Surgical methods of a slipped disc
A surgical technique that is still rarely used today is the insertion of a disc prosthesis after removal of the own disc. The most common procedure is the so-called microdiscectomy. Here, the surgical team gains access to the intervertebral disc through an incision a few centimetres long above the spine.
Under x-ray control, the protruding disc tissue is then vaporized, so that the compressed nerve root can be relieved and the cause of pain can be eliminated. The procedure is usually performed under general anesthesia, rarely also under regional anesthesia, and is therefore completely painless. In specialised centres, this surgical technique can also be performed on an outpatient basis.
Besides this surgical procedure, there are also minimally invasive methods such as percutaneous laser disc decompression (PLDD). These are becoming increasingly popular because they are supposed to be less traumatizing due to the small surgical field. In terms of their success rate, however, they are not superior to microdiscectomy.
In addition to open surgery, minimally invasive surgical procedures also exist in disc surgery. These include the so-called “Percutaneous Laser Disk Decompression” (PLDD). Its greatest advantage is that it is performed under regional anesthesia, so that the patient is spared a general anesthesia in any case.
The indications for a PLDD correspond in principle to those of other surgical procedures of the intervertebral disc. The procedure is therefore mainly used in cases of progressive or suddenly occurring severe nerve damage, which manifests itself mainly in muscle weakness of the legs and functional impairment of the bladder and rectum. Nevertheless, the laser procedure is not suitable for every patient and every stage of disc disease.
For example, conservative measures are usually sufficient for mild intervertebral disc symptoms, whereas in the case of more severe diseases it is often difficult to achieve an improvement in symptoms with PLDD. At the beginning of the procedure, a puncture cannula and then a laser fiber is inserted through the skin into the gelatinous core of the disc. Since this is not done by open surgery, the positioning must be checked radiologically, i.e. by means of CT or X-ray.
The energy of the laser beam causes a denaturation of proteins and a vaporization of liquid in the tissue of the disc. This leads to a shrinking of the intervertebral disc and ultimately to a relief of the compressed nerve root. Superficially, only a small dot-shaped scar will be visible afterwards. The procedure can therefore rightly be described as very gentle and is therefore enjoying increasing popularity in neurosurgery.
Exercises in case of damage to the intervertebral disc
In order to prevent a herniated disc or a recurrence after an already suffered herniated disc, various measures can be taken. In particular, learning a good posture in everyday life and regular training of the trunk and back muscles play an important role. For this training, special exercises can be done at home or back-friendly sports can be practiced.
The latter classically include sports such as cycling, swimming and table tennis. When building up the back muscles in a targeted way, particular emphasis should be placed on strengthening the small, deep-seated muscles. This muscle group, known as “autochthonous”, runs from vertebra to vertebra along the entire spine and is of enormous importance when it comes to the stability of the spine.
Since it responds primarily to fast movements, it can be trained, for example, by asymmetrically moving the arms. For this purpose, a shoulder-wide stand in a slightly squatting position should be adopted. The arms are now moved quickly back and forth for about 30 seconds.
This causes a slight rotational movement in the upper body, which activates the autochthonous muscles. The exercise should be repeated two to three times after each one-minute break and performed daily. It is important, however, that the back is kept straight!
Despite all the motivation to train the back muscles, two things should still be considered: the best evening exercises are worth little if you remain inactive during the day! Even the occasional stretching, stretching and running around in the office or climbing stairs is helpful and sensible. Secondly, besides training your back, you should not forget that abdominal muscle training is also important.
As an opponent of the back muscles it is very important for the stability of the spine. If it is untrained compared to the back, the pelvis tilts forward and a hollow back is formed. Sit-ups with legs raised at a 90-degree angle or alternately raising arms and legs in a quadruped position are very back-friendly exercises.
