Lumbar disc herniation microsurgery

It is a selective intervention performed posteriorly to remove the existing neurological compression due to a vertebral disc defect. They require a correct etiological diagnosis and assess that there is no instability in the segment to be treated as well as discard secondary diagnoses and assess the existence or not of neurological complications.

This intervention is indicated mainly in herniated discs at the lumbar level. These lesions can produce both central stenosis and foraminal stenosis and give very specific symptoms depending on the level of compression and is justified by a failure in conservative treatment or constant and evolving neurological involvement. It is very important to ensure that there is no instability, as it can have a negative impact after treatment. An experienced surgeon understands these concepts very well and before proposing this treatment, he will have made a precise diagnosis and explained the therapeutic alternatives in his case.

It is performed in the operating room under general anesthesia, for which a preoperative study with the anesthetist is necessary and can be performed a few days before. During the procedure, a fluoroscope is also used to locate the region to be intervened, marking before the incision and controlling the procedure with it to avoid commenting on errors and treating segments that are not affected. The procedure usually lasts between 30-50 min, on average, and consists of removing the disc that causes the problems.

Before performing this procedure, a correct medical evaluation and having a lumbar girdle with appropriate posterior reinforcement is recommended. The procedure has different protocols that will be specified according to the patient's health status. It is an outpatient procedure and is discharged the same day of the intervention (4-6 hours later) and recommendations of rest for 15 days as well as medical treatment to treat the inflammation caused by the intervention.

After 15 days after the intervention, the surgical team will assess its evolution and its postoperative period can begin to be integrated with muscle strengthening measures, nutritional recommendations or radiographic control with 2 evaluations planned per month and 3 months after the intervention, although, If necessary, the patient's situation will be assessed at all times, especially if circumstances outside the protocol could appear such as falls at home, hernia recurrence, surgical wound infections or pain that is difficult to manage due to intolerance to the medication or side effects to the drugs.