect the risk of herniated disc. If a family member has a herniated disc, the risk of other family members may also increase.

Trauma or Injuries: Traumatic events such as accidents or falls can cause the disc to become damaged and eventually herniate.

As a result, a herniated disc can develop for many different reasons and knowing the risk factors is important in preventing this disease.

What are the symptoms of a herniated disc?

A herniated disc is most commonly recognized by pain felt in the lower back and legs, but this condition can also present with a number of other symptoms. Typical symptoms of a herniated disc are:

Radicular Pain: This pain, often called “sciatica”, starts from the waist area and spreads to the leg.

Numbness and Tingling: There may be loss of sensation, tingling or burning sensation in the legs or feet.

Muscle Weakness: Depending on the area of ​​the herniated disc, muscle weakness may occur in the legs.

Restriction of Movement: There may be stiffness in the waist or a feeling of discomfort when moving.

Pelvic Problems: In some severe cases of herniated disc, pelvic dysfunction such as urinary incontinence or impotence may occur.

Painful Sitting and Walking: Individuals with a herniated disc may feel increasing pain when they sit or walk for long periods of time.

Fatigue: There may be a general state of tiredness as the body reacts to constant pain or discomfort.

Balance Problems: In some cases, nerve compression due to a herniated disc can cause balance problems.

Symptoms of a herniated disc may vary from person to person, and the severity of symptoms may vary depending on the location and size of the hernia.

What are the Diagnostic Methods of Lumbar Herniation?

In case of suspicion of a herniated disc, a series of evaluations and tests are performed to ensure that the patient receives a complete and accurate diagnosis. This process includes these steps:

Patient Anamnesis: The doctor questions the patient’s complaints, the onset, severity, duration and spread of pain in detail. It also obtains information about the patient’s past injuries, lifestyle, and general health.

Physical Examination: A careful examination is performed to determine the pain points in the patient’s waist and leg areas. In addition, it is checked whether there is any limitation of movement, muscle weakness or loss of reflexes.

Neurological Evaluation: Reflexes, muscle strength, and sensory loss are tested to determine how nerve function is affected.

Imaging Tests

X-ray: Shows bone structures and evaluates the space between vertebrae for bone fractures or other abnormalities.
Magnetic Resonance (MR) Imaging: Provides detailed information about the spine, discs and nerve roots. The size and location of the herniated disc can be determined with this method.
Computed Tomography (CT): Provides cross-sectional images of the spine and nearby structures.
EMG (Electromyogram): It is a test that evaluates nerve damage and function. It is used to determine which nerves are affected by a herniated disc.

These diagnostic methods help the doctor detect the presence, location and severity of a herniated disc so that the most appropriate treatment method can be decided.

Approach to Lumbar Disc Herniation and Treatment Options

A herniated disc occurs as a result of damage to the spinal discs. Different treatment approaches can be adopted depending on the symptoms experienced by the patient and the severity of the herniated disc.

Non-Surgical Methods for the Treatment of Disc Herniation

When non-surgical methods are preferred in the treatment of herniated disc, the following approaches are generally adopted:

Rest and Activity Modification: Short-term bed rest may be recommended to relieve herniated disc pain. However, long-term rest is generally not recommended, as remaining sedentary can lead to muscle weakness.

Medication: Anti-inflammatory medications and painkillers are often used to reduce pain and inflammation.

Physical Therapy: Includes exercise and stretching methods to strengthen the waist and surrounding muscles, increase flexibility and reduce pain.

Epidural Steroid Injections: Injections administered directly around the herniated disc can help relieve pain and inflammation.

Hot and Cold Application: Hot and cold compresses can be used to relieve muscle spasms and pain in the waist area.

Electrotherapy and Ultrasound: Used to relieve muscle spasms and pain, increase blood circulation and accelerate healing.

Manual Therapy: It is aimed to reduce muscle spasms and pain with massage and mobilization techniques.

Treatment for a herniated disc should be planned individually, depending on the severity and duration of symptoms experienced by the patient, their impact on quality of life, and other health conditions. In order to facilitate the patient’s return to work and daily life activities and to prevent possible relapses, it is essential to create a treatment plan under the guidance of a doctor and physiotherapist.

Lumbar Herniated Surgery

Surgical intervention for a herniated disc is considered when relief cannot be achieved with non-surgical methods or when nerve compression is severe. The main purpose of the surgery is to remove the herniated disc material that is pressing on the nerves and causing pain.

Discectomy Procedure

In this procedure, some or all of the herniated disc material pressing on the nerve is removed. Thanks to advanced technology, this procedure is performed with a minimally invasive approach, usually using microscopic or endoscopic methods. This minimally invasive approach allows patients to recover faster and stay in hospital for a shorter time.

Surgery Process

Discectomy is usually performed under general anesthesia, but sometimes local or spinal anesthesia may also be applied. The patient is positioned face down on the operating table and the operation area is prepared in a sterile manner. The surgeon begins the procedure by making a small incision in the area where the herniated disc is located.

The musculature of the spine is carefully pulled aside using special surgical instruments, allowing access to the spine and nerve tissue. Sometimes, the surgeon may need to remove a small section of the spinal bone, called the lamina, to expand the working area; This procedure is called laminotomy.

The herniated disc material and any free fragments are carefully removed so as not to put pressure on the nerve. If necessary, other possible obstructions and bone growths such as osteophytes that may compress the nerve are also removed.

After the operation is completed, the incision area is carefully closed and covered with a sterile bandage. After surgery, patients are usually discharged on the same day or the next day. Before the patient is discharged, detailed information is given about the post-surgical care and rehabilitation process.

Recovery Process After Disc Herniation Surgery

The recovery steps to follow after herniated disc surgery are:

Beginning of Movement: In the first hours after surgery, the patient should begin to move slowly, usually within 3 to 5 hours. This promotes blood circulation and reduces the risk of potential complications.

Discharge: Following successful completion of the operation, patients can usually return home the day after surgery.

Return to Work: The patient can return to work between the 1st week (light office work) and the 4th to 8th weeks (physically challenging work), depending on the post-operative profession and the physical intensity of the work.

Starting Physical Activity: It is recommended that the patient start light cardiovascular exercises from the 10th week, in accordance with the doctor’s advice. For more intense activities, doctor’s advice should be sought.

Riding Transportation: It is generally considered safe for the patient to drive or travel by public transportation from the 4th week after the operation. However, this period may vary depending on the extent of the surgery and the general health condition of the patient.

During the recovery process, in addition to the physical therapy program recommended by the doctor, it is also important to recommend the use of lumbar support products and other rehabilitation tools necessary for waist health. If the patient notices pain, numbness, or other abnormal symptoms, he or she should contact his or her doctor immediately.