TREATMENTS
LUMBAR DISCECTOMY
A lumbar discectomy is a surgery to resect a degenerative or slipped disc causing lower back pain.
Lumbar Discectomy
An incision is created at the posterior via the back muscles to remove the disc or bone pieces pressing against the nerves. Dr Makan performs a discectomy when medication and physical therapy fails to reduce leg or back pain and nerve pain.
Why is a lumbar discectomy required?
Lumbar discectomy is often carried out to treat nerve or back pain and a lack of feeling in the legs.
Dr Makan performs a discectomy when imaging scans (CT scan, MRI or myelogram) indicate:
- A herniated disc
- Leg or foot pain
- Sciatica due to damage to the sciatic nerve that resides in the gluteal region
- Weakness in the legs
- Bowel incontinence
- Lack of sensation in the genital region
Procedure
Before surgery, preparation takes place whereby Dr Makan administers anaesthesia and cleanses and prepares the area for him to cut through. Then, using x-ray imaging by means of fluoroscopy, Dr Makan guides a fine needle into the skin through the bone to find the vertebrae and locate the herniated disc. Then, with an open discectomy, Dr Makan makes a lengthy incision at the centre of the back above the affected region. Often the back muscles are folded over to reach the vertebrae. In addition, an x-ray is done to confirm the injured vertebrae.
In comparison, a less invasive discectomy involves a faster recovery and much fewer incisions. First, a tiny cut of about 1 inch is made on the side of the back. Next, Dr Makan uses a dilator to push muscles and create a passage to access the vertebrae. Next, he creates a tiny hole in the lamina above and underneath the nerves. Once he removes the lamina, he pushes the nerve root's protective sac aside and looks for the damaged disc. Fortunately, he only removes the damaged parts of the disc pressing against the spinal nerve roots and synovial cysts or bone spurs. Finally, Dr Makan removes the dilator, sews the cuts using staples or stitches, and seals the opening with skin glue.
Recovery
After surgery, supervision is required for at least forty-eight hours. Dr Makan provides specific post-operative instructions to be followed for two weeks, after which he assesses the response to treatment at a follow-up consultation.
FAQ
Prior to surgery, you will be asked to sign consent forms and discuss any medication you take or any chronic conditions you have. In addition, Dr Makan will order pre-surgical tests such as a chest x-ray, blood test and electrocardiogram. It’s also very important for you to discontinue the use of blood thinners and non-steroidal anti-inflammatories.
On the morning of surgery, expect the following:
- On the day of surgery, do not drink or eat anything
- Shower using antibacterial soap to wash your skin and prevent infection
- Do not wear any makeup or jewellery
- Bring a list of medications, including the dosage and allergies you have
- Do not bend or rotate your back after surgery
- Do not lift anything heavy
- Avoid strenuous exercises
- You will not be able to drive for three days after surgery or while using pain medication.
- Avoid drinking alcohol or mixing pain medicine with alcohol
You will benefit from physical therapy exercises. Physiotherapy will help you regain lower back strength. Should you decide to attend these sessions, your return to full mobility will happen sooner than expected.