MINIMALLY INVASIVE SURGERY
The advanced surgical treatment to decrease pain and operative time and offer faster recovery
Microscopic lumbar discectomy: The “gold standard” surgical treatment for herniated disc patients
When you experience some tingling, numbness or weakness that originates in the lower back and travels through the buttocks and down to the leg, you might have a lumbar herniated disc disease.
Not all patients with herniated discs are candidates for the open discectomy procedure. Most people find pain relief with the use of nonsurgical treatments such as rest, physical therapy, acupuncture therapy, chiropractic, anti-inflammatory medications and epidural steroid injections. However, sometimes the pain does not respond to these therapies and may require a more aggressive intervention.
Dr. Sarij Srisuparp, Orthopedic and Spine Surgeon, Bangkok Hospital, explained how herniated disc disease occurs and how lumbar herniated disc patients can be treated.
“Herniated discs occur when the outer wall of a disc becomes weakened, allowing the soft inner part of the disc, the nucleus pulposus, to push its way out. When the inner disc material leaks out passing the regular margin of the outer disc wall, it can press against sensitive nerve tissue in the spine causing weakness, tingling or pain in the back area and into one or both legs.”
Prior to an open discectomy procedure, doctors would recommend alternative treatments, such as pain relievers together with nonsurgical treatments and epidural steroid injection. During these procedures, measures of disability related to pain are required.
“To determine the level of severity of the disease, we utilise a pain score chart to measure the degree of pain and a disability index to measure the ability of a patient to participate in daily life activities. These can be used to evaluate individual patients initially to monitor them over time and to judge the effectiveness of treatments.”
Injection of steroids into selected nerve root * may be required to diagnose the specific source of nerve root pain and for therapeutic relief of the lower back and leg pain.
“X-rays ( by fluoroscope) are also used to ensure that steroid are delivered to the correct location. If the patient’s pain goes away after the injection, it can be inferred that the back pain generator is the specific nerve root that has just been injected. Steroids also help reduce inflammation around the nerve root.
After we know the exact location of the problem area, “minimally invasive surgery” can be performed, if needed.”
As a JCI-accredited hospital, Bangkok Spine Center, Bangkok Hospital, offers a fully integrated service and complete medical team, comprising neuro-spine surgeon, orthopaedic-spine surgeon, neurologist, psychiatrist, anesthesiologist, rehabilitation physician and others.
Bangkok Spine Center also implements the latest available technology, such as microscope, O-ARM and navigation and intra-operative neurologic monitoring equipment and employs a modern minimally invasive surgery technique called “Microscopic Discectomy” which is widely accepted around the world as a “gold standard” surgical treatment for herniated discs because of its low recurrent rate of disc herniation.
“If lower back and leg pain don’t respond to nonsurgical treatment, we may recommend microscopic lumbar discectomy to remove the section of the disc that is protruding from the disc wall and any other disc fragments that may have been expelled from the disc.”
Potential benefits of this popular surgical technique comprise less muscle and local damage, better cosmesis, decreased pain and operative time and faster recovery after surgery.
“Before discharge from hospital, a patient needs to feel comfortable to perform activities by his or her self, such as sitting and getting out of a car, getting into and out of bed, sitting on a chair, going to the toilet and bathing, as well as taking medicines for wound pain.”
“At home, the patient should not sit for more than 60 minutes at a time, lift heavy objects or perform vigorous activities, or sit in a car going for a rough ride for the first two weeks after surgery. After two weeks, the patient needs to start exercise program to build up belly and back muscles. Controlling their weight is also important to avoid getting excessive fat in the body.”
Source: Bangkok Post