Professor MD Thomas Gösling
Herniated discs is common spinal problem which can cause compression to spine nerves. In Spine Center of Clinic of Braunschweig, Germany we offer a number of options for treatment of invertebral disks hernias including surgery. If you consider what is proper treatment for you first you need understand some base thing on spine anatomy.
The spinal column consists of the 33 separate vertebras that are the bony segments consisting of the cylindrical ventral body and arch. Joined together the vertebras provide the pathway for the spinal cord. The bodies of vertebras are separated by intervertebral disks that function to amortize the motion and eliminate rubbing of the vertebras against each other. Intervertebral disks are formed by fiber outer ring called annulus and gel-filled center (nucleus). Elasticity of the disks that absorb the fluid during the night makes them springs providing flexibility and protection for the bones. With age intervertebral disks lose their ability to accumulate fluids and become thinner and more brittle and also may develop hernias or bulging of the disk tissues which condition is called herniated disk.
Herniated disk is intrusion of inner softer layer through the ruptured outer ring that results in bulging of the disk edge. Herniated disk create a pressure to nearby nerves which can cause pain, muscle weakness and numbness of the tissues. Depending of degree herniated disks can be cured with conservative methods or with surgery.
Back surgery for spinal disk herniation is one of the most common operations on the spinal column. Depending on location of a herniated disk you can distinct cervical herniated disk surgery, thoracic herniated disk surgery or lumbar herniated disk surgery.
Lumbar (low back) herniation is the most typical as lumbar region has more pressure and easier degenerates with time and under the load. The most affected with herniation disk is between the fifth and fourth lumbar vertebra. Back surgery for herniated disk in lumbar spine is rather common option when pain cannot be cured by conservative treatment in more than 12 weeks.
Cervical spine herniated disk surgery is not so common. ‘Cervical’ means related to the neck. Cervical herniation most often happens between the five and six or the six and seven vertebras and can compress the nerve root causing pain and other symptoms in the neck, upper back, shoulders, arms and hands. Surgery is recommended when other means are not helpful.
Thoracic surgery for herniated discs is most rare option that only decided in cases of spinal cord dysfunction with related neurological problems.
Depending on degree of herniation you may need disc removing (discectomy) or even replacement. Another option for relieving herniated disk symptoms is cervical fusion.
Discectomy is dissection of a bulged part of intervertebral disk to eliminate the pressure for nerve roots and relieve pain. It may be preceded by laminectomy, removal of the small portions of the arch on the back of vertebra (lamina) to proved access to the disk. Classical technique of disk removal implies a large incision and can be performed via posterior of anterior approach or theirs combination. Rehabilitation after traditional discectomy.
Miscro surgery for herniated disk became extremely popular in the latest years. It is minimally invasive method that can be performed even on outpatient base. Small incision is made over the diseased vertebra to get access to the herniated disk. A surgeon uses a microscope to see the site of operation. Affected part of the disk is removed with a special scissors to give room to the spinal nerve and, then, the incision is sutured.
Endoscopic discectomy is another type of minimally invasive surgery for herniated disk. While miscrodiscectomy is still open surgery though with smaller incision, scope surgery uses “keyhole” incision to introduce an optical device and another hole to deliver surgical tools. The advantages of endoscopic operation are less bleeding, less body damage and shorter recovery. But some doctors says that endoscopic disk removal has higher rate of some specific complications.
There are some risks involved in disk surgery:
You may choose any of above methods for you back herniated disc surgery but most important thing is not surgical techniques as any of them can be beneficial but surgeon skill. Experience and qualification of your surgeon determine a course of surgery and its success. Top spine experts of Clinic of Braunschweig can guarantee you highly professional level of service and the best postoperative care. If you are considering on treatment, contact us and you will have detailed consultation on the best options in your particular case.