Lumbar spine diseases are very common, and most of them are caused by strain and aging . It is customarily called degenerative lumbar spine disease in medicine.
outpatient doctors often encounter patients asking questions: I’m only in my early 40s, and I’m still alive and well in every aspect, why is it aging? In fact, the aging of the human spine does come earlier than we think. Most of the aging of is starting from the age of 30 or 40. Some people may appear earlier due to genetic reasons, and it is not 30 There is obvious aging phenomenon in the structure of the spine at age.
A certain part of the human body is aging, and aging is two completely different concepts!
Severe degenerative diseases of the lumbar spine, such as massive lumbar disc herniation , lumbar spinal stenosis, lumbar spondylolisthesis, and lumbar instability often require surgical treatment. There are three types of commonly used surgical methods: lumbar discectomy, lumbar spinal canal decompression, and lumbar interbody fusion .
(picture source: Internet)
lumbar discectomy
spine surgeons have a relatively late understanding of disc herniation.
It is well known that low back pain and disease have existed for a long time, and doctors will remove the herniated disc fragments through surgery very early. However, the doctors at at the time believed that the tissue fragments cut by were hyperplastic cartilage or cartilage tumors. Until the beginning of the last century, two young neurosurgeons in the United States believed that it was necessary to perform pathological examinations on the surgically removed tissue. The result was unexpected. These have been considered fragments of tumor tissue, and the cell structure is very similar to that of human intervertebral discs!
Since then, 's intervertebral disc is broken, protruding and compressing nerves, causing patients to have low back pain and lower limb pain. The mechanism of is accepted by doctors.
(picture source: Internet)
The earliest way to remove the intervertebral disc is to open a large opening in the back of , remove all the lamina and small joints on the back of the spine, expose the nerve structure in the spinal canal, and pull the nerve to one side , And then remove the fragment protruding in the spinal canal. At that time, there was no CT, and there was no advanced examination such as MR that could directly see the position and size of the intervertebral disc. Doctors only speculated based on the patient's clinical symptoms. It is conceivable that surgery is of exploratory nature, and often two laminas are removed and the protruding fragments cannot be found.
Early surgery has a great damage to the normal structure of the spine, and there are many sequelae .
(picture source: Internet)
After continuous improvement, the surgical trauma has become very small. Doctors
can use endoscopes and other tools to enter the spinal canal and deal with the intervertebral discs through the lumbar intervertebral intervertebral space, or use the more lateral intervertebral foramen to treat the intervertebral canal and intervertebral discs in the intervertebral space.
can not only take out the intervertebral disc directly with tools, but also destroy and dissolve it in situ. These operations have corresponding names such as discectomy, nucleolysis, disc ablation and so on.
In order to minimize trauma and preserve the function of the original intervertebral disc, doctors generally only remove part of the intervertebral disc tissue, so there are various names such as fragment removal, limited resection, partial resection, and subtotal resection .
(picture source: Internet)
Lumbar intervertebral disc is an important structure connecting two adjacent vertebrae. It has conduction load, cushion impact, and provides suitable intervertebral activity mode .
A damaged intervertebral disc, if you continue to keep and use it, it is likely to appear again or more times.
Therefore, pure discectomy for the treatment of lumbar disc herniation, is only a temporary measure, which is a palliative operation . When the doctor evaluates the patient, there is a high probability of re-protrusion in the near future, or because the intervertebral disc has been severely damaged even if part of the intervertebral disc is removedIf there is obvious low back and leg pain, the patient will be advised to undergo interbody fusion.
