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Lumbar disc surgery is usually considered when a patient’s lower back pain is severe and has not been sufficiently managed with conservative treatments. Clearly, the decision to undergo any surgery is not to be taken lightly. However, with advances in the field of endoscopic spine surgery, the decision to schedule lumbar disc surgery has become much easier.
The lumbar spine is comprised of the five vertebrae (L1-L5) in the lower back (some individuals have six). These vertebrae are the strongest in the spine and they support much of the body’s weight; they’re also extremely flexible. But, the combination of high stress and frequent motion can often lead to problems, and eventually individuals may need to consider lumbar disc surgery as a treatment option.
Two common problem areas in the lumbar spine are the facet joints and the intervertebral discs. In the case of the facet joints, these cartilage-coated synovial joints act as hinges and allow the spine to move without friction. The intervertebral discs, on the other hand, are soft, spongy pads that separate the vertebrae and act as shock absorbers. When functioning correctly, the joints interlock the spinal vertebrae and the discs cushion the vertebrae, but both are susceptible to damage. It is this damage that can lead to nerve compression and a variety of painful symptoms.
Some conditions that might warrant lumbar disc surgery include:
Degenerative disc disease
Herniated or ruptured discs
Protruded or bulging discs
And many more
Common Back Surgeries for Lumbar Disc Herniation
Discectomy involves removing fragments of the disc that press on and irritate the spinal nerve root. Discectomy is the most common surgery performed for a low back disc herniation. It has about an 80% to 90% success rate for relieving radicular symptoms such as sciatica, numbness, weakness and/or pain down one leg.
Discectomies may be full operations (called “open discectomies”) or they may be minimally invasive procedures. Due to technological advances in medical/surgical techniques, devices and equipment, the trend in surgery is toward the minimally invasive. Two types of minimally invasive procedures are the microdiscectomy and percutaneous arthroscopic discectomy.
If you are deciding which kind of discectomy to have, consider the skill set of your potential surgeon. Some doctors may insist on performing an open discectomy because they haven’t been thoroughly training in the minimally invasive types. Others may specialize in one type of procedure over the other. Check your doctor’s competencies and compare them with those of other surgeons before deciding who will perform the procedure.
Spinal fusion involves removing the disc and fusing the adjacent bones together. If you have instability in your spine or you’ve already had one or more discectomies, you may need a spinal fusion. Spinal fusion may require that hardware, such as plates and screws, be installed. It may also involve a bone graft. Doctors only rarely perform spinal fusions with microdiscectomies.
Surgery for herniated lumbar disc generally relieves leg pain with great success. It is less effective for relieving back pain, though. (Exercise often is the best way to manage back pain.) Along with leg pain relief, surgery may help stop your leg from getting weaker.
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