Gold standard in lumbar hernia surgery

Specialists say that people with desk jobs are in the highest-risk group for lumbar hernia. About 80 percent of adults suffer from some form of pain in the lower back area. In most cases, lower back pain is caused by living conditions, strenuous working conditions, various physical accidents or incorrect posture. Undoubtedly desk jobs play a significant role in the occurrence of this medical problem.

Op. Salih Aydın, MD, a Brain, Spine and Neurosurgery Specialist at Emsey Hospital, said that the final point in chronic lower back pain is lumbar hernia. Although more prevalent in the between the ages of 30 and 60, it can occur in other age groups as well.

Factors like low physical activity, a prevalence of desk jobs, smoking and a sedentary lifestyle damage spinal disks, leading to the occurrence of lumbar hernias at early ages. An important cause of lumbar and leg pain is lumbar hernias that intensify later in life.

Contrary to general belief, the spine is not the only structure bearing the load of our bodies. Muscles in the neck, back and abdomen also play an important role. A sedentary lifestyle with little physical activity puts the entire load on the spine, rather than distributing it throughout the muscles. Weak muscles lead to the development of hernias between the disks. The problem is exacerbated if the person is overweight. However, it is still possible to overcome this problem by making a change in lifestyle.

Surgery becomes an option when conservative treatment methods like physiotherapy, medication treatment, resting or similar options become ineffective, or if the patient cannot be treated or presents pronounced, progressive neurological findings like foot problems, urological problems or persistent pain.

Surgical interventions aimed at lumbar hernia and the lumbar area in general are very precise operations for the patient. They might require multiple surgical operations.

Op. Salih Aydın, MD describes Turkey as an ideal place for these surgeries and emphasizes the importance of conducting them according to certain criteria. Op. Aydın says, “ It is imperative to correctly diagnose the patient and perform the correct from of surgery at the right time. Each discipline should effectively determine their boundaries. Failing to do so may result in what we term “unsuccessful lumbar surgeries which result in pain problems for the patient." Such patients might have to undergo two or more surgical operations to achieve optimal results."

Op. Salih Aydın, MD added, “ There are two forms of surgery performed today: Posterior open system and the percutaneous method that is performed over the skin. Until recently microscopic microsurgery was the golden standard for this treatment. Open micro-discectomy was introduced at the beginning of the 20th century. However, the excitement created by endoscopy nowadays was the same when microscopic disk surgery was introduced back then. It was very important to perform the procedure without harming spinal stabilization - in other words the ability of movement. Compared to the endoscopic method the microscopic microsurgery system is considered as an invasive method. Endoscopic disk surgery should be regarded as the new golden standard."

In endoscopic surgeries, the hernia is identified using a scopy (imaging) device. The device is used to locate the hernia and determine where it will be removed. This way, it is possible to mark it step-by-step and reach the hernia area. Removing the hernia relieves the leg nerve, while radiofrequency method reduces pressure on the disk.

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