Herniated disc (Intervertebral hernia)
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Herniated disc is one of the most common causes of back pain. The pathology develops mainly in middle-aged people. For the elderly, this disease is not characteristic in view of the age features of the structure of the pulpous nucleus.
Approximately 80% of cases of disc protrusion appear in the lumbar region, between the fourth and fifth lumbar vertebrae, or between the fifth lumbar and the first sacral one. The remaining cases are the hernia of the spine in the cervical area. In the thoracic area, the hernia is practically not found - their proportion is less than 1% in the overall structure of the disease.
Back pain is the key symptom. Pain grows in lying position and while sharp movements. There is a spasm of muscles in the problem area. Prolonged course of the disease is dangerous with nerve atrophy. As a result, there are violations of sensitivity, weakness in the legs, disorders of the pelvic organs. When the hernia is localized in the cervical region, hands often go numb, dizziness occurs, and blood pressure rises.
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Conservative treatment
Conservative as well as surgical methods of treatment of the herniated disc are used in Germany. Here you can also undergo rehabilitation after the surgery and it will help you to fully restore your work ability.
Following conservative methods are applied for herniated disc:
- Pain killers and anti-inflammatory drugs
- Massage
- Manual therapy
- Acupuncture
- Blockade of nerves with local anesthetics and glucocorticoids
- Physiotherapy exercises to strengthen the muscles and reduce the axial load on the spine
- Decrease in body weight - for the same purpose
This approach is effective in 85% of patients. However, in some patients steady pain syndrome persists despite the therapeutic measures carried out. There may be neurological disorders. If the pain does not go away, one needs to undergo a surgery. Radical treatment of hernia with modern methods is almost always successful.
Surgical treatment
Let’s have a look at the key types of surgeries that are applied for the herniated disc treatment.
Laser treatment is considered to be a minimally-invasive procedure. Surgery is carried out in the outpatient conditions. Laser treatment is only possible if the protrusion is of small size. This is the way doctors conduct the therapy at the stage of protrusion. Protrusion is the first stage of hernia formation when the integrity of the hernia sac has not been broken yet.
Microdiscectomy is a "golden standard" of surgical treatment of the intervertebral hernia when the partial removal of the disc is performed. It is removed together with herniated disc. The advantage of the operation is its high efficiency and low risk of relapse. The disadvantage is that it is more traumatic than endoscopic interventions. Microdiscectomy leads to the elimination of symptoms in 90% of cases.
Endoscopic nucleotomy is the procedure when hernia is removed by endoscopic surgery. The so called “keyhole surgery” is used. The doctor introduces tools and a video camera through the minimal cuts. Then he performs a hernia removal. The procedure is almost as effective as microdiscectomy. In this case, it is much less traumatic. A patient quickly recovers and no longer suffers from pain. In Germany, this surgery is used very often.
Of its shortcomings, it is worth mentioning only a 2 times higher risk of recurrence, in comparison with microdiscectomy. It depends primarily on the size of the defect of the fibrous ring. Bigger it is, higher the probability that a hernia will reappear in the same place is. Therefore, a thorough examination before the intervention is required. In the case of a small defect, an endoscopic nucleotomy is performed. If it has considerable size, microdiscectomy is indicated.
Discectomy and prosthetics of the disc is the most effective surgery. At the same time, it is the most traumatic and the most expensive one. But the risk of recurrence is completely excluded. The effectiveness of the intervention is close to 100%, because the damaged disc is completely removed. Instead, an artificial endoprosthesis is installed. No disc - no problem. Hernia will never appear there again. Nonetheless, carrying out this operation does not exclude the appearance of protrusions in other intervertebral discs. A person completely retains mobility after a discectomy with prosthetics, because an artificial disk has the same properties as a real one.
Benefits of treatment in Germany
Diseases of the spine are much more effectively treated in Germany than in developing countries. The main advantages of undergoing therapy in this country for patients with a herniated disc are listed below.
- Effective and safe surgeries. Minimally invasive surgical interventions are often used in Germany. There are many highly qualified specialists working there who fully know the technique of carrying out endoscopic operations. A person recovers very quickly after such procedures, because the tissue damage is minimal.
- No risk of neurologic complications. Doctors carry out all manipulations very carefully not to damage spinal cord or its roots. Therefore, after the intervention, there is no neurological deficiency, pain, weakness in legs, etc. A person completely restores working capacity, and the pain syndrome does not bother him/her anymore.
- Quality anesthesia. The surgery is not going to be painful. Doctors use modern methods of anesthesia. Pain killers are also used during the postoperative period. Therefore, the tolerability of surgical intervention is as good as its results.
- Conditions of stay in the hospital. High level of household comfort, individual diet, quality care and constant attention from medical personnel - that's what awaits you in Germany. All wards are well equipped. The patient's wishes are taken into account and, if possible, are fulfilled. Treatment of diseases of the spine is conducted in good conditions.
- Elimination of accompanying pathologies. In Germany, doctors pay attention not only to the hernia itself, but also to the reason that caused it. If possible, the main disease is treated as long as without it a hernia usually appears again. The primary pathology can be osteochondrosis, scoliosis, systemic connective tissue diseases, osteomyelitis, infections, etc. If necessary, not only the hernia, but also the main pathology is treated, which prevents the recurrence or the hernia in other parts of the spinal column.
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Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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