Hernia removal within the day

Lumbar disc herniation removal

Article index

1. What is a lumbar disc herniation removal?

2. When is a nucleotomy indicated?

3. How is the percutaneous hernia removal performed on the day?

4. Recommendations before and after a nucleotomy

5. Follow-up to a percutaneous hernia removal

What is a lumbar disc herniation removal?

It is a nucleotomy, a percutaneous spinal surgery that is minimally invasive and is performed posteolaterally to remove a part of the herniated disc that compresses the nerves causing low back pain (lumbago) to the patient. They require a correct 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.

When is a nucleotomy indicated?

This intervention is indicated mainly in lumbar disc hernias. These lesions can produce 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 and before proposing this treatment, he will have made a precise diagnosis and explained the therapeutic alternatives in his case.

How is the percutaneous hernia removal performed on the day?

It is performed in the operating room under local anesthesia and sedation, 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 placing the cannulas to introduce the nucleotomy materials and controlling the procedure with it to avoid errors and treat segments that are not affected. The procedure usually takes between 30-50 min, on average, and involves removing the disc fragments that are causing the problems.

Recommendations before and after a nucleotomy

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.

Follow-up to a percutaneous hernia removal

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.
Remember that this information is made for disclosure purposes and that only a spine specialist will indicate the appropriate treatment for your spinal problem.
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