Recently, I watched "Hurricane" for the second time, and noticed a very small clip, which said that the actor An Xin went to the doctor, and the doctor told him that his lumbar disc herniation was already very serious, and the traction could only be relieved, and he still had to have surgery. After hearing this, An Xin said, "Surgery is not wasted", this sentence caused the author to think, will surgery for lumbar disc herniation really be "wasted"? In fact, it is not easy to answer this question, because the answer is not absolute. After consulting with a professional, I learned that although surgery carries certain risks, it does have some benefits. Experts emphasize that not all herniated discs require surgical management. Although surgical techniques have advanced greatly from open to minimally invasive surgery, it is necessary to be vigilant about the risk of structural instability and degeneration of the intervertebral disc and spine as a whole that surgery may bring. In other words, inappropriate destructive surgery, while it may be successful from a doctor's point of view, is not effective in addressing the patient's pain and may even lead to worsening of the condition. Therefore, the most critical to the effective treatment of herniated disc is to choose the most favorable treatment according to the degree of progression of the disease and the overall condition of the patient.
The lumbar intervertebral disc is an indispensable "shock absorbing belt" between adjacent vertebrae, with which we can cushion and distribute pressure while walking, running, jumping, sitting, lying down, lifting heavy objects, etc., while maintaining the stability and flexibility of the spine. With age, the impact of daily activities and lifestyle habits, the structure of the spine may change, which can easily lead to degeneration and herniation of the intervertebral disc due to uneven compression. Long-term compression of the annulus fibrosus may rupture, causing the nucleus pulposus to puncture the annulus fibrosus, compressing the nerve, or causing inflammation to irritate the nerve, causing symptoms such as pain and numbness. Therefore, once the above symptoms appear, do not tolerate or delay, and be sure to seek a specialist for examination. Even if you are diagnosed with a herniated disc in your lumbar spine, there is no need to fear because surgery is not the only treatment option. In addition to open surgery (laminectomy decompression), fixation surgery, etc., which sounds very "scary", there are also minimally invasive surgeries that are less invasive and have a faster recovery, such as intervertebral foraminoscopic surgery. In addition, there is less invasive percutaneous decompression, and there are also repairing and regenerating intervertebral disc treatments. Therefore, it does not mean that a person is going to be "wasted" by undergoing lumbar disc surgery.
1. Under what circumstances does lumbar disc herniation require surgery?
More than 80% of lumbar disc herniation can be improved by conservative treatment, and surgery is only required in the following special cases:
Compression of the nerve, causing the corresponding neurological symptoms, may require surgery. For example, compression of the cauda equina nerve leads to urinary and urinary dysfunction; Compression of the sciatic nerve has produced a decrease in muscle strength, and even a disorder, which is a sign that requires surgery, and if it is not operated on in time, it can even lead to paralysis and urinary dysfunction, and the consequences are unacceptable to many people;
Lumbar intervertebral disc herniation is the highest incidence of lumbar 4-5 and lumbar 5-sacral 1 discs, accounting for about 90%-96%. Those who have a clear diagnosis and have failed to respond to long-term systematic conservative treatment. It is best to undergo surgical treatment after 3 months of regular and systematic conservative treatment, with no obvious improvement in symptoms, and the diagnosis is confirmed by CT or contrast examination;
The disease progresses gradually, and the neurological symptoms are obvious. The patient's condition is aggravated, muscle weakness occurs, numbness and even prolapse in the innervated area, signs of nerve damage appear on physical examination, and the nerve root compression status is consistent with the symptoms in combination with CT, angiography, etc., which requires surgery as soon as possible;
Patients with lumbar intervertebral disc herniation combined with other lumbar vertebrae bony lesions requiring surgical treatment or exploration.
2. What are the surgical options for lumbar disc herniation?
With the rapid development of medical technology, there are many surgical methods for lumbar disc herniation, and patients with lumbar disc herniation can adopt different surgical plans according to their own conditions.
