Lumbar-Disk Surgery

Lumbar disc surgery is surgery to one of the discs of the lumbar spine. the lumbar spine is the last section of the vertebral spine and includes the five vertebral bone L1-L5, as well as associated structures including the discs, ligaments, facet joints, and muscles. People are more likely to experience pain in the lumbar spine due to its position towards the base of the back and the amount of weight pressures it must endure, because of the trunk, arms, neck and head. With animals that walk on all fours, the force of gravity is dispersed more equally throughout their spine and the energy of gravity is also redirected through all four legs. With our backs, the force of gravity is more concentrated towards the last vertebral bones and discs of the spine, as well as the sacroiliac joints in the pelvis. Because of the unique architecture of the human spine, and the amount of pressure its individual components must absorb as we sit, stand, and walk, and land, the rates that these structures wear our may be quicker that the same elements higher up in the spine. As certain structures wear our, the results of degenerative changes to the spine may include a change in its curvature, the loss of disc height, herniations of the disc, and arthritis. These changes may cause back pain. We may experience back pain when pain sensitive nerves in the degenerated structures inform the brain of a problem by sending pain signals. We may also experience pain as a direct result of the nerves of the spine becoming compressed or when there is compression to one of the nerve roots on either side of the spine becoming compressed. Nerve root compression is the most common cause of radiculopathy in the arms in legs. Radiculopathy is pain, weakness, numbness, or difficulty moving one of the arms and legs as a result of nerve root compression in the near the point where the spinal cord branches into out of the spine as nerve roots. Often radiculopathy that that involves pain or associated neurologic symptoms (numbness, weakness, difficulty moving) in the legs is the result of nerve impingement in the lumbar-sacral spine.

Surgery may be considered to be an appropriate treatment for back pain if one or more of the following conditions are present:
  • The person has severe back pain.
  • The person's back pain condition has neurologic components, including the various radiculopathy symptoms as mentioned above.
  • The condition has been diagnosed as one or more compressed nerve roots or compression of the spinal cord itself, as is often the case with the diagnosis of lumbar spinal stenosis.
  • The patient has a chronic lower back pain condition that has persisted despite the trials of more conservative treatments, such as medications, physical therapy, and pain injections.
Symptoms such as lower back pain with radiculopathy in one or both legs suggest a pinched nerve in the spine, and may be cause for surgery to remove whatever elements of the spine are causing the nerve compression. The most common causes of lower back pain that requires surgery are lumbar herniated discs or bulging discs. Both involve the weakening of the disc wall, which results in part of it pressing into the nearby nerve. In the event of a bulging disc, the wall weakens to the point where it outer wall (the annulus fibrosus) becomes warped, and bends outwards to press into the nearby nerve. When the disc herniates, its wall breaks completely, to allow the material in its center to squirt outwards. If this outwards projection of the nucleus impacts the nerve, it will likely cause the symptoms associated with radiculopathy and sciatica. Lumbar-Disk surgery procedures include:
  • Lumbar herniated disc surgery
  • Microdiscectomy
  • Laminectomy