What is the cause of lumbar disc nucleus pulposus detachment?

Under normal circumstances, there is a nucleus pulposus in the middle of the intervertebral disc, and there are some fibrous tissues around the nucleus pulposus. If the fibrous tissue is damaged, the nucleus pulposus will fall off, causing compression of the nerves, thus causing the intervertebral disc to herniate. This will cause pain to the patient. If the condition is serious, surgery is required for treatment. This is also a common manifestation of lumbar disc herniation.

Surgery

1. Indications for surgery:

① Patients whose non-surgical treatment is ineffective or whose recurrent symptoms are severe and affect their work and life ② Patients whose symptoms of neurological damage are obvious and extensive or even continue to worsen. Patients who are suspected of having complete rupture of the annulus fibrosus and protrusion of nucleus pulposus fragments into the spinal canal ③ Patients with central lumbar disc herniation and urinary and bowel dysfunction ④ Patients with obvious lumbar spinal stenosis.

2. Preoperative preparation

It includes X-ray positioning, which is done by marking the area with obvious tenderness and radiating pain with methylene blue, fixing a metal marker at the area with tape, and taking an AP X-ray of the lumbar spine for reference during the operation.

3. Surgery is performed under local anesthesia

The yellow ligament and the upper and lower vertebral plates of the affected part are gently retracted to expose the dura mater and nerve roots. The protruding intervertebral disc is circumcised with a long-handled knife, and the fibrous ring of the protruding part is removed. The pituitary forceps are inserted into the intervertebral space to remove the residual degenerate nucleus pulposus tissue. The wound is rinsed and sutured after complete bleeding. The operation must be meticulous and attention must be paid to hemostasis during the operation to prevent nerve damage. Gentomycin should be injected into the spinal canal after the operation to prevent intervertebral infection and a rubber tube should be placed for drainage before closing the wound.

Generally, only one intervertebral space is exposed during surgery. However, if two nucleus pulposus herniations are diagnosed before surgery or no abnormality is found in one intervertebral space, the other space can be exposed. Patients with lumbar spinal stenosis should undergo adequate decompression in addition to discectomy according to the degree of spinal stenosis, because the use of lamina fenestration or laminectomy does not affect the stability of the spine. The ability to move around the ground will recover quickly 3 days after surgery, and light work can be resumed 2 to 3 months later. Heavy physical labor should be avoided within half a year after surgery.

The above article introduces the surgical treatment methods for lumbar disc herniation in great detail. I believe everyone has a certain understanding of it. However, surgical treatment also has certain risks. It is hoped that patients can make good preparations before surgery and take good care of themselves after surgery, which can also reduce the risks brought by surgery. The editor here wishes that all patients with lumbar disc herniation can get rid of the trouble of this disease as soon as possible.