The spine is made up of many bones called vertebrae. These are roughly circular and between each vertebra is a 'disc'. The discs are made of strong 'rubber-like' tissue which allows the spine to be fairly flexible. A disc has a stronger fibrous outer part, and a softer jelly-like middle part called the nucleus pulposus.
The spinal cord, which contains the nerves that come from the brain, is protected by the spine. Nerves from the spinal cord come out from between the vertebrae to take and receive messages to various parts of the body.
Strong ligaments attach to the vertebrae. These give extra support and strength to the spine. Various muscles also surround, and are attached to, various parts of the spine. (The muscles and ligaments are not shown in the diagram below for clarity.)
At what age can a slipped disc occur?
A slipped disc in the lower back is most often seen between the ages of 30 and 50. In the cervical vertebrae around the neck, slipped discs are most often seen between the ages of 40 and 60.
Who Gets A Slipped Disc?
What Are The Symptoms Of A Slipped Disc?
Back pain
The pain is often severe, and usually comes on suddenly. The pain is usually eased by lying down flat, and is often made worse if you move your back, cough, or sneeze.
Nerve root pain (usually 'sciatica')
Nerve root pain is pain that occurs because a nerve coming from the spinal cord is pressed on ('trapped') by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Nerve root pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc, the sciatic nerve is the most commonly affected nerve. (The term 'sciatica' means nerve root pain of the sciatic nerve.) The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg. There is a sciatic nerve for each leg.
Lumbago, or what is more commonly known to people as lower back pain , is one of the most widespread and prevalent spinal problems. The reason for such persistent back pain is any kind of pathological problem in the lumbar region of the spine, which is made up of the last five vertebrae.
Lumbar spine problems are most often caused by herniated inter-vertebral discs, anomalous developments on the vertebral bodies (osteophytes), which apply pressure on the spinal nerves that leads to narrowing of the spinal column around the spinal cord. The most important procedures followed in a lumbar Spine Surgery are decompression and fusion.
Decompression : Lumbar Decompression spine surgery in India is performed to assuage pain caused by pinched nerves. The surgery is generally recommended in cases of spinal stenosis caused by thickened joints, loosened ligaments, bony growths, or disc herniation.
The various procedures used for Decompressing Lumbar spine are:• Discectomy• Laminotomy or Laminectomy• Port Hole Decompression• Foraminotomy or Foraminectomy• Osteophyte removal• Corpectomy
Fusion : Lumbar fusion surgeryin India has two individual approaches. The most common process used is the posterior approach, where the surgery is done from the back. The three main Posterior fusion techniques are:
• Postero lateral gutter fusion surgery• Posterior lumbar interbody fusion (PLIF) surgery• Transforaminal lumbar interbody fusion (TLIF) surgeryThe anterior approach involves placing the bone directly into the section between the vertebrae where the shock-absorption disc had been situated.
Candidates
Lumbarspine surgery in India is indicated for people who have pain that extends (radiates) from the back to the buttocks or back of thigh, pain that interferes with daily activities, weakness of legs or feet, numbness of legs, feet, or toes, loss of bowel of bladder control, had physiotherapeutic & medication input, but that hasn't helped.
Expected ResultsMost patients can expect a dramatic and lasting improvement in their back and leg pain after the lumbar spinal surgery . Though the success rates are excellent in Lumbar surgery , it can be lower in patients who smoke, are overweight, have diabetes or other significant medical illnesses, have osteoporosis, or who have had radiation treatments that included the lower back. Good nutrition and slowly increasing activity (as recommended by your physician) in the recovery period can help achieve success.
RecoveryYou are likely to experience pain and discomfort after the surgery which will be controlled with pain killers prescribed by your surgeon. You would be advised to walk the same day or the next after the surgery to prevent any clot formation. You would also be advised to do breathing exercises after the lumbar surgery for better circulation of blood and decrease the risk of any lung problem. You would need to stay at the hospital for about 5-6 days after the surgery and can go back home with specific instructions to follow. Many people return to work in 3-4 weeks after the surgery. But you may or may not be allowed to do heavy work depending upon your specific condition.
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