Lumbar disc herniation is a common lumbar disease, and surgery is the way to solve most lumbar disc herniation problems. According to Yang Dehong, chief physician of the Department of Spine Orthopedics, Nanfang Hospital of Southern Medical University, the current surgical treatment of lumbar disc herniation includes minimally invasive surgery and fusion surgery. Which surgery should the patient choose? Is surgery necessary?
A small number of patients can make the symptoms disappear through conservative treatment.
Yang Dehong said that with age, various organs of the human body will age, and the intervertebral disc is no exception. Intervertebral disc herniation is a benign degenerative disease and will not endanger life. , Can be relieved by treatment. Surgery is not the first choice for the treatment of lumbar disc herniation, but conservative treatment.
"A small number of patients can make the symptoms disappear through conservative treatment." He explained that the human body has a strong immune system that can remove and absorb some of the herniated discs; in addition, the human body has a strong adaptive function. After a period of time, the herniated discs Still or calcified, but the symptoms disappeared. However, only a small group of people with small disc herniation, relatively stable lumbar spine, and not very serious symptoms can be cured by conservative treatment, and most people need to rely on surgery. For this small group of people undergoing conservative treatment, their symptoms worsen during the course of treatment and need to be reviewed for imaging and may need surgery at any time.
"Symptoms are severe, affecting life and work, and patients whose conservative treatment is ineffective need to consider surgery." In this regard, Yang Dehong pointed out that surgery is not a panacea, and there are risks in both minimally invasive and broad operations. Can do no surgery without surgery, and can do minor surgery without major surgery. The purpose of the operation is to relieve symptoms, and the safety of the operation is the most important, and try to avoid reoperation in the future.
The choice of lumbar disc herniation surgery depends on two aspects:
"So far, no operation is 100% that meets everyone’s expectations." Yang Dehong said, whether to choose minimally invasive or fusion internal fixation for lumbar disc herniation, It is necessary to comprehensively consider the patient's condition and the patient's wishes. Although different doctors may recommend different surgical methods, they will first consider the effectiveness of the operation, and then the surgical trauma. Generally speaking, the problems that can be solved by minimally invasive surgery can be solved by traditional surgical surgery, and the latter has a larger indication range than the former. Therefore, no matter what kind of surgical method the doctor uses, it will be based on the condition of the patient, combined with the patient's ideas, and give the most appropriate advice.
minimally invasive surgery is to remove the protruding intervertebral disc that compresses the nerve through a small surgical trauma. The most significant advantage of the operation is that the trauma is small and the patient recovers quickly after the operation. Intervertebral disc herniation is a degenerative disease. It is a disease caused by the aging of the human body. The degeneration of the intervertebral disc, the narrowing of the gap, and the destruction of the fibrous annulus cannot be completely repaired. Therefore, there is a recurrence rate of about 20%. The possibility of stability. Fusion internal fixation surgery is to completely remove the intervertebral space of the herniated intervertebral disc and implant bone or bone material. In the future, the bone connection will grow in this segment of the space. This is the ultimate operation for this segment of the lumbar spine. Although the intervertebral disc will not be herniated, the motion function of this segment will be shared by other segments, and it may also cause the degeneration of the adjacent segment to require reoperation, but the incidence of this situation is relatively low.
He said that if patients want to minimize the reoperation rate, they can choose fusion and internal fixation; if they want to solve the symptoms and minimize the damage to healthy tissues, if they want to leave the final operation to new technologies that may appear in the future, they can choose minimally invasive surgery.
In addition to the patient's own needs, medical conditions are an important consideration for patients to choose the type of surgery. Yang Dehong introduced that both minimally invasive surgery and fusion surgery require special equipment, and doctors with rich surgical experience can handle more surgical indications. However, not every unit has the corresponding equipment, and not every doctor is skilled in performing these two types of operations. Patients need to fully evaluate their own situation before choosing the type of surgery.
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