What is Lumbar disc herniation?
Lumbar disc herniation occurs when one of the cartilage discs between the vertebrae in the lumbar spine protrudes and irritates one of the spinal nerve roots that make up the sciatic nerve.
A herniated lumbar disc gives rise to sciatic pain in the leg which can be severe and impact your quality of life.
What causes Lumbar disc herniation?
A long process of degenerative changes within the disc causes it. That leads to cracks in the perimeter of the disc and allows the soft cartilage from the centre to protrude.
Typically, it is triggered by a minor event like getting out of bed, twisting, or picking something up.
Why have surgery?
Lumbar disc herniation surgery is one of the most common spinal surgeries.
The major benefit of the surgery for Lumbar disc herniation is to relieve pain, which in over ninety per cent of cases is immediate. For everyone else, it takes a little longer.
The Surgical Process
The surgery takes place under a full anaesthetic, so it requires admission to the hospital for between one and three nights.
- We place you face down on the operating table and then anaesthetise you.
- Using X-rays, we find the correct level to operate and make a small incision in the middle of your back.
- We then we expose the spine on the side of the pain and remove a little bit of bone and ligament so we can see the spinal nerve root. Using a microscope, we gently move the nerve across so we can see the protruded disc underneath.
- Then we pluck out that loose fragment of disk and check that there are no more loose pieces lying around. After this the nerve is safe and free.
- Then we close the incisions.
The whole operation takes about an hour, occasionally longer.
The immediate after-effects of surgery
There will be some pain at the site of the surgery at the site, though the experience varies.
For some people it can be quite sharp. For others, it is just a dull numbing pain.
It usually settles down within a week or two.
Your Recovery from Lumbar disc herniation surgery
Initial pain relief is via an intravenous drip which we usually stop the day after surgery. Then switch you over to oral tablets.
We get you up and walking the day after surgery, and you can go home as soon as you feel comfortable. For many people, that is the day after surgery. Sometimes, people might stay an extra night or two.
Most people are feeling good by two weeks after the surgery. So, if you have a sedentary job or work from home, you can start back up after two weeks. If your job involves more physical work and heavy lifting, allow yourself six weeks.
In that first six weeks, my advice for everyone is that the best form of recovery is to go walking as much as you can. And only after that initial six weeks should you resume any of your normal exercise routines.
Typically physiotherapy is not required, but if you want it, then again, wait till after the six-week recovery period.
POST-OPERATIVE follow up
I will see you post-operatively, one or two weeks after the surgery and again after six weeks. To assess how you are going in your rehabilitation and to discuss any side effects you might be having.
If you have any questions about Lumbar disc herniation and surgery, please don't hesitate to contact us.
Author:
Dr Ralph Stanford
Dr Stanford is a spinal surgeon with over 20 years’ experience. He is Head of Department of Orthopaedics at Prince of Wales Hospital and adept in all surgical approaches to successfully treat his patients.
Dedicated to lifelong learning, Ralph attends spinal conferences worldwide and regularly consults with colleagues about successful treatments.
He is also a current member of Spinal PFET and an active researcher in spine disorders.
If you have any questions he can be contacted on 02 9650 4893 or info@powspine.com.au.