- Microendoscopic discectomy (MED)
- Percutaneous Laser Disc Decompression (PLDD)
- Thermonucleoplasty (IDET)
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Dyskopatia affects more and more people. Strong pain prevents them from living a normal life. Sometimes surgery is the only way to improve its comfort. Modern treatments are safe, do not leave scars and quickly get you back on your feet. Check what is the surgical treatment of discopathy: microendoscopic discectomy, percutaneous laser disc decompression, thermonucleoplasty.
Spine discopathyis usually treated primarily with rehabilitation and pharmacological treatment. However, if persistent or recurrent pain that interferes with work and normal functioning at home, your doctor may consider surgery. The most modern ones are less invasive than classic surgery, shorten the stay in the hospital and allow you to quickly return to daily activities. However, you have to be aware that no treatment can solve the problem in 100%, it only eliminates or significantly reduces the pain. Then, you should continue rehabilitation, take care of the spine, avoiding anything that hurts it. The choice of the method of surgery depends on the stage of the disease.
Microendoscopic discectomy (MED)
It is a minimally invasive surgical technique used in the case of significant displacement or prolapse of the nucleus pulposus into the spinal canal and compression of the nerve structures located there. The operation is performed under general anesthesia under X-ray control. The doctor makes an incision in the skin (approx. 2 cm) through which the endoscope is inserted (a device with a built-in camera that transmits a 20-fold magnified image of the operating field to the monitor through the optical fiber). Then, while observing the inside of the canal on the monitor, with special tools, he removes the fragment of the disk that compresses the nerves. After the operation, he puts on a suture and a dressing. The treatment takes about an hour.
WHAT AFTER THE TREATMENT? An antibiotic and a painkiller are given. After 3-5 hours, the patient can get up, and on the second day he can leave the hospital. After 7 days, the stitches are removed. There is no need for special rehabilitation, convalescence at home takes 3-4 weeks, then you can return to your daily activities. Complications are extremely rare (e.g. infection in the intervertebral space). The treatment is reimbursed. In a private hospital, it costs 8-10 thousand. PLN.
Percutaneous Laser Disc Decompression (PLDD)
Allows the removal of a part of the nucleus pulposus andreducing the pressure on the diseased nerve root with the use of medical laser energy. The indication for surgery is pain in the lumbar region that persists for more than 6 months despite treatment. Patients with the so-called closed hernia, with minor degenerative changes, without significant narrowing of the lumen of the spinal canal. The disc must be resilient and not too flattened. It is a good method for people in the early stages of the disease and for the elderly, as it carries no risk of general complications. The procedure is performed under local anesthesia, but for psychological comfort, sedatives are also administered intravenously. Under the control of X-ray or computed tomography, a special needle is inserted into the diseased intervertebral disc, and then an optical fiber is inserted into it, the end of which is connected to the laser. With the help of the high energy generated by this device, the nucleus fragment is removed and the water gradually evaporates. As a result of these processes, the pressure inside the disc is significantly reduced, and thus the pressure on the nerve roots is reduced or lessened. The treatment takes 10-30 minutes.
What after the treatment? Only a few hours after the surgery, the sick person can go home. During the first few days, many patients feel discomfort at the injection site. You may find relief with ice, or you can take a non-steroidal pain reliever. After a few days, most return to sedentary work, but for 2 weeks you should avoid long sitting, often standing up from the desk. The disc takes 4-6 weeks to heal. Complications occur sporadically (e.g. temporary disturbance of sensation in the leg, hands, depending on the operated segment, less often disc infection). In 90 percent of patients, pain complaints disappear, some of them relapse. A procedure in a private clinic costs approx. PLN 4,000. PLN.
Thermonucleoplasty (IDET)
It is a method of percutaneous lumbar discopathy surgery that allows the disc tissue to be broken down and the pressure on the diseased nerve root is reduced by means of high temperature. The indication for surgery is constant pain in the lumbar region or radiating to the leg, worsening with the torso bend or sitting, which lasts over 6 months despite treatment. IDET is offered to young people with non-advanced lumbar discopathy, who did not have a rupture of the fibrous ring, significant disc deformation, lowering of the space between the vertebrae, narrowing of the spinal canal, as well as neurological deficit (sensory disturbance, leg paresis). Under X-ray control, a catheter is inserted into the intervertebral space (it is placed in the intervertebral disc on the inside of the fibrous ring) with a thinwire connected to the electricity. Under the influence of the temperature of approx. 50 ° C, the structure changes and the collagen fibers of the fibrous ring shrink and the volume of the disc decreases. The procedure is performed under local anesthesia and takes about 20 minutes.
What after the treatment? You can leave the hospital one day after the procedure. During the first few days, many patients experience pain at the injection site. It can be relieved by applying ice and taking non-steroidal pain medications. Improvement is seen after 2 weeks. For 6 weeks you should wear a corset or an orthopedic belt and use exercises to strengthen your abdominal muscles. A rare complication is damage to the nerve roots in the lumbar region, causing muscle paresis. The operation does not guarantee a permanent recovery from the symptoms. In the event of recurrence of pain, some patients are qualified for disc removal by classic surgery. The procedure is reimbursed and costs about PLN 4,000 in a private clinic. PLN.
ImportantHow does discopathy develop?
Discs (pucks) separate adjacent circles. Composed of a pulp nucleus filled with a jelly-like substance and surrounded by a fibrous ring, they act as a bearing in the spine that allows movement between adjacent vertebrae. They keep the vertebrae at appropriate intervals and absorb shocks. If, as a result of overloading the spine, the disc "flattens", the adjacent joints begin to rub against each other. The articular cartilage becomes thinner and thinner, it becomes scratched and uneven. Over time, the fibrous ring is broken, as a result of which the nucleus pulposus dislodges (dislodging of the disc). The resulting ridge may put pressure on the spinal cord or nerve roots. Pain occurs and increases with movement.