Lumbar Disc Herniation (Herniated Disc)

The spine is made up of a series of connected bones called vertebrae. The vertebrae prevent the spinal cord from being damaged. They are joined to one another by discs and facet joints. The outer layer of the disc is formed by the "annulus fibrosus" and its inner layer by the "nucleus pulposus." As we get older, the center of the disc loses water and the disc cushion begins to break down. The disc continues to deteriorate, and tears begin to form in its outer layer. If the gelatinous layer in the middle of the disc pushes outward and irritates a nerve root, this is called a lumbar disc herniation (a herniated disc in the lower back). Disc herniation is usually seen in the lowest two discs of the lumbar spine, in the lower vertebrae of the lower back.

The classic signs of a lumbar disc herniation are pain, numbness, a tingling sensation, or weakness in the legs. This painful condition is called "sciatica." The conservative treatment methods used for disc herniation are short-term rest, anti-inflammatory medications, painkillers, physical therapy, exercise, short-term use of a brace, and epidural steroid injections. In 80% of cases, results are achieved with these treatment methods within the first 3 months and the patient can improve. Surgery is required in cases where these treatments do not provide relief, where a marked loss of strength develops while standing, and in patients who develop urinary and fecal incontinence. The goal is to prevent the herniated disc from pressing on and irritating the nerves and, in this way, causing complaints such as pain and loss of strength. The most commonly used method is a discectomy. Here the aim is to remove the disc fragment that is causing the pressure.

In a lumbar disc herniation, the discectomy can be performed with the classic (open) technique, with microsurgery, or endoscopically. After the operation, the patient is helped to their feet and walked. They are discharged on the 1st day. They are able to return to work within 7-10 days. In a lumbar disc herniation, the likelihood of the herniation recurring at the same level is around 5%.