Disk Herniation (Lumbar Disc Herniation)
There are 5 vertebrae in the lumbar part of the spine. There are discs between each vertebra and the last vertebra (sacrum): 98% of herniated discs occur between L4-5 and L5-S1 (between the last 2 spaces). In humans, the center of gravity is centered on the L5 spine. Heavy lifting, trauma, sudden movement and even sneezing may be among the causes. Generally, medical treatment and rest are applied first. If there is leg pain that does not go away within 5-7 days, a herniated disc should be suspected and an MRI should be performed. If root compression due to an extruded (fragmentary) herniated disc is detected after MRI, surgical treatment is recommended instead of wasting time by treating with FTR and/or alternative methods. Because
during this lost time, losses such as numbness in the leg, loss of strength in the foot and loss of reflexes due to the pressure on the nerve root may sometimes not return. Today, there are many treatment methods such as percutaneous discectomy, endoscopic discectomy and microdiscectomy. The same treatment is not applied to every patient. However, among these, microdiscectomy is the most commonly used surgical method today.
Post-operative leg pain will be relieved, mobility will increase, and neurological losses, if any, will be regained over time. However, it is recommended not to perform any strenuous movements by giving the tissue the opportunity to heal for up to 45 days
after the surgery. Afterwards, it would be appropriate to be informed
by a physiotherapist about the movements and lifestyle that should be performed.
/> Lumbar hernias may recur in the same place at a rate of 5-7%. It may depend on the patient's age, gender, weight, work performed, traumas experienced, genetic factors and surgical success. Additionally, the same
patient may develop lumbar herniations in other spaces, on the right or left.
Cervical Disc Herniation
The human spine is divided into five regions from top to bottom.
Of these, Cervical (Cervical Disc Herniation) The neck) region consists of 7 vertebrae (spine) located at the top. Cervical
vertebrae (neck vertebrae) are smaller and flatter because they carry less load than other parts of the spine. Except for the 1st and 2nd cervical vertebra, both vertebrae are There are cushions, defined as
discs, in its lining. Their main task is to equally distribute the forces on the spine, while at the same time ensuring the flexibility and continuity of neck movements.
Herniation of the core part of the cervical disc and water loss is a natural process. Ruptured cervical disc
herniation may occur with acute (sudden) hyperflexion, rotation, or both movements. Here, it causes pressure on the nerve root in the spinal cord
or neural foramen and causes severe arm pain.
In the clinical evaluation of the patient with cervical disc disease, it is necessary to listen to the complaints, perform a meticulous
examination and select appropriate diagnostic methods. There is no neck pain in surgical cervical hernia
. Only if there is a pain in the arm, a cervical herniation should be suspected.
Radicular symptoms (signs of pressure on the nerve root) are mostly due to lateral disc herniation.
Pain. - decreases as the side arm is raised above the head. The sensation of touch and pain decreases in the appropriate
dermotoma. A decrease in deep tendon reflexes is typical in the appropriate myotome. Sensory and motor
changes are often simultaneous. It is very difficult to bear the pain in a surgical cervical disc herniation, and the decision to operate may be made before these late findings appear. There is arm pain, which usually increases at night and wakes up. Surgical treatment may include decompression, stabilization, or both. The anterior surgical
approach (front of the neck) is the most commonly applied procedure in cervical disc disease, however, the posterior approach is used in appropriate cases. The type of surgery is determined according to the age of the patient, the cause of the current
complaint, and radiological and clinical findings.
Today, anterior (front) simple discectomy (microdiscectomy), interbody cage fusion, mobile
cage( - movable), cervical prosthesis and posterior (from the back) laminectomy-discectomy are the commonly applied methods depending on the patient's
condition. In cases with the correct surgical indication,
results are very satisfactory.
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