The initial treatment of a herniated disc should be conservative, as clinical improvement is observed in most patients. In case of absence of response to medical-conservative treatment, persistence of pain or progression of the symptomatology with establishment of a motor / sensory deficit, the surgical option should be considered.
The choice of a certain type of surgical approach for the treatment of a lumbar disc herniation depends on a variety of factors, among which influence:
- The type of herniation.
- The location.
- Whether it is a pure herniation or there are associated degenerative phenomena.
- The patient’s age and physical condition.
- The need for additional stabilization.
As a general rule, a lumbar microdiscectomy is the method of choice, since it is a simple, fast and minimally invasive approach.
What are the advantages of using minimally invasive techniques?
The evolution of surgical instruments, the improvement of optics and the possibility of magnifying the visual field with the introduction of light in increasingly smaller surgical fields, with incisions of 1.5 cm or less, as well as the improvement of the physician’s technical capacity and the acquisition of three-dimensional knowledge of the vertebral anatomy, make it possible to approach hernias with increasingly smaller incisions and increasingly favorable results.
This benefits post-operative recovery, as the degree of exposure, muscle dissection involved and intraoperative bleeding are much lower, reducing hospital stay and facilitating the return to work in shorter periods of time.
What will the postoperative period and the results be like?
The postoperative period following herniated disc surgery is very short and the symptoms that caused the surgery generally disappear after the operation. Usually within a few hours after surgery a patient can walk with little discomfort from the surgical incision cut. The results are good in more than 90% of patients and the patient resumes normal life within 4 weeks. We should limit any attitude that involves lumbar overload, especially in the first weeks after surgery.
There is no contraindication for active walking after surgery. However, we should avoid any traction or sport that increases pressure on the recently operated disc, as well as any forced postures. Postural hygiene and correct handling of loads as well as maintaining an adequate weight, avoiding smoking and adopting a healthy lifestyle are factors to be taken into account in the subsequent course of the condition.