Open lumbar disc surgery: review of candidates, advantages and disadvantages

Open lumbar disc surgery: review of candidates, advantages and disadvantages

Dr. Mahmoud Yazdan Panahi
Dr. Mahmoud Yazdan Panahi
Tehran
Open lumbar disc operation is prescribed when non-surgical methods such as medicine, physiotherapy or injection cannot relieve severe pain and pressure on the nerve roots. This surgery is performed to remove part of the damaged disc and reduce pressure on the spinal cord and nerves, and is usually recommended in cases such as advanced lumbar disc herniation, spinal canal stenosis, or severe motor weakness. The main advantage of open lumbar disc surgery is the rapid relief of pain and the return of the patient's mobility. However, this method can have disadvantages such as long recovery period, possibility of infection or recurrence of lumbar disc. For this reason, the choice of this type of surgery should be done with the opinion of a spine surgery specialist and after a detailed examination of the patient's condition. What is open lumbar disc surgery? When an intervertebral disc protrudes or tears, it puts severe pressure on the spinal nerves, causing pain, numbness, or even muscle weakness. In such cases, non-surgical treatments such as medication, physical therapy or injections are usually not sufficient for recovery. In this situation, the doctor may recommend open lumbar disc surgery as a standard and definitive procedure.Diskectomy: What It Is, Purpose, Procedure & Recovery In this procedure, the surgeon directly accesses the damaged disc by making an incision in the lower back and removes the protruding or torn part to relieve the pressure on the nerve roots. This type of lumbar disc surgery still has an important place in the treatment of patients due to the wide access of the surgeon and the possibility of correcting complex spine problems. Under what circumstances is open lumbar disc surgery recommended? Doctors go for this surgery only when other treatment methods have failed. Patients who have persistent pain, extensive numbness, or motor weakness are often a good candidate for this treatment. In addition, in situations where the protrusion of the disc causes severe compression of the spinal cord and there is a risk of permanent neurological complications, Open surgery is the main choice. Even in some cases, if the patient has urinary or stool incontinence, it becomes necessary to perform the operation quickly. In such cases, open lumbar disc surgery can help reduce pain and return the patient's mobility. Key Differences: Open Lumbar Disc Surgery vs. Minimally Invasive Procedures There are significant differences between open and minimally invasive spine procedures. In closed lumbar disc surgery, smaller incisions are made, muscles are less damaged and recovery time is shorter. But these methods are not suitable for all patients, and in cases where the damage is extensive or complex, the surgeon has to resort to the open method. In open surgery, the surgeon's vision is more complete and he can better evaluate and correct the different structures of the spine. Procedures for open lumbar disc surgery Open lumbar disc surgery is usually performed under general anesthesia. First, the patient is placed on the surgical bed lying on his stomach. Then the surgeon makes an incision in the lower back to access the spine. After the muscles are removed, a small part of the vertebral bone is removed to open the way to the disc. In the next step, the protruding or torn part of the disc that puts pressure on the nerves is carefully separated and removed. In some cases, if necessary, excess disc fragments are also drained to reduce the risk of recurrence. After finishing the work, the surgical site is sutured and the patient is transferred to the post-operative care department. The entire surgical procedure takes between one and three hours, depending on the patient's condition. Advantages and disadvantages of open lumbar disc surgery Every surgical method has its limitations in addition to its benefits. The main advantage of this type of surgery is the full access of the surgeon to the damaged disc, which allows precise correction of the problem. In many patients, after performing this procedure, a significant decrease in pain, improvement in muscle strength and increase in movement ability are observed. It is also less likely to cause symptoms to return than with less invasive procedures because the affected area is completely removed. However, the disadvantages of this method should not be overlooked. Larger incisions and more muscle manipulation lead to postoperative pain, bleeding, and longer recovery times. Some patients may need more time to return to work or daily activities due to these factors. Preoperative preparations and critical care after open lumbar disc surgery Before open lumbar disc surgery, the patient must go through a series of preparatory measures to minimize the risk of the operation. These measures include taking blood tests, checking the heart and lungs, stopping or changing some medications such as anticoagulants, and quitting smoking. Also, the doctor may recommend that the patient fast a few hours before the operation. After the surgery, post-operative care is very important. The patient usually stays in the hospital for a day or two to monitor his general condition. Controlling pain with prescribed drugs, taking care of the suture site, and preventing infection are the main primary measures. In the following days, physical therapy and gentle exercises will help the gradual return of mobility. Recovery period and return to daily activities after open lumbar disc surgery The duration of recovery after this operation varies depending on the general condition of the patient and the extent of the injury. Typically, patients have to wait a few weeks to return to their daily activities. In the early days, relative rest is recommended, but staying in bed for a long time can slow down the healing process. Physiotherapy and exercises under expert supervision help strengthen the back and abdominal muscles and make the spine more stable. Most patients will be able to resume light activities such as walking or office work after four to six weeks. In general, patience and follow-up of rehabilitation exercises are the keys to a faster and safer return to normal life after open lumbar disc surgery. Possible complications and strategies for their prevention and management in open lumbar disc surgery Like any other surgical procedure, performing this operation can also be associated with complications. Among the most common problems are surgical site infection, bleeding, blood clots in leg veins, or damage to nerve roots. In some patients, there is also a possibility of recurrence of disc protrusion, especially if the principles of post-operative care are not followed. Meanwhile, choosing an experienced surgeon plays a decisive role. Dr. Yazdan Panahi with high expertise and experience in the field of spine, by using advanced techniques and careful post-operative care, has been able to play a significant role in reducing complications and achieving successful results for patients. As a result, visiting a skilled surgeon and fully following medical recommendations is the key to preventing and managing possible complications of open lumbar disc surgery.

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