تعريف

Intervertebral discs are located between each backbone (vertebra). When damaged, these discs can put pressure on nerves as they leave the spinal cord. An intervertebral diskectomy is a back surgery that removes all or part of these discs. The procedure is most often done on lumbar discs (located in the lower back). It may also be done on cervical discs in the neck. There are two methods for this surgery:

  • Open procedure—A large incision is made.
  • Microdiskectomy—Small incisions are made, and the doctor inserts tiny instruments through these incisions.

أسباب هذا الإجراء

These discs normally serve as cushions between the bones. The discs can become damaged or dry with age. Injury can also cause a disc to bulge (or herniate). These changes can create pressure on nerves leaving the spine. This can cause pain, numbness, and weakness.

The best time to have this surgery is debatable. This is because—for some patients—having early surgery may not result in less pain or disability. In most cases, surgery is only done after other treatments have failed. Other treatments typically include:

Laparoscopic

  • استراحة
  • علاج بدني
  • الأدوية

The goal of surgery is to eliminate pain, weakness, and numbness caused by the disc pressing on a nerve. You may feel relief right away, or it may take months for the nerve root to heal. In some cases, your symptoms may not improve. Your doctor will carefully evaluate you before surgery to determine what the best option is.

المضاعفات المحتملة

Complications are rare, but no procedure is completely free of risk. If you are planning to have intervertebral diskectomy, your سيقوم الطبيب بمراجعة القائمة من المضاعفات المحتملة، والتي قد تشمل:

  • نزيف
  • العدوى
  • تلف العصب
  • Bladder or bowel incontinence
  • Leakage of spinal fluid
  • Another herniated disk (may happen within the first three months after surgery)

تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:

  • Chronic conditions (eg, diabetes)
  • Prior spine surgeries
  • سن متقدم
  • التدخين

تأكد من مناقشة هذه المخاطر مع طبيبك قبل الجراحة.

ما يمكن توقعه

قبل الإجراء

طبيبك سوف المرجح أن تفعل ما يلي:

  • اختبار بدني
  • Ask about the pain and when it started
  • Obtain an MRI scan —a test that uses magnetic waves to make pictures of structures inside the back
  • Discography —an imaging test used to detect a herniated disk; involves injecting dye into a disc in the spine and taking an x-ray to determine if there are any leaks

المؤدية إلى الإجراء الخاص بك:

  • التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
    • الأدوية المضادة للالتهابات (مثل الأسبرين)
    • Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
  • Arrange to have someone drive you home. Also, arrange for someone to help you at home.
  • تناول وجبة خفيفة في الليلة السابقة للجراحة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.
  • Wear comfortable clothing to the hospital.

التخدير

General anesthesia will be used. It will block any pain and keep you asleep during surgery.

وصف الإجراء

There are different types of surgical procedures, including:

Anterior Cervical Diskectomy

A cut will be made in the skin on the left or right side of the neck. The doctor will go through a muscle to reach the spine. The disc material will be removed after the doctor uses an x-ray to confirm that it is the correct disc. A portion of the bone may be removed to give the nerve more space. A bone graft may be placed to fuse the vertebrae.

Posterior Cervical Diskectomy

A cut will be made in the skin at the back of the neck. The muscles will be pushed aside. A small piece of bone will be removed to get to the disc space ( laminectomy). Next, the doctor will gently push the nerve aside and remove the disc material.

Lumbar Diskectomy

The doctor will make a 1-1½ inch cut in the skin on the lower back. The muscles will be moved out of the way. A small part of the bone may need to be removed to gain access to the nerve and disc. The disc or disc fragments will then be removed.

Diskectomy

كم من الوقت سيستغرق ؟

This depends on:

  • Which method your doctor uses (open or minimally invasive)
  • Which procedure you need

For example, the minimally invasive surgery may take longer, but the recovery is faster.

كم هو مؤلم ؟

You will have pain while recovering. Your doctor will give you pain medicine.

متوسط ​​الإقامة في المستشفى

هذا surgery is most commonly done in a hospital setting. It may be possible to go home on the same day of the surgery. If you have a cervical diskectomy, you may have to stay in the hospital for a few days.

رعاية ما بعد العملية

Follow your doctor’s instructions . Bending, lifting, or twisting may be limited for six weeks. You will work with a physical therapist to stretch and strengthen your muscles. This will help to decrease the risk of future back problems. Ask your doctor about when it is safe to shower, bathe, or soak in water.

استدعاء الطبيب

بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • احمرار أو تورم أو ألم متزايد أو نزيف شديد أو أي إفرازات من موقع الشق
  • خدر أو وخز
  • ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
  • Pain, burning, urgency or frequency of urination, or bleeding in the urine
  • سعال وضيق في التنفس أو ألم في الصدر
  • Loss of bladder or bowel control

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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