Patients suffering from herniated disc(s) of the spine have a variety of options available to them to help alleviate the pain they feel. When conservative methods do not deal with the symptoms, there is a minimally invasive and highly effective procedure that can be performed: the lumbar microdiscectomy. The relevant anatomy, preoperative diagnostic tests/procedures, preoperative procedures, including OR setup, prepping of patient, and draping, the surgical procedure and post operative results and potential complications will be described and discussed.
Discectomy literally means “cutting out the disc”. A microdiscectomy involves the cutting out of a vertebral disc, typically only a portion, via microscopic aids. The main indication for a microdiscectomy is a herniated lumbar disc or discs and is performed when conservative treatments such as rest, bracing, weight loss, physical therapy/exercise, anti-inflammatory medication, chiropractic manipulation and activity modification does not alleviate pain or correct the condition. An intervertebral disc is a kidney- shaped structure located between each pair of vertebrae that allows the back to flex and bend. The disc has a nucleus of semi-liquid substance and is surrounded by several layers of fibrous rings called the annulus fibrosis. The function of the disc is to cushion and absorb shock along the vertebrae of the spinal column that is caused by normal movements such as sitting, standing or lifting. Stress caused by bending, twisting and lifting heavy weights, aging, and specific trauma can result in the breakdown of the annulus fibrosis to the point where the nucleic material will leak out and push on the surrounding nerve. This is what is known as a herniated ...
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...improvement in or elimination of sciatica pain was reported” (Maria Hersht, Eric M. Massicotte, & Mark Bernstein, 2006, p. 448).
Reference
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Goldman, M. A. (2008). Pocket Guide to the Operating Room. Philadelphia, PA: F.A. Davis Company.
Maria Hersht, B., Eric M. Massicotte, M., & Mark Bernstein, M. M. (2006, March 13). Patient satisfaction with outpatient lumbar microsurgical discectomy: a qualitative study. Toronto, Ontario, Canada.
Rothrock, J. C. (2007). Alexander's Care of the Patient in Surgery. St Louis, MO: Mosby Elsevier.
Saris, S. (2011). Patient Guide to Minimally Invasive Lumbar Microdiscectomy. Retrieved 10 19, 2011, from Neurosurgery Associates: Rhode Island and Southeastern Massachusetts: http://neurosurgery-associated.com/min.htm
Popular television paint a glorified image of doctors removing the seriousness of medical procedures. In the non-fiction short story, “The First Appendectomy,” William Nolen primarily aims to persuade the reader that real surgery is full of stress and high stakes decisions rather than this unrealistic view portrayed by movies.
Availability of nerve block therapy, chiropractic treatment and high dose of pain medicine which will promote numbness, reduce sciatic nerve pain, minimize fatigue and decrease pain sensation. Similarly, implanted pain pumps which delivers a medicine directly to the spinal cord and symptoms can be controlled by smaller dose than needed dose with oral medication.
...her important consideration is that artificial disc replacement surgery requires an anterior approach through the stomach, and can cause major damage to important blood vessels, intestines, and urinary system components. Will's herniated discs are located in the lower lumbar region, and these vertabae have a low degree of flexation compared to vertabrae higher up in the spine. This means that replacement discs won't aid that much in retaining mobility, and lumbar fusion won't reduce flexation by that high of a degree. The experience of the surgeon should also be taken into consideration, and few surgeons have adequate experience with total disc replacement at this time. These reasons lead me to believe that a lumbar fusion would be the safest surgery for Will, providing adequate pain relief, and wouldn't limit his range of motion enough to warrant replacement discs.
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
Spinal Stenosis is a term commonly used to describe a narrowing of the spinal canal. This problem is much more common in people over the age of 60. However, it can occur in younger people who have abnormally small spine canals as a type of birth defect. The problem usually causes back pain and leg pain that comes and goes with activities such as walking. The purpose of this information is to help you understand: the anatomy of the spine related to spinal stenosis the signs and symptoms of lumbar spinal stenosis, how the condition is diagnosed, and the treatments available for the condition.