The traditional removal surgery treatment is to make an incision about 6-10cm in the patient's lower back, partially remove the lamina and articular facets, or perform discectomy through the laminar space, and when combined with lumbar instability and lumbar spinal stenosis, spinal fusion is required at the same time. Obviously, traditional enucleation surgery has the disadvantage of being invasive. Moreover, many people are likely to have damaged the intervertebral disc before surgery, and when the surgery removes the herniated tissue, it is necessary to pull the tissue, which will further cause damage and aggravate the damage of the intervertebral disc. Therefore, after the removal of the herniated tissue, the root cause of the damage of the intervertebral disc itself and the rupture of the annulus fibrosus still exists, so many people often do not get better or have a high recurrence rate after the herniation removal surgery such as the pometroscope.
Most readers may feel that the risks of surgery cannot be avoided, but it is actually possible to use cutting-edge regenerative therapies such as the "Discseel® Procedure" and "DST Disc Repair and Regeneration". The principle of DST intervertebral disc repair and regeneration is to accurately inject the physiological agent that can repair the damaged fibrous ring into the intervertebral disc at the disease point through a puncture needle, and the drug will soon adhere to the damaged fibrous annulus to achieve the purpose of repair. DST intervertebral disc repair and regeneration treatment can not only repair the ruptured fibrous annulus, but also promote the regeneration of intradiscal tissues, so that the intervertebral disc can restore a certain elastic function and is not easy to re-damage, which is also a treatment effect that cannot be achieved by other minimally invasive surgeries.
In addition, the Discseel®Procedure and DST Disc Repair and Regeneration have the advantages of being widely applicable. It is also suitable for a variety of conditions, such as intervertebral disc herniation, intervertebral disc degeneration, lumbar spinal stenosis, lumbar spondylolisthesis, spondylolisthesis, lumbar isthmus bifida, lumbar instability, scoliosis, etc., and even those who have not improved after other intervertebral disc surgery, or recurrence after surgery, may be suitable for DST therapy.
In April 2023, it was reported that the Discseel®Procedure was widely introduced by hospitals in and outside the U.S. Department of Defense to treat veterans across the United States, and this medical technology was promoted to hospitals in the U.S. Department of Defense at home and abroad.
The Discseel®Procedure, developed by American spine surgeons and launched in 2010, is an advanced treatment for spinal diseases. As of February 2024, the therapy has successfully treated more than 8,000 cases in the United States. At present, only Nochu Lumbar Spine Hospital in Japan has been officially authorized to carry out this technology in Asia, and has successfully treated more than 5,000 patients as of February 2024.
Finally, I attach the tips for Chinese patients to seek medical treatment in Japan:
1. Preliminary consultation: Search for Wild Lumbar Spine Hospital with Bing, find contact information on the official website to contact them, and inform them of your details (this hospital has a special medical translator who will assist you in consultation and diagnosis).
2. Free preliminary diagnosis consultation: Send the MRI (MRI) and other electronic images you took in the hospital to the doctors of the Nonaka Lumbar Spine Hospital for a preliminary diagnosis before coming to the hospital to determine whether it is suitable for the treatment of their hospital. If you don't have an MRI, you can make an appointment and go to their hospital for an examination, and if you make an appointment in advance, you can also get treatment on the same day after the examination. In addition, the hospital has interpreters who understand Chinese, so you don't have to worry about the different languages of the consultation.
3. Make an appointment: After the preliminary diagnosis comes out, if it is suitable for the treatment of their hospital, you can make an appointment with them.
4. Apply for a visa and go to Japan for medical treatment: Remember to apply for a visa in advance, book air tickets and hotels, and hospital UnionPay cards and credit cards can also be used. In addition, since you can be discharged on the same day of treatment at this hospital, you can apply for a tourist visa.
5. Visit, examination and diagnosis: After arriving at the hospital, you will first need to do MRI (MRI) and X-ray examination, and then the attending doctor will recommend the appropriate treatment for you according to the test results and explain it in detail.
6. Treatment: After the treatment content is decided, the treatment can be done after the appointment is made in advance and the doctor is discussed. The treatment time varies depending on the treatment, but after local anesthesia, the treatment time is about 15~30 minutes.
7. Rest and discharge: After the treatment, you can be discharged from the hospital after resting for about 1 hour.
8. Post-operative service: After treatment, there is generally no need to go to the hospital. The hospital staff will contact you regularly to understand the postoperative situation and answer questions.