Lumbar Discectomy:- Diagnosis, Risks, Procedure, Recovery
What Is Lumbar Discectomy?
Lumbar discectomy is surgical procedure to fix a disc in the lower back spine. this surgery make smaller cuts (incisions) And this causes less damage to surrounding tissue.
Your backbone, or spinal column, is made up of a chain of bones called the vertebrae. Your spinal cord runs through the spinal column. The bones help protect the cord from injury. Discs sit between each vertebra to provide cushioning and support. Large nerves called nerve roots lead from the spinal cord through small holes in the bones called foramen. These nerve roots send and receive signals to and from the body. The signals are sent to and from your brain through the spinal cord.
Sometimes the outer wall of one of these discs may dry out and weaken with age or injury. When this happens, the soft, inner part of the disc bulges out. This is called a herniated or bulging disc. This bulging disc can press on the spinal cord and cause symptoms such as pain, tingling, or weakness in a nearby part of the body.
Why might I need a lumbar discectomy?
You may need lumbar discectomy surgery if you have a herniated disc in your lower back that is causing symptoms. The symptoms may include pain, numbness, weakness, or tingling in the back spine and in one of your legs.
Lumbar discectomy can’t be used to treat all cases of back pain. And not everyone with a herniated disc needs a lumbar discectomy. Your Surgeons might advise the surgery if you’ve tried other treatments but still have severe symptoms. Other treatments to try first include physical therapy, anti-inflammatory medicines and spine pain injection.
Talk to your doctor about the risks and benefits of lumbar discectomy surgery in India.
What are the risks of a lumbar discectomy?
Every surgery has risks. Risks for this surgery include:
- Bleeding
- Blood clots
- Infection
- Injury to nearby nerves
- Reaction to anesthetic agents
- Only short-term (temporary) relief and need for another surgery.
Your risks may vary depending on your age and your general health. Talk with your Surgeons about the risks that most apply to you.
Diagnosis of Lumbar Discectomy
Blood tests:- Levels of white blood cells, hemoglobin, blood clotting factors are performed prior to surgery. These levels should be normal, and if they are not, surgery needs to be rescheduled till all these parameters attain normal levels. Blood tests can also determine if the functions of vitals body organs like liver, kidneys, thyroid gland is optimum or not.
Electromyography test:- An electromyography test is another diagnostic test that could be ordered by the doctor before a lumbar discectomy surgery since this test reveals nerve and muscle dysfunction.
X-rays:- X-rays are ordered by the doctor to help him assess condition of vertebrae present in spine.
Magnetic resonance imaging (MRI):- Results of an MRI scan provide detailed information of nerves, ligaments and tissues surrounding the spinal region. And hence, MRI is ordered by the doctor before surgery.
Computed tomography scan (CT Scan):- Alternatively, spinal structures can be studied with the help of images created out of CT scanning
What happens before surgery?
Your Surgeon will explain the surgery to you and if you have any question or doubt you can ask your surgeons.
You will be asked to sign a consent form that gives your permission to do the surgery.
Your doctor will do a physical exam to make sure that you are in good health before undergoing the procedure. You may have blood tests or other diagnostic tests.
Inform your doctor if your are sensitive or allergy from any medicine, latex, tape and anesthesia medicines
Inform your doctor about your medical history, prescribed medicine and herbal supplements that you are taking, Like you are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting.
If you are pregnant or think you could be, inform your surgeons.
Ensure that you do not have anything to eat and drink after midnight the night before your surgery.
Morning of surgery
- Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing.
- Wear flat-heeled shoes with closed backs.
- Remove make-up, hairpins, contacts, body piercings, nail polish, etc.
- Leave all valuables and jewelry at home.
- Bring a list of medications with dosages and the times of day usually taken.
- Bring a list of allergies to medication or foods.
Arrive at the hospital 4 hours before (surgery center 3 hour before) your scheduled surgery time to complete the necessary paperwork and pre-procedure work-ups. An anesthesiologist will talk with you and explain the effects of anesthesia and its risks.
What happens during a lumbar discectomy?
There are several options for the surgery. Your surgeon can help explain the details of your procedure. It may take about 1 hour. Here is an example of what you might expect:
You will receive a local anesthetic by IV so that you won’t feel any pain or discomfort during the procedure. And you will still be awake. Or you may have general anesthesia and sleep through the procedure.
Your Surgeons will carefully watch your vital signs during the procedure. This involve things like your blood pressure and heart rate.
Your surgeon will make a small cut (incision) on your back, at the level of the affected disc.
During the procedure, your surgeon will use a special type of X-ray to make sure of the correct location.
Your surgeon will first insert a wire into the intervertebral space. Your surgeon will push a slightly larger tube over this wire. Then your surgeon will push a second, larger tube over that one. He or she may even push a third tube over the second one. This will gently push apart the tissue down to the vertebra. Finally, your surgeon will remove all except the largest tube.
Your surgeon will put special small tools through this tube, including a camera and a light.
Your surgeon will remove the herniated part of the disc using small tools. He or she will also do any other needed repairs.
The tools and tube are removed.
A small bandage is placed to close your wound.
What happens after a lumbar discectomy?
The lumbar discectomy surgery is generally perform an outpatient procedure. which means you can go home the same day of the procedure. You will probably need to stay for a couple of hours after the procedure at the recovery area. sometime stay for over night in the hospital.
Your Surgeon will give you instructions about how you can use your back. You might need to limit lifting or bending.
Your Surgeon may have you wear a back brace for a limited time after the procedure. You may need physical therapy after surgery to help strengthen your back.
You may see some fluid draining from your small incision. This is normal. inform to your doctor right away if there is a large amount of drainage from the incision site.
Sometimes the procedure causes slightly more pain for a while. But you can take pain piles to relief the pain. Usually this goes away quickly. Your pain should become less than it was before your surgery.
Recovery and prevention
Schedule a follow-up appointment with your surgeon for 1 weeks after surgery. Physical therapy may be necessary for some people.
The recovery time varies from 1 to 4 weeks depending on the underlying disease treated and your general health. You may feel pain at the site of the incision. The original pain may not be completely relieved immediately after surgery. Aim to keep a positive attitude and diligently perform your physical therapy exercises if prescribed.
Most people can return to work in 2 to 4 weeks or less with jobs that are not physically challenging. Others may need to wait at least 8 to 12 weeks to return to work for jobs that require heavy lifting or operating heavy machinery.
Recurrences of back pain are common. The key to avoiding recurrence is prevention:
- Proper lifting techniques
- Good posture during sitting, standing, moving, and sleeping
- Appropriate exercise program
- An ergonomic work area
- Healthy weight and lean body mass
- A positive attitude and relaxation techniques (e.g., stress management)
- No smoking
Frequently Asked Questions about Lumbar Discectomy ?
Q. How much does lumbar discectomy surgery cost in India
A. The average cost of lumbar discectomy in India range between 3000-8000 USD, depends on surgeons experience and hospital location
Q. What is the success rate of a lumbar discectomy?
A. The success rate for discectomy spine surgery is generally high, with one extensive medical study showing good or excellent results overall for 96% of people who have the procedure.
Q. How long does it take to recover from a lumbar discectomy?
A. The recovery time varies from 1 to 4 weeks depending on the underlying disease treated and your general health. You may feel pain at the site of the incision. The original pain may not be completely relieved immediately after surgery.