20-01-2021

What are the types of surgery for repairing a herniated disc?

A herniated disc can significantly impair a person’s quality of life. Sometimes, the only way to remedy the situation and alleviate the pain is through surgery. The specialists in neurosurgery from Instituto Clavel explain the importance of a getting a correct diagnosis and what treatment options there are for each case. 

First of all, it is important to clearly understand what a herniated disc is. The definition of a hernia is the protrusion of any organ or tissue outside its normal location. In the case of disc herniation, this occurs when an intervertebral disc in the cervical or lumbar area ruptures, and its content protrudes beyond the edges of the disc. 

Generally speaking, it is usually the soft center (nucleus pulposus) of the disc that expels material through a tear in the outer ring (annulus). In most cases, this kind of hernia is caused by the natural wear on the disc over the years, although there may also be other causes such as obesity, type of professional activity, or an accident, among others. 

The location and extent of the tear in the outer ring, as well as the amount of material expelled, will determine the symptoms of a herniated disc. This means that the symptoms of can range from little to no pain, or, if the herniated disc is in the same area where the spinal nerve roots run, it can press on them and cause pain, weakness and numbness. In the case of lumbar disc herniation, this will affect the legs or buttocks. In cervical disc herniation, the effects are on the shoulders, arms and hands. 

When this happens, it is essential to see a specialist in spine pathology for an evaluation to find out whether surgery is needed, and if so, which kind will have the best results for your case.  

The importance of correct diagnosis for herniated disc surgery 

Each case is different. For this reason, if surgery is to be performed for a herniated disc, the diagnosis must be correct for the surgery to be effective. In fact, back pain might come from some other cause besides a hernia, or there may be more than one herniated disc, yet only one of them causes the symptoms. This is why the specialist's evaluation must take into account the symptoms, evolution of the condition, physical examination, and imaging tests

At Instituto Clavel our team of experts has the EOS scanner, which yields a high quality image of the patient's complete skeleton. This helps us understand the problem more accurately and recommend the most appropriate treatment, which may involve surgery or not, depending on the specific case. If surgery is necessary, a careful diagnosis will allow us to choose which surgical technique is the most appropriate. 

Types of surgery for a herniated disc  

As we have said, the type of operation or surgical technique chosen will depend on the diagnosis. Currently, there are different options such as arthrodesis or disc fusion surgery, which consists of fixing or immobilizing two or more vertebrae to keep them permanently together, or disc arthroplasty or ADR (Artificial Disc Replacement), which consists of replacing the damaged disc damaged with an artificial one. 

At Instituto Clavel, whenever possible, we opt for cervical microdiscectomy for arthroplasty or lumbar microdiscectomy. We explain in more detail below: 

  • For cervical disc herniation: The surgery is most frequently performed with the anterolateral approach, a minimally invasive route of access to the cervical spine, because it avoids damage to the paravertebral muscles and manipulation of the nerves. It is also effective for complete disc resection and decompression of the nerve root. After this, the degenerated disc is replaced by an artificial one, which allows the natural mobility of the spine to be preserved because it is designed to mimic a healthy natural disc. 
  • For lumbar disc herniation: In most cases, we will opt for a simple microdiscectomy, which consists of extracting the hernia tissue and, depending on the case, partially emptying the affected disc. In cases of hernias with a very wide base causing nerve root compression, or associated with other pathologies, arthroplasty or disc replacement will also be considered. If additional elements of the anatomy are damaged, arthodesis or lumbar fusion will be chosen.  

Bear in mind, however, that this information is general, and, as we have explained, each case is different and it is essential to get a personalized evaluation from by a specialist, who will take into account all the determining factors for deciding on the most effective procedure. 

Recovery after surgery for a herniated disc 

The recovery time after surgery on a herniated disc will vary depending on the patient's previous condition, the type of surgery chosen and, of course, the rehabilitation steps taken. At Instituto Clavel we are committed to the minimally invasive techniques that we have referred to above because, in addition to offering better results, they allow a faster recovery. Although the case of each patient is different, generally they can return to work within 2 to 5 weeks after cervical disc surgery, and within 4 to 10 weeks, in the case of lumbar disc surgery. 

After the operation, we recommend that the patient undergo personalized rehabilitation with the traumatologists and physiotherapists specialized in the spine at FisioSpine. We work hand in hand with FisioSpine to offer our patients comprehensive treatment, from the moment they arrive at the center until they are fully recovered. 

Do you have any questions? We invite you to contact us so that we can assist you more personally, and you can also check our web to find out more about the treatments we offer. 

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