A herniated disc is a disease that occurs when the cartilage between the vertebrae slips due to excessive strain and enters the spinal canal, putting pressure on the nerves coming to the legs and the spinal cord. Its medical name is "discal hernia".
Whichever spinal bone it occurs between, the herniated disc is called by the name of that region. For example; If the cartilage between the 4th and 5th vertebrae has shifted, it is called L4-5 hernia discal. If the pain is in the right leg, it is called right L4-5, and if it is in the left leg, it is called left L4-5 hernia discal. A herniated disc most commonly occurs between L4-5 and the L5-S1 spaces below it. It is less commonly seen at L3-4 or rarely at L2-3 and L1-2 distances.
Practically, lumbar herniation is divided into two separate groups:
a) Lumbar herniation in the beginning stage
b) Lumbar herniation in the advanced stage
It is possible to separate. The treatment to be applied at each stage is different.
Therefore, a good diagnosis is half of the treatment.
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There is a pain in the side's leg, starting from the hip and extending to the heel. Since the sciatic nerve is under pressure, there is a rope-shaped pain along the sciatic nerve at the back of the leg, and patients say that it is pulled by a rope from the back of their legs. The pain becomes worse with coughing and straining. There may be no lower back pain in cases of herniated disc. The main symptom is pain in the leg. Although leg pain is usually in one leg, pain may be felt in both legs as a result of the large size of the hernia and its pressure on the spinal cord directly from the midline. But it mostly shows symptoms in one-sided leg. In some patients, stepping on the heel of the foot or walking on tiptoe is not possible or reduced due to loss of strength. In other words, there has been a loss of strength. This is evidence that the herniated disc is advanced. Additionally, some patients may experience paralysis in urination. In these patients, urine is evacuated with a catheter.
The severity of pain is not related to the size of the hernia. The region where it is located is important. The piece of cartilage that forms the hernia is just below the nerve coming to the leg. If it gets tight and pinches the nerve, the pain becomes severe. Sometimes, although a very large hernia is seen on MRI, the patient may have little pain. In this case, the cartilage that has slipped out of place is seated in the space on the side of the nerve, rather than right under the nerve. Since a very small part of it stays under the nerve and creates pressure, the pain is less. Or, conversely, the patient may arrive on a stretcher even though the hernia appears to be very small. For this reason, the patient's pain is not a definitive diagnostic method for us.
In other words, the patient's hernia is very large or advanced if the patient has a lot of pain.
HERNIA SURGERY
I would like to emphasize that; Only 5% of herniated disc patients can be treated with surgery. The remaining 95% of patients can recover with non-surgical treatment methods. Unfortunately, in our country, especially neurosurgeons give priority to surgery in the treatment of herniated disc.
When patients were followed for 10 years after herniated disc surgery, problems were observed in nearly half of these patients. In some of them, the hernia recurred, in some of them, a condition called adhesion occurred at the surgery site, and in some of them, waist slippage was detected in the lumbar spine bones (at the level of surgery). For this reason, surgery is not a guaranteed and long-term treatment method.
Disc herniated disc surgery should be considered as a last resort. Disc herniation surgery should not be the first choice of treatment due to its risks.
Disc herniated disc surgery 1) We can divide it into 3: Microsurgery, 2) Classical surgery, 3) The new method performed by hammering platinum.
My primary preference is microsurgery, which causes the least harm to the patient and minimizes the risk. This lumbar disc herniation surgery is performed with 2 stitches. Since it is done under a microscope, the possibility of damaging the nerves is very low. However, it is not possible to apply this method, that is, herniated disc surgery with a microscope, to every patient. However, it is best to force the patient to operate under a microscope.
The healing process of herniated disc surgery varies depending on the type of surgery performed. In microsurgery, the patient is made to stand up the next day and after an average of 15 days, if the work is not too heavy, the patient can return to work. It can return to normal.
THERN HERNIATED DISCUSSION
Disintegrated disc treatment: It is divided into two: surgical methods and non-surgical treatment methods.
Non-surgical treatment methods of herniated disc
1- Manual Treatment
2- Medical Ozone Therapy
3- Various Physical Therapy Methods.
The surgery for herniated disc can be divided into
1- Classical Herniated Disc Surgery
2- Microsurgery
3- Surgeries performed using platinum.
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