Indications, techniques and post-operative period for endoscopic microdiscectomy
Endoscopic microdiscectomy is a minimally invasive neurosurgical intervention. It is carried out to eliminate compression of a nerve root or the spinal cord. The operation requires the use of special tools, in particular of the microscope. Rehabilitation after surgery is required.
Indications and contraindications for surgical intervention
Endoscopic microdiscectomy is conducted in the presence of a hernia, the size of which exceeds 0.6 mm. surgical intervention is possible in the absence of a sequestrum, swelling and tearing. with In neurology this type of surgery is only done in cases, when a person is operated for the first time. Naturally, if there is damage to the spine.
The Operation is not performed in case if the hernia is characterized by large size. The main contraindications include:
- cauda equina syndrome
- spinal stenosis
- instability of the spinal segment.
An Operation on the lumbar spine may not be conducted in case if the person previously has been operated. Its implementation is accompanied by many difficulties, particularly at the level of L5-S1. With caution surgery is performed when serious violations in the lumbar spine. To perform an operation needs an experienced specialist, this will avoid complications in the future. The only consequence of the surgical intervention may be recurrence of the hernia. In this case, does not exclude the possibility of discomfort and infection.
Preparation for surgery and its implementation
for a herniated disc microdiscectomy holding is the best method of removal. However, before this procedure you need to prepare. The first step is to get tested, according to which it is possible to assess the overall human condition. For this study urine and blood. It is important to define the place of localization of hernia, the use of modern diagnostic methods, particularly MRI and CT. Before surgery should refuse food for 8 hours. The responsible role for the anaesthetist, he should examine the patient and determine the optimal dose of anesthetic.
The Surgery to remove the herniated disc is performed through an incision whose length does not exceed 4 cm. It Is in the spinal column lumbar. The first thing the surgeon lifts the muscle responsible for straightening the back. This is done using special hooks. To cross a scalpel the muscle impractical, it moves easily. Then the doctor can begin substantive work. Pushed back through the muscle to access the spine. Removing a membrane over the nerve roots, the surgeon continues surgery. In order to consider the end uses of the microscope. In most cases, removed a small portion of the inner surface of the facet joint. This allows easier access to nerve roots, making it possible to remove them with excessive voltage.
The operations are careful manipulation to remove the tissue of the intervertebral disc. During this surgery, the majority of ligaments, muscles and joints are not affected. Is not affected the integrity and the mechanical structure.
recovery Period after a microdiscectomy
surgery is performed in hospital. However, immediately after removal of the hernia, the person can go home. In some cases, means a stay in hospital, but no more than one day. Despite this, in the postoperative period the man should visit the doctor. This will allow you to monitor its condition and prevent possible complications. Rehabilitation is a long and difficult process. The person will have some time to abandon the heavy work and bending of the spine. The recovery period usually takes about 6 weeks.
Rehabilitation does not imply severe restrictions. The patient may return to usual lifestyle and even engage in physical activity. Sports activities do not affect the reappearance of the hernia. Moreover, due to the uncomplicated regular practice can avoid negative effects. The effectiveness of surgery is high and is about 95%. In 5% of cases may develop recurrence. The postoperative period requires constant monitoring by a doctor. The likelihood of recurrence is maintained in the first three months after surgery. However, in some cases it can occur years later.
Microdiscectomy with stabilizations allows you to get rid of the hernia, but does not exclude the probability of its reappearance.
In this case, it is desirable to resort to another surgery – spinal fusion. The operation involves removal of the intervertebral disc. It is advisable to carry out surgery of this type at constant relapses. Optimal treatment may appoint a doctor. He observes the patient in the postoperative period.