Contents
What is a herniated disc?
A herniated disc occurs when the normal structure of the discs in the spine is disrupted. The discs between the vertebrae contain a gel-like inner part (nucleus pulposus) and a hard outer sheath (annulus fibrosus). In a herniated disc, the outer sheath of the discs ruptures and the inner gel-like substance leaks out. This can put pressure on the surrounding nerves and cause symptoms such as pain, numbness and loss of strength.
Symptoms of a herniated disc:
- Low back pain: Depending on the size of the hernia and the pressure on the nerves, it can sometimes be severe.
- Leg pain (sciatica): Depending on the nerve compression, it starts from the buttocks and spreads towards the legs.
- Numbness or tingling: Can be felt in the legs, feet or fingers.
- Muscle weakness: Loss of strength in the leg muscles is possible when the bulging disc material presses on the nerves.
- Difficulty walking: Pressure on the nerves can lead to restricted movement.
- Loss of control over urination or defecation (more rare): This is one of the symptoms of “cauda equina syndrome” and requires urgent surgical intervention.
Treatment Options for Lumbar Hernia
The treatment of a herniated disc is usually determined by the size of the herniated disc, the symptoms and the impact on the quality of life. Treatment methods are divided into two main groups: non-surgical (conservative) treatments and surgical intervention.
1. Non-Surgical Treatment
Many cases of herniated discs can be treated with non-surgical methods. These approaches include:
- Medication: Painkillers, muscle relaxants and anti-inflammatory drugs are used.
- Physical therapy and exercise: Muscle strengthening and stretching exercises are used to develop the muscles of the shoulders, lower back and legs.
- Rest and lifestyle modification: The patient should avoid overloading in daily activities.
- Injection therapy: Epidural steroid injections can relieve inflammation and pain in the nerve roots.
2. Surgical Treatment
Surgical treatment is usually considered if the patient does not improve despite conservative treatment or if their condition worsens. For example, surgery may be necessary if the pain is very severe, if the nerve damage is progressing or if there is an emergency such as cauda equina syndrome.
The following methods are usually used in surgical intervention:
Laminectomy
- Part or all of a vertebra is removed to relieve pressure on the spine.
- It is usually done for patients with advanced nerve compression.
Disc prosthesis or fusion (spinal fusion):
Recovery After Surgery
The post-operative recovery process is usually supported by
- Physical therapy and rehabilitation: After surgery, a physical therapy program is applied to strengthen the person's muscles and increase mobility.
- Medication: Medication may be prescribed to control pain after surgery.
- Activity modification: Patients should not lift heavy weights for a while, avoid sitting for long periods and do the recommended activities.
Risks and Possible Complications of Surgery
As with any surgical procedure, herniated disc surgery may also have some risks:
- Infection
- Anesthesia-related complications
- Nerve injuries
- Recurrence of hernia (recurrent hernia)
- Bleeding or clot formation
Conclusion:
Surgical intervention in lumbar disc herniation is an appropriate option depending on the patient's condition and the severity of the symptoms. However, surgery is usually preferred when other treatment methods fail. When deciding on surgery, a good physical examination, imaging results and expert opinions on which treatment is appropriate should be taken into consideration.
