What is internal fixation for lumbar disc herniation?

In daily life, lumbar disc herniation is a relatively common physical disease. It is usually caused by long-term physical fatigue or frequent physical work that leads to lumbar muscle strain. Suffering from lumbar disc herniation will not only affect physical health, but also easily cause some complications. Lumbar disc herniation internal fixation is a common treatment method that achieves the purpose of treatment through internal fixation.

What is internal fixation for lumbar disc herniation?

1. What is lumbar fusion and internal fixation?

Lumbar fusion and internal fixation is a basic surgical technique for the treatment of lumbar spine diseases. Through anterior, anterolateral, lateral, posterolateral, and posterior lumbar surgeries, bone grafting or implantation of fusion devices, facet joints, and intertransverse process bone grafting is performed to achieve bony fusion between the lumbar intervertebral joints, thereby establishing and maintaining lumbar stability.

2. What is the operation process of fusion internal fixation?

The surgery was performed under general anesthesia. The skin was incised, the muscles were peeled off to the pedicle, and pedicle screws were inserted into the pedicles of the relevant vertebral bodies. The intervertebral disc compressing the nerve is removed, the narrow nerve root canal is enlarged to relieve the compression on the lumbar nerve root, and then an intervertebral fusion device (or autologous bone fragments) is implanted, and the pedicle screw connecting rod is placed and tightened. Finally, complete the suture (the first layer is the deep fascia, the second layer is the subcutaneous suture, and the third layer is the skin suture).

3. What are the indications for fusion internal fixation?

Different doctors have different professional abilities, and it is difficult for different doctors to have a unified standard for the indications of lumbar fusion internal fixation. Some doctors believe that fusion and internal fixation are suitable for degenerative spondylolisthesis of lumbar vertebrae of degree II or above in the elderly, isthmic spondylolisthesis in young people, and symptomatic degenerative scoliosis of more than 30 degrees (these are the doctors who have the strictest grasp of the indications for lumbar fusion and internal fixation). Some doctors have broader indications and include intervertebral disc herniation as an indication for fusion and internal fixation.

Special reminder: Lumbar disc herniation and mild vertebral slippage are not indications for surgery, nor are they indications for fusion and internal fixation surgery. Imaging manifestations are only an important reference for deciding whether to undergo surgery. The decision on whether to undergo surgery and the specific surgical procedure must be made in combination with clinical symptoms.

What are the advantages of fusion fixation?

Fusion and internal fixation achieve stable reconstruction of the spine, and theoretically the surgical segment will not relapse.

5. What are the disadvantages of fusion internal fixation?

Fusion and internal fixation surgery is a double-edged sword, with both advantages and disadvantages. Now, combined with my communication with many patients after fusion and internal fixation surgery, the summary is as follows:

① This surgical procedure causes great damage to the patient's muscle groups, and has certain injuries to the supraspinal ligaments and interspinal ligament tissues. The damage to bone tissue is the greatest among all lumbar surgeries. It is the most painful and takes the longest recovery time among all types of lumbar surgeries.

② The load on adjacent lumbar discs will increase after surgery, and the risk of adjacent lumbar disc degeneration will increase. After fusion and internal fixation surgery is performed on certain segments, the load originally borne by five lumbar intervertebral discs is now borne by four, three or two lumbar intervertebral discs - this is equivalent to reducing the labor force while keeping the labor intensity unchanged. The per capita work intensity becomes greater, and the risk of adjacent lumbar intervertebral disc degeneration increases.

③It will sacrifice the spinal motion function of the surgical segment. In the three fusion and internal fixation surgery groups I am in, many patients reported that they had limited bending after the surgery.