Disc Removal/ Disc Prolapse Surgery

Disc prolapse is a condition in which there is a break in the harder outer area of the disc, and jelly-like material comes out and causes pressure on the nerves. All of the pressure arises from the pressure on the nerves. Disc prolapse is also the most common cause of sciatica pain.

The symptoms of disc prolapse include:

• Pain and stiffness of the low back
• Numbness, tingling, feeling of pins and needles, crawling of insects or loss of feeling of touch from back till foot, shooting pain like current flow or burning sensation from back travelling till foot.
• Difficulty in performing daily activities like
  a) Driving
  b) Difficulty in walking
  c) Sitting for a long time
  d) Bending to lift objects
  e) Coughing or sneezing or applying pressure using the washroom increases pain
• In very severe cases, loss of bladder and bowel control
• In severe cases, muscle weakness

Risk factors include:

• Earlier injury to the back
• Stress to the back like heavy weight lifting, manual work, abnormal sleep posture
• Looking at a particular point for a long time like computer working, painting, reading, or mobile use for long hours without maintaining proper position.
• Driving for very long hours

Disc prolapse can occur suddenly and be very severe, so much so that the patient cannot stand from bed or walk. It can also develop slowly over time. It depends on why disc prolapse occurs; if it is due to injury, it can cause sudden pain. In arthritis and other degenerative diseases of the spine, disc prolapse takes a longer time, and pain increases over time.

If pain has started in the back and goes down to the legs with pain in the buttocks, it can be due to disc prolapse. But if pain is present in the groin or at the hip, which increases with movement at the hip, it is due to the hip. Kindly consult the doctor to know the difference.

Disc prolapse is identified and diagnosed in following ways:

• Physical examination with a detailed history to find the cause of sciatica pain.
• X-rays of low back
• Computed tomography (CT) scans.
• MRI
• EMG
• NCV
• Myelogram (type of CT scan)

Disc prolapse can arise because of many causes and can occur at any age. It can be prevented in following ways:

• Maintain Good Posture. Place computers and phones in such a way that there is no pressure on your back while using them. Keep back straight when seated and use the arm-rest. While driving, maintain good posture. Keep your elbow, wrist, and hand straight. Use a mouse for computers instead of the touchpad and keep the screen at the level of eyes.
• Sleep Correctly so as Not to Strain Back. Use a pillow for head support; the head and neck should all be aligned. Place a pillow below the knees. It removes pressure from the low back.
• Take Frequent Breaks. move around, and stretch your body. If working for a long time in a sitting position, stretch back every hour.
• Avoid Heavy Weight Lifting. Weight lifting on the head and shoulders. Avoid lifting heavy weights by bending your back; bend your knees and lift.
• Exercise Regularly. do yoga or join physiotherapy sessions to strengthen back muscles.
• Don’t drive for Long. Avoid driving for very long hours continuously, take breaks in between.

Many patients 80-90 % are treated without surgery, and the results are good. It includes:

• Rest
• Physiotherapy
• Hot and cold massage treatment
• Painkillers and muscle relaxants
• Use of a lumbar brace

Many patients will only be treated with this; consult your surgeon and follow the advice.

If pressure on the nerve is severe, it may result in damage to the nerve. This will cause a FOOT DROP condition in which it will be very difficult to walk normally, and severe damage may result in loss of sensation in the lower limb depending on the nerve root affected. In very severe cases, bladder bowel control loss will occur. Consult your surgeon about low back pain, which lasts for a long duration.

In cases where the patient has taken treatment for more than three months, it is called chronic pain. Consult your surgeon immediately.

The surgery for Disc Prolapse is done in following cases:

• After treatment for a long time, the problem remains.
• The patient is not able to perform daily activities because of pain.
• Problems like weakness of legs, loss sensation of touch, unable to control bladder or bowel, thinning of legs muscles.
• Difficulty in maintaining balance or walking.

A final decision has to be taken in consult with a surgeon.

Many surgical options are present; the patient, in consultation with the surgeon, should know about what surgery is to be done and the risks of surgery. The role of surgery is to remove pressure from the nerve. The disc removal surgery involves the removal of a portion of the disc that is causing pressure on nerves.

This can be done in two ways:

• Microdiscectomy: It is a minimally invasive spine surgery in which surgery is done with a small incision/ cut. Microdiscectomy involves a small cut given on the back, and using special instruments, the portion of the disc which is causing the problem is removed along with other structures, causing pressure on nerves. Since the small cut is used, recovery is faster than giving more significant cuts used in the past.
• Endoscopic Disc Removal: It is also minimal invasive spine surgery done with small cuts/incisions. Endoscopic disc removal involves giving a minimal cut in the back and using a camera and other instruments to remove a portion of the disc that is causing problems for the patient. Since the cut is minimal and less damage to the surrounding structure is done, recovery is fast, and the patient returns to everyday life fast.

Kindly consult with the surgeon about which surgery is best for the patient.

The main problem with disc prolapse is caused by the portion of the disc causing problems. So only a portion of the disc is removed to keep the natural spine shape. Other structures are not damaged. This helps in:

• Spine remains stable
• Risks of surgery are less
• In complete disc removal, spine bones will have to be fused to maintain the stability of the spine
• Faster recovery

Usually, a patient has to stay for 1-2 days in the hospital.

Disc removal surgery with new technologies, a better understanding of the problem, and the use of Minimal Invasive Spine Surgery is routinely performed worldwide with a reasonable success rate. Final results depend on the patient's condition, so consult with the surgeon.

Recovery usually takes 4-6 weeks, after which the patient will have to join light duties. For complete recovery, it will take 2-3 months.

Very next day, with the help of some assistance and after a review with the doctor and physiotherapist, the patient will be allowed to walk.

The risk factors of disc removal surgery includes:

• Infection
• Injury to blood vessels and nerves
• Damage to the dura
• Injury to the spinal cord
• Failure to correct problems for which surgery was done

It depends on the hospital category chosen by patients and the type of surgery discussed with the surgeon. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and include complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the discharge of the patient. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he/she can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurance has included disc removal surgery.