Cartilage is a joint disc between the vertebrae in the spine, in the cervical, thoracic and lumbar vertebrae. It consists of a cartilage and jelly material and is surrounded by a strong, protective capsule.
The wear and tear of the cartilage is the result of incorrect movement of the vertebrae, carrying a heavy object, or an accident that led to injury to the vertebrae. The possibility of a herniated disc in patients increases as a result of hereditary factors, congenital defects in the vertebrae, defects in the tissue formation of cartilage, or patients with rheumatism and its types. It has been proven that smoking leads to dry and worn cartilage, which leads to an increased possibility of a herniated disc. Smoking has become a major cause of a herniated disc
Symptoms of a lumbar herniated disc
By herniated disc, we mean moving a fragmented part of the cartilage out of place. Symptoms of the disease depend on where the fragmented cartilage slipped into and these symptoms
Localized pain in the lower back that may be likely to start.
And it progresses to worse or better and is a result of cartilage wearing out or protruding without causing pressure on the nerves feeding the lower extremities
– If the cartilage has slid towards the nerve outlet
Going to the left or right lower extremity, and causing pressure on the lumbar or sacral nerve, it may lead to pain in the lower extremity, numbness in the leg and foot, and difficulty walking. If pressure develops on the nerve, it may lead to nerve weakness, limb and foot movement, and difficulty walking
– And if the cartilage slid towards the middle of the spinal canal
It leads to pressure on the entire nerve nerve inside the spinal canal, causing pain in the legs, numbness of the mechanisms and legs, and difficulty walking. And if the disease progresses, it may lead to a loss of control over the urine and stool outputs, and this stage is so dangerous that it requires emergency surgery.
Herniated Disc Treatment
When the patient visits the specialist doctor, and makes sure that there is no weakness in the nerves feeding the lower extremities or the nerves to the exit points of urine or stool, the priority is conservative treatment, and it includes sedative drugs, rest, exercise, swimming, moderate walking, and physical therapy, and it may also include cortisone In the spinal canal around the lumbar and sacral nerves. The success rate for controlling the symptoms of a herniated disc with conservative treatment is about 80%.
We resort to surgical treatment in cases of deification
– The presence of severe weakness in one or both of the lower extremities
– Impairment in controlling urine and stool outputs
Failure of conservative treatment and the patient`s intolerance to pain.
In the first two cases, the need for surgery is urgent, in order to save the damaged nerves as quickly as possible before permanent damage occurs.
Laparoscopic surgical treatment
Neurotechnical surgery is used using a posterior endoscope to remove the herniated disc to avoid the risks of large cuts of skin, muscle and bone tissue, as is the case with conventional surgery, reduce the length of stay in the hospital, reduce the financial cost, and accelerate the patient`s movement from his bed after the operation
This advanced surgery is done using general anesthesia and the patient is placed asleep on his stomach. We insert a tube with a diameter of 2 cm from the lumbar region towards the side of the herniated disc, we remove the herniated disc and expand the nerve outlet, and then we close the small wound
After the patient recovers from the effects of the operation and the anesthesia, the patient feels the pain in his leg has disappeared, and we move the patient and allow him to walk the next day, and he can leave the hospital with a sick rest for several weeks. We recommend that the patient use some back strengthening exercises three weeks after the date of the operation, and after two weeks he can return to work
The success rate in controlling pain using a rear endoscope to remove a herniated disc is 95%. The rate of complications is about 5% and includes the possibility of wound or cartilage inflammation, nerve inflammation, or the possibility of returning the patient to the operating room and removing another part of the cartilage.