In certain patients, surgery may be the best option for relief of symptoms and prevention of loss of function by removing the protruded portion of the disc and providing more room for the nerve root.
Edison, NJ (PRWEB) October 04, 2011
“For people living with lower back pain caused by a herniated disc, there is some relief: it’s unlikely they will have to go under the knife because symptoms generally improve gradually with conservative treatment,” according to Kaixuan Liu MD, PhD, chief surgeon at Atlantic Spinal Care in Edison, N.J. In fact, half will recover within one month, and the majority of those afflicted improve within six months. However, 10 percent will require surgery for a herniated disc. For the more than 250,000 Americans a year who undergo surgery to remove or repair herniated discs, modern science means a kinder, gentler experience.
What causes a herniated disc?
Dr. Liu details, “In a healthy disc, the outer wall is thick and tough; however, as degeneration sets in, the wall thins and dries out, allowing for the possibility of cracks or tears. Once that occurs, the disc can herniate when the inner disc material seeps through the outer wall of the disc.” The difference between a herniated disc in the back and a herniated disc in the neck is that the back herniation creates pain and symptoms in the neck, shoulder, and arms, while the latter manifests with symptoms in the lower back, buttocks, legs, and feet.
When is surgery necessary?
“Loss of bladder or bowel functions caused by a herniated disc usually indicates a need for immediate surgery,” says Dr. Liu. “In certain patients, surgery may be the best option for relief of symptoms and prevention of loss of function by removing the protruded portion of the disc and providing more room for the nerve root.” According to a recent study in the European Spine Journal, neurosurgery doctors at Leiden University in the Netherlands found that early surgery in patients with 6-12 weeks of nerve pain led to faster pain relief than prolonged conservative treatment.
What happens during a herniated disc operation?
Herniated discs have traditionally been treated with open back surgery. This procedure typically takes three hours and requires a large incision in order to get to the tissues in and around the spinal column, followed by cutting and tearing of the muscles, tissues, and surrounding structure.
“Open back surgery used to be the only means to gain access to the damaged disc,” says Dr. Liu. “However, it requires general anesthesia and a long recovery time. Modern techniques can take 75 minutes and allow for a smaller incision and less tissue manipulation.” Minimally invasive methods use an endoscope, a telescope-like device that carries a tiny camera that allows the surgeon to see the tissues that need attention. No muscles are cut, so there is less post-operative pain. Average recovery time is one to two days at home, whereas open spinal surgery can be two to three days in a hospital bed.
Dr. Liu outlines three minimally invasive herniated disc operations:
Endoscopic Spine Surgery: The surgeon only needs to make a small incision (usually less than a half-inch long) to insert the endoscope. There is no tissue removal and in most cases, the operation only requires only local anesthesia. Many patients are able to go home the same day, and typical recovery time is four to six weeks.
Endoscopic Discectomy: X-ray imaging and magnified video is used to guide an endoscopic probe into the damaged disc space to remove material that is causing pain. There is no bone removal, muscle damage, or large skin incisions.
Endoscopic Foraminotomy: This minimally invasive surgery is used to relieve pressure caused by compression from bone spurs, disc bulges, disc herniations, scar tissue, or excessive ligament development. Patients usually return to their normal activities in no time.
About Dr. Liu: Kaixuan Liu, M.D., Ph.D., is a renowned endoscopic spine surgeon and founder of Atlantic Spinal Care, LLC, in Edison, New Jersey (http://www.laser-spine.com).
Dr. Liu is certified by The American Board of Pain Medicine and The American Board of Anesthesiology, and is a member of The International Society for Advancement of Spine Surgery, The American Society of Interventional Pain Physicians (ASIPP), The American Academy of Pain Medicine (AAPM), The International Intradiscal Therapy Society (IITS), and The American Society of Anesthesiologists (ASA). He also serves as an international surgeon for The Spinal Foundations in England.