Lumbar disc herniation
A disc herniation is a fragment of an intervertebral disc that is migrated and may compress one or several nerve roots.
It is responsible for pain in the legs: sciatica or cruralgia.
When the pain is associated with a loss of strength in the lower limbs, or genito urinary troubles, the surgical treatment is an emergency.
The surgical treatment aims at releasing the compressed nerve root by removing the disc herniation in the spinal canal.
Iterative disc herniations are possible even though rare.
Hernie discale lombaire
Lumbar disc herniation surgery
The surgery is done when the medical treatment (painkillers, infiltrations, physiotherapy) does not provide effective pain relieve, or in cases of neurologic deficits (muscle weakness, genito urinary troubles)
The surgery is performed through a posterior approach. Wether the approach is open for a microdiscectomy, or endoscopic, there is anyway minimum muscle damage and surgery is minimally invasive.
A fenestration is usually done first, meaning creating a working space in between the posterior part of the two vertebra above and below the index level. The yellow ligament is removed, and then the compressed nerve root is exposed, carefully retracted if necessary, and then the disc herniation is removed.
By the end of the procedure, the nerve root and the dura should be free from any conflit coming from the joint or the disc.
The patient should be able to stand and walk within few hours after surgery, and allowed to get back home the same day or the day after.