Historically, each year 11,000 people are added to the existing 230,000 cases of Spinal Cord Injury in the United States. Sad to say that young population ranging from 16-30 years old are affected by the Spinal Cord Injury. Learning the physiology of central nervous system is essential in understanding the function of spinal column. Central Nervous system is made up of spinal cord and the brain. The brain responds and receives sensory input from the spinal cord. The spinal cord is the communication link between the brain and the rest of the body. The spinal cord is a thick whitish cord of nerve tissue that extends from the brain to a point in the lower back called “conus medularis”. The spinal cord is encased in a protective canal that is formed by spinal vertebrae. The vertebrae and nerves are classified into several sections beginning from the neck. The first section shows seven cervical vertebrae, C-1 TO C-7. The next section is the 12 thoracic vertebrae, T1-T12, the 3rd section is called lumbar, L1-L5, the 4th section has 5 sacral and 1 coccygeal vertebrae. Each section is numbered from the top with a letter that corresponds to spinal section. For example the first section below the skull is C-1, the next section is T-1 in the thoracic section. When the spinal column is injured the communication would be disrupted between the brain and the parts of the body that is affected. The injury could be complete when no nerve fibers are functioning below the level of injury or incomplete when one or more nerve fibers are secure. The amount of functional loss depends on the level of injury. The higher the damaged the more of the body is affected including the neurological completeness of the injury. Individuals with neurological...
..., Ducker, T.B., ….. Young, W. (1997). International Standards for Neurological and Functional Classification of Spinal Cord Injury: International Medical Society of Paraplegia, 35, 266 – 274.
A medical assistant’s cooperation and presence during a surgical procedure is essential in order to provide satisfactory patient care. Although the role of the medical assistant may not shine though as strongly as the physician’s, their subtle presence provide organization in the form of administrative and clinical tasks to facilitate the physician’s demanding profession. During a surgical procedure, such as an incision and drainage of an abscess, the medical assistant is the patient’s first point of contact. The medical assistant’s role in any surgical procedure will begin as the patient schedules an appointment with the providing health care provider.
Urgent surgical intervention is more common in patients with an incomplete spinal injury. If the neurologic dysfunction worsens, urgent surgical intervention is necessary. The decision to operate depends on many circumstances. The cause and extent of the injury and spinal stability issues is to be taken in consideration. The type of surgery to be performed is decided by the surgeon. Surgery to treat a spinal injury involves decompressing the spine and stabilizing the spine. Surgery may not reverse spinal cord damage. However, decompression and spinal stabilization are important to prevent pain, deformity, and progression of neurologic deficits such as weakness, tingling, bowel or bladder
Weiner, S.S. & Nordin, M. (2010). Prevention and management of chronic back pain. Best Practice & Research Clinical Rheumatology, 24, 267-279. http://dx.doi:10.1016/j.berh.2009.12.001
No significant research has been done on the instance of complications and infections that occur during or as a result of minimally invasive spinal surgery. By conducting this study, the hope is to determine which method of spinal surgery is superior in terms of minimizing infection and complications. The information that this should conclusively prove will be beneficial to both doctors and patients to determine treatment courses for the best possible outcome.
Herniated discs are one of the most common spinal conditions that can affect a person's’ life. Although herniated discs typically cause pain in the lower back, the potential for pain to be transferred to other parts of the body as well is possible since a herniated disc is the pinching of nerves within the spinal cord region. In laymen’s terms, herniated discs are not a laughing matter or a back pain to be overlooked.
If you are at the point where you are considering scheduling lower back surgery to overcome the pain stemming from a degenerative spine condition, it is important that you do the research necessary to explore all of your options. While your doctor may be pushing for open spine surgery, many individuals can find the same chance of pain relief from a much less invasive endoscopic option, which is why it is so important that you always receive a second or even third opinion before scheduling any type of surgery. The last thing you'd want to do is consent to a highly invasive surgery when you could schedule an outpatient treatment instead.
Sullivan, M. E., Trial, J., Baker, C., Inaba, K., Etcheverry, J., Nally, M., & Crookes, P. (2014). A framework for professionalism in surgery: What is important to medical students? The American Journal of Surgery, 207(2), 255-259. Retrieved from ProQuest.
Spine surgeries are one of the most critical surgeries done in the medical field as they require so much of care even afterwards. It takes a lot of time as well to return to the normal daily routine of a person. Spine surgery mainly includes the below mentioned procedures: