Lumbar Disk Herniation
By the age of 20 the joints in the back begin to wear. During the years there are tears in the discs, the “shockabsorbers”
of the spine. A large tear in a disc causes acute back pain. The capsule of the disc will eventually burst
and the spongy cartilage material from the disc, the "nucleus pulposus tissue" which is more or less fragmented
in this stage, can be extruded into the spinal canal and compress a nerve root. We call that a disk herniation. The
compression of the nerve root will cause pain down to your leg and foot, sometimes as excruciating as if
someone was carving at it with a knife. In these occasions you may need strong painkillers.
Quite often the leg pain will subside after a few months and the muscle and nerve functions restored to almost
normal. The disc tissue in the herniation is found to be irritating to the nerve roots. Thus, anti-inflammatory
medication is recommended early. Manipulation of the spine can make it worse. Surgery is recommended after 8-
12 weeks if conservative treatment fails. The purpose of the operation is to relieve the leg pain. If the back pain
is still a problem after 6 months one might consider major spine surgery as a fusion or an arthroplasty.
If all the inclusion criteria given here are positive the chance of a good outcome of surgery is over 90%. If
however, the symptoms have more or less subsided, the outcome of surgery will be subsequently more
questionable. About 30% of all people have been found to have non- symptomatic disc herniation on MRI. It is
therefore very important for you to have the symptoms examined and evaluated by a spine surgeon.
Modern microsurgical technique will reduce damage to the muscles and permit earlier return to normal activity.
There are a few different optional methods. You will have more information from your spine surgeon which
alternative is preferred in your case. The operation is performed with the patient in prone position, in general or
local anaesthesia. It takes about one hour. The disc fragments are resected and the disc is cleared from loose
material. Sometimes the spinal canal is too narrow and needs to be enlarged. Next day you are permitted to sit
and walk. However, you have to take it easy a few days to minimise post-operative bleeding.