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| Microdisc Surgery |
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A herniated disc can occur from minor or major injuries. A disc can herniate from simply bending over to tie your shoes to a sneeze or cough to being involved in a motor accident. The diagnosis of a herniated disc is often made from a thorough physical examination. Workup via CT or MRI comes at a later time and usually not first. The treatment is conservative, as 85% of the patients with a herniated disc can be treated without surgery. Treatment alternatives include anti-inflammatories, muscle relaxants, oral low dose steroids, epidural injections and most importantly, physical therapy. If these fail, then surgical intervention might be considered. Surgery is indicated only if all measures have failed and there is the presence of leg pain and a nerve functioning deficit (weakness, numbness, or loss of function). Surgical options include microdiscectomy, endoscopic discectomy, laminectomy and discectomy, and possible discectomy and interbody fusion. All these procedures are individualized to the patients problem and each procedure is not for everyone. If a micro or endoscopic discectomy is the procedure of choice. This is often performed as an outpatient or an overnight stay. The surgery involves making a small one inch incision and with gentle retraction on the muscle and ligaments, identify the disc and involved nerve root and remove only that portion of the disc that's herniated. Now a distinction must be made between a bulging or protruded disc (which is one that is still within the disc space but is sticking out more than normal) and a herniated disc (which is completely out of the disc space pressing on the spinal cord and nerve) versus finally an extruded disc (which is one in which a piece of disc material has broken free of the disc and is causing pressure on the nerve). These operations are performed only on herniated or extruded disc material and not for disc bulges or protruded discs. Postoperative management involves an activity and rehab program designed for the patients and in association with his job description and functional needs. We begin therapy within the first week postop, a walking/aerobic program is instituted followed then by a flexibility and strengthening program. Duration of therapy is individualized and is one though, that the patient takes an active role in and is taught home exercises and the need to continue this program for his or her own back's good. Following back surgery, with proper care and continuation of a home exercise program, most patients will return to frill activity without much limitations. Back surgery is not crippling or leads one to stop living life or working, only if you do not take an active role in your own rehab and exercise program will it affect you. At the Orthopaedic, Pediatric and Spine Institute, we teach, instruct, and educate you on your back and coupled with state-of-the-art physical therapy modalities, we are able to offer you and provide for you all aspects important to recovering from that back or disc problem. Give us a call to see how we can make a difference in your care. |
