AM I A CANDIDATE FOR LUMBAR DISCECTOMY?
People who are injured in a fall, a motor vehicle accident and even those who have had no known trauma can develop problems in the lower back. Individuals that mistakenly lift excessively or with the wrong body mechanics can also acutely injure themselves. Athletes in some sports will have a significant incidence of injuring the lumbar spine.
Injury to the lumbar spine will cause pain in the following areas:
- Lower back
- Sometimes down the legs.
LOWER BACK PAIN PATIENT TESTIMONIAL
WHEN IS A LUMBAR DISCECTOMY PROCEDURE NECESSARY?
If you are experiencing any of the symptoms below, a lumbar discectomy could be right for you:
- Lower back pain
- Pain in the hips and/or legs
- Weakness, tingling or numbness in the legs
Tingling and numbness can also occur. Weakness that happens acutely is a very significant issue that should be investigated quickly. Loss of control of bowels or bladder, as well as loss of use/control of the lower extremities, signify an emergency.
It is necessary to undergo an MRI to be able to see the lumbar discs as they are the primary cause of the symptoms. By the time a disc is herniated, the presence of pain and other symptoms in the same region of the spine typically denote asymptomatic disc or discs. That person is frequently a candidate for the lumbar discectomy procedure at the levels of the herniated discs. Dr. Watson will assess your symptoms in his Tampa office before proposing the best treatment plan for lower back pain relief.
WHAT CAUSES LUMBAR NERVE COMPRESSION?
The typical cause of nerve compression is either a disc herniation that narrows the neural foramen or exit point for a segmental nerve from the spinal canal. That compression can also occur because of the presence of bony prominences in the neural foramen typically growing off of the back of the vertebral bodies. There may also be compression by a facet complex that overgrows because of an injury or degenerative process. Nerve compression can only be determined by evidence seen on an MRI scan as similar symptoms can occur with the inflammatory process involved with a herniated disc.
WHAT SYMPTOMS ARE TREATED BY LUMBAR DISCECTOMY?
The procedure will typically relieve low back pain as well as symptoms in the buttocks and legs. The leg symptoms include the following:
- Possible numbness
There are some cases in the low back where the lumbar discectomy procedure will not be indicated to treat the patient’s symptoms because the risks outweigh the benefit.
WHEN IS LOWER BACK SURGERY NECESSARY?
This procedure is an option as are the other discectomy procedures. Most patients have several alternatives and the discectomy is just one. It is helpful for relieving much of the pain and other symptoms in the low back and legs. The procedure is not needed unless the patient has symptoms severe enough for that individual to desire some sort of significant intervention including surgery to relieve the symptoms. In that circumstance, the lumbar DND is a good option for many who would prefer not to undergo a more invasive discectomy and/or fusion.
HOW IS A LUMBAR DISCECTOMY PERFORMED?
After being comfortably positioned on the operating table in the face-down position, the patient is given oxygen, connected to appropriate monitors and administered intravenous sedation to induce sleep. The patient may have a breathing tube inserted into the trachea or windpipe if considered necessary for safety during the procedure. This is accomplished after the patient goes to sleep.
A Thulium laser is then used to treat the posterior annulus of each symptomatic herniated disc and potentially some bulging discs. The procedure places sufficient energy into the annulus to turn off the nociceptors or pain nerves, char the annulus and sometimes shrink the bulge or herniation as well as seal the blood vessels extending into the annulus. These vessels bring compounds to the disc that cause further inflammation and pain in the area. This procedure is what relieves much of the low back and even leg pain as well as weakness, tingling and numbness in the legs. Lumbar facets that are symptomatic can be treated at the end of this portion of the procedure.
Completion of the procedure commences by injection of antibiotics into the disc(s), removal of the needles from the disc(s) and then placing a sterile dressing over the needle insertion sites.
HOW LONG DOES A LUMBAR DISCECTOMY PROCEDURE TAKE?
The Lumbar Discectomy and Neural Decompression Procedures are performed in a surgery center and typically is accomplished over the course of 75 minutes to 2 1/2 hours depending on the anatomy of the patient, the complexity of the pathology and how many discs are problematic.
WHAT HAPPENS AFTER MY LUMBAR DISCECTOMY SURGERY?
After the procedure is completed, the patient is awakened and moved to the recovery room until discharge. The average time in the recovery room is about 1 hour.