How is herniated disc surgery, risks and post-operative performed
Surgery to treat herniated, dorsal, lumbar or cervical hernia is indicated in cases where there has been no improvement in symptoms of pain and discomfort, even with treatment based on drugs and physiotherapy, or when there are signs of loss of strength or sensitivity. This is because this procedure offers some risks, such as limiting the movement of the spine or infection, for example.
The type of surgery can vary, with the traditional opening of the skin to reach the spine, or with the use of more recent and less invasive techniques, with the aid of a microscope, for example. Recovery can be varied according to the injury and technique used and, therefore, performing rehabilitation physiotherapy helps to improve symptoms and return the patient to his daily activities more quickly.
Types of surgery
The type of surgery can vary according to the location of the hernia, with the technique available at the hospital or according to the needs of each patient, being determined by the orthopedist or neurosurgeon. The main types are:
1. Traditional surgery
It is done with the opening of the skin, with a cut, to reach the spine. The choice of where to access the spine is made according to the closest location to reach the disc, which can be from the front, as is common in cervical hernia, from the side or from the back, as is common in lumbar hernia.
It is done with a skin access to reach the injured region. The choice of the spine access location is made according to the injury and experience of the orthopedic surgeon.
This surgery is usually done under general anesthesia, and the damaged intervertebral disc can be removed, partially or completely. Then, a material can be used to join the 2 vertebrae or an artificial material can be used to replace the removed disc. The time of surgery varies according to the location and the hernia situation of each person, but lasts about 2 hours.
2. Minimally invasive surgery
Minimally invasive surgery uses new techniques that allow a smaller opening of the skin, which provides less movement of the structures around the spine, a faster surgery time and less risk of complications, such as bleeding and infection.
The main techniques used are:
- Microsurgery: the manipulation of the intervertebral disc is done with the help of a surgical microscope, requiring a smaller opening of the skin.
- Endoscopic surgery: it is a technique made through the insertion of small accesses in the skin, thus allowing a procedure with faster recovery and less postoperative pain.
Minimally invasive surgery can be performed with local anesthesia and sedation, lasting about 1 hour or less. During surgery, a radiofrequency or laser device can be used to remove the herniated part of the disc and, for this reason, this type of surgery is also known as laser surgery.
Risks of surgery
Herniated disc surgery can present some complications, but the risk is very small, mainly due to the increasingly modern techniques and devices that have been used. The main complications that can arise are:
- Persistence of pain in the spine;
- Nerve damage around the spine;
- Difficulty moving the spine.
Due to these risks, surgery is reserved for those with unbearable symptoms, or when there has been no improvement with other forms of treatment for herniated discs. Find out what the treatment and physiotherapy possibilities are for lumbar disc herniation and cervical disc herniation.
How is recovery
The postoperative period varies according to the surgery, and the length of stay is around 2 days in minimally invasive surgery and can reach 5 days in conventional surgery.
The possibility of doing activities such as driving or returning to work is also faster in minimally invasive surgery. In traditional surgery, in order to return to work, a longer rest period is necessary. More intense activities, such as physical exercises, are only released after the surgeon's evaluation and symptom improvement.
In the recovery period, analgesic or anti-inflammatory drugs, prescribed by the doctor, should be used to relieve pain. Rehabilitation physiotherapy should also be started, with techniques to help recover movement and maintain good posture. See what care should be taken after spine surgery to speed up post-operative recovery.
Watch the following video and learn other tips that can help with recovery: