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Lumbar Discectomy
- Days In Hospital 2 days
- Outside Hospital Stay 15 days
- Success Rate %
Indicative minimum cost
$ 4500
Indicative maximum cost
$ 7000
Overview of Lumbar Discectomy in India
Lumbar discectomy is a surgical procedure that involves the removal of some part of the herniated or injured intervertebral disc in the lumbar region of the spine (back region). People usually opt for the lumbar discectomy operation when conventional therapies fail to relieve their symptoms, and they suffer from severe pain and neurological damage.
This surgery proves beneficial for those who suffer from chronic back pain. The person will be able to walk, run, and bend comfortably following the operation. A small incision is made in the affected region to perform the surgery.
What is Lumbar Discectomy?
Herniation of a vertebral disk is an ailment of the back commonly experienced by people. In herniated disk disease, the outer layer of the disk becomes fragile due to aging or injury. As a result, the inner part of the disk comes out. The inner part of the disk, which has come out, irritates the sensitive nerve in the spinal cord, resulting in extreme pain experienced by the individual. Lumbar discectomy or open discectomy is a surgical procedure that entails removal of part of the injured disk.
Types of Lumbar Discectomy:
Open Discectomy: This procedure entails making a big incision ranging from 2 to 4 inches into the back. Back muscles will be moved aside to have a clear view of the spine. Used for complex cases or severe disc problems.
Microdiscectomy (Microscopic Discectomy): This procedure uses special microscopic technology for the discectomy procedure. The surgeon uses a smaller incision ranging from 1 to 1.5 inches to remove the disc using special tiny surgical instruments. Muscles will have little damage; therefore, patients can have a fast recovery time.
Endoscopic discectomy: It involves the insertion of a thin tube that has tiny light and camera (endoscope). It uses a small skin incision where the surgeon uses small instruments inserted in the endoscope tube to extract the disc.
Percutaneous Discectomy: This procedure uses X-ray imaging technology. It involves using needles to insert special tools or lasers through a probe to either dissolve or suction away part of the disc.
Procedure:
Neurological physical exam
This is carried out to assess how well the nerves that run from the spine to the legs are working.
Myelogram
X-rays are requested by the physician to assist him to evaluate the status of the vertebrae within the spine. The myelogram test will show whether there is any compression due to herniation of the nerves or spinal cord. Therefore, dye is injected into the spinal cord to have better X-ray pictures. This process is referred to as myelogram.
Magnetic resonance imaging (MRI)
An MRI scan's results offer comprehensive details about the tissues, ligaments, and nerves that surround the spinal area. Therefore, the doctor orders an MRI before to surgery.
Computed tomography scan (CT Scan)
As an alternative, pictures produced by CT scanning can be used to study spinal structures.
Nerve conduction velocity test
The nerve conduction velocity test is a way of testing the health and functionality of a nerve. Electrodes that are adhesive in nature are attached to some predefined spinal nerves. An electric impulse is sent, and the amount of time it takes to reach another nerve is recorded.
Electromyography test
Before a lumbar discectomy procedure, the doctor may also request an electromyography test because it can identify nerve and muscle problems.
Miscellaneous
In order to evaluate your muscle strength and stability, the doctor will ask you to execute generic movements.
Blood tests
White blood cell counts, hemoglobin, and blood clotting factors are measured before surgery. The normal levels of these should be observed, and if that is not the case, then surgery should be delayed until the parameters get back to their normal values. Blood tests can also help in ascertaining whether or not the functioning of important body organs like liver, kidney, and thyroid glands are optimal.
Physiotherapy
The lumbar discectomy procedure will require a change in the structural formation of the vertebral column. Before surgery, certain exercises will be suggested by the physiotherapist that will assist in building up the strength of the back muscles. Therefore, after the surgery, the individual will not experience much difficulty in movement.
Anesthesia
In order to determine whether the patient is allergic to medicine, the doctor examines the patient carefully. This will help to select the type of anesthetic that can be administered.
How Lumbar Discectomy Surgery Performed?
The process is estimated to take about an hour to finish. The first step involves administering anesthesia to the patient by the experienced surgeon, after which the anesthesiologist and other medical doctors will be examining the patient's blood pressure and heart rate.
The surgeon cuts a small hole in the patient's back near the ruptured disc via special X-rays. Using the intervertebral space, the lead surgeon will thread a wire and pass through the wire another big tube. The doctor may choose to pass a third tube as well.
This step compresses the tissues surrounding the vertebrae. After this, the surgeon will remove all but the biggest tube. He removes the herniated discs and makes all necessary repairs. Then, he will remove all the tubes and dress the wound.
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Cost of Lumbar Discectomy in India
Prices are indicative only. The hospital sets the final cost after reviewing the patient's case.
Depending on the facility and the intricacy of the case, lumbar discectomy costs in India often range from USD 4500 to USD 7500.
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Indications of Lumbar Discectomy:
The choice to have a lumbar discectomy is usually made when conservative treatments have failed to alleviate symptoms or when the individual experiences persistent pain or neurological problems. Below are a few signs that indicate the need for a lumbar discectomy:
Difficulty walking or standing- As the soft material exits the cracks in the lumbar disc, causing pain, the person cannot stand for a long period of time. This disrupts the person’s daily routine. However, performing a lumbar discectomy reduces the severity of pain by cutting off the damaged part of the lumbar disc. Once the person undergoes the surgery, he begins standing and walking easily.
Nerve problems: Sometimes lumbar disc herniation may press against the spinal cord, resulting in various neurological symptoms. These symptoms include numbness, tingling sensation, and weakness in the legs. If these symptoms become severe, the doctor may recommend having a lumbar discectomy to treat the condition.
Ineffectiveness of non-surgical treatment alternatives- Microdiscectomy can be effective in patients who have attempted to alleviate their back pain through the use of medications, injections or physical treatments. The failure of these approaches may also affect the buttocks and cause pain when moving downwards.
Loss of bowel and bladder control- In some cases herniated lumbar disc can lead to compression of cauda equina, a group of nerves located at the bottom of the spine. It may lead to appearance of cauda equina syndrome with symptoms such as incontinence, significant weakness or numbness in the legs, and dysfunction in sexual life. Cauda equina syndrome is an emergency case requiring surgical removal of the disease causing damage to the f spinal nerves.
Risk Factors:
Anesthetic problems
There is a possibility of some problem with the anesthesia, but that can be sorted out by discussing the matter with the patient before the surgical operation. Moreover, there is the possibility of anesthetic agents affecting the functioning of the lungs. These possibilities must be explained to the patient before the surgery.
Nerve damage
The misplacement of the surgical tools can be capable of damaging the nerves that surround the spinal region or even the spinal cord. The numbness and weakness in the muscles is caused by the damage.
Blood clots
Deep vein thrombosis is another name for blood clots that lead to swelling of the legs due to blood vessel clotting within the legs. When these clots break loose and flow through the blood vessels, they can end up blocking the blood vessels supplying the lungs. This is a very dangerous medical problem that can be fatal.
Recurrent disc herniation
A recurrent disc herniation may arise in 5-10% of patients undergoing an open discectomy when the previously operated upon disc gets reinjured following the procedure.
Pain persists: Many times, there is a situation in which the patient reports pain persisting even post-surgery.
Risk of injury
Surgical carelessness puts the kidneys, intestines, and other important organs that surround the spinal region at risk of harm.
Wrongly operated site
The risk of operating the wrong disc is very minimal since there are a lot of discs in the spinal area. But in case this occurs, it can be rectified during the operation process through the use of X-rays to ascertain that the right disc was operated on.
Bleeding
Post-spine operation bleeding is something that is uncommon to come across. This condition may arise as a result of damaged nerves and tissues in the area where the operation was performed.
Infection
Vertebral infections can arise a few days or weeks after the procedure. Microorganisms can reach the patient’s body through the wound where the surgery is performed. The infection may affect the vertebrae and aggravate the patient's condition. If the infection progresses, an operation can help cure it.
Spinal Fluid Leak
Spinal fluid leakage after back surgery is very common. This might happen due to a tear in surgery or after surgery. However, there is a resolution to this problem.