Spinal hernia surgery consequences. Consequences of removal of intervertebral hernia

He knows what kind of pain comes with it - long-lasting, not going away for weeks, not responding to painkillers, and how hard every movement is. And sometimes the disease even leads to paralysis of the limbs and disorders in the functioning of important internal organs, and then, of course, there can be no talk of normal life activity at all. When all methods of conservative treatment are exhausted, and “things are still there” or, even worse, they are rolling downhill, and causes arise that require immediate intervention, then the question of removing the pathology is raised. An operation to remove a herniated disc sometimes becomes the last alternative for such a patient and the hope that it will bring a cure.

The decision to operate to remove a vertebral hernia should be made by a person carefully, carefully and not hastily. The temporary period after which, in the absence of effect from traditional methods of treatment, is proposed, is considered to be a month and a half. However, it is better to increase this period to three months, if, of course, you have enough strength and endurance, and there is no deterioration in health. In most cases, we are in too much of a hurry and quickly give in to panic, and we really don’t like to endure pain and often exaggerate it. And we also spare ourselves and are lazy to do physical therapy, which is a decisive factor in recovery

The doctor must honestly warn the patient:

• surgery to remove a herniated disc does not provide a 100% guarantee of cure,
• often leads to relapses and consequences
• the patient must take an active part in treatment during the rehabilitation period to avoid these possible relapses and consequences

Types of surgery to remove spinal hernia

Here are the main operations for removing intervertebral hernia:

• discectomy
• laminectomy
• endoscopy
• microdiscectomy
• disc nucleoplasty
• laser discoplasty

Each method has its own strengths and weaknesses. The choice of type of operation depends on the anamnesis (medical history), diagnosis, choice of the patient and his financial capabilities.

Discectomy- is considered an outdated method of removing spinal hernia. The essence of this open surgery— through an incision in the skin approximately 8 cm long, under general anesthesia, the entire disc with pathology or part of it is removed, as well as resection of the bony processes of the vertebrae that touch the arteries or spinal cord.

Disadvantages of this method:

• Due to possible penetrations into the spinal canal, the risk of inflammatory processes in the meninges increases. This requires wide antibacterial therapy and the patient’s stay in the hospital for up to 10 days
• Supportive and motor muscles recover more slowly due to the large surface area of ​​damage

Advantages:

1. Lowest recurrence rate with radical disc removal (approximately 3% during the first year)
   This is explained by the fact that a hernia can always re-develop in the remaining parts of the disc, while a completely removed disc is replaced by fibrous connective tissue during healing.
2. Relatively low price

Perhaps these two advantages will prove decisive for those who are rightly in no hurry to write off this conservative method.

Laminectomy is an operation under local or general anesthesia to remove that part of the vertebral arch (lamina) to which the hernia presses the nerve root.

Advantages:

1. Rapid healing, the patient can leave the hospital on the third day
2. As a result of the release of the nerve, the pain subsides almost immediately and the blood supply to the spine improves

Flaws:

1. Bleeding and risk of infection after surgery (incision length up to 10 cm)
2. Risk of nerve damage and blocked blood vessels

Endoscopy is a popular and widely advertised minimally invasive operation to remove intervertebral disc herniation. The use of a special spinal endoscope and microscopic instruments makes it possible to make a minimal incision (up to 5 mm). An endoscope with a lamp and a camera that transmits a multi-magnified image onto a screen is inserted into the lateral foramen (this is the hole through which the nerve root passes), then the hernia or its sequestration is removed with a very thin instrument.

Advantages:

1. The operation is almost bloodless and lasts only about an hour
2. The muscles and ligaments are not damaged, but are moved apart by special tube dilators, which ensures good postoperative healing
3. The patient is discharged almost the next day
4. The recovery period for the spine is theoretically 3 weeks

However, don’t let such obvious advantages make you too happy. endoscopic surgery. She has no less, and maybe more shortcomings. Therefore, you need to weigh everything carefully before making a decision.

The disadvantages are the following:

1. This method is not suitable for all types of spinal hernias; their location plays an important role
2. The operation is most often performed under spinal anesthesia, which itself, due to its consequences and complications, requires careful preparation and preliminary intravenous infusions. Otherwise, a persistent headache may occur as a complication.
3. The risk of complications and relapses after surgery is approximately 10%, and this is not such a small figure. Many people believe that the cause of hernia recurrence is the epidural syndrome that often occurs after surgery.
4. And finally, endoscopic removal of a vertebral hernia is quite expensive.

Microdiscectomy- This neurosurgery for the removal of interdisc herniation, performed at the microscopic level using the most modern instruments and a powerful microscope. Its essence is to penetrate through a 3-4 cm incision into the area of ​​the compressed nerve, remove the herniated disc and thus release the nerve.

On at the moment This type of operation is considered quite successful and is often used.

The operation is performed under general anesthesia. The muscle tissue is also not damaged. To gain access to the compressed nerve, part of the spinal ligamentum flavum and, if necessary, the edges of the lamina are removed. The freed nerve is carefully moved to the side and the nucleus deforming the disc or its fallen fragments are removed. To regenerate an operated disc, it can be performed laser irradiation. IN lately operations are performed with preservation of the ligamentum flavum, if the interstitial space is wide enough and the orifices of the nerve root are projected onto it

Advantages of the operation:
1. Effective and quick pain relief
2. Short period of hospital stay: discharge is possible on the third day
3. Possibility of removing hernias in several places at once
4. You can return to inactive activity in a month, to active physical activity in a month and a half.

However, during both endoscopy and microdiscectomy, despite the short period of restoration of the musculoskeletal ability of the spine, it is recommended to wear supporting rigid corsets for two months.

The disadvantages of microdisectomy include:

1. Cicatricial adhesive epiduritis, leading to repeated radicular pain and relapses in approximately 10−15% of cases
2. High price: approximate cost microdisectomy with laser reconstruction of the disc in a Moscow clinic - about 70,000 rubles

is a modern minimally invasive operation to remove interdisc herniation, performed under local anesthesia, the meaning of which is to reduce pressure on the nerve root from the hernia.

Under X-ray control, a needle with a diameter of 2-3 mm is inserted into the damaged disc, through which radio frequency, laser or plasma radiation is supplied by a generator. The needle is inserted in several places, which creates channels in which, under the influence of heating up to 52 degrees, the disk substance partially disintegrates. As a result, the pressure of the disc on the nerve decreases and the pain subsides.

The advantages of this operation:

1. Simple and safe, the operation lasts approximately 40 minutes
2. Minimum consequences and complications after surgery
3. You can go home in a few hours

Cons:
This method, unfortunately, can remove hernias no larger than 7 mm.

Laser discoplasty- this operation can be performed either separately, in order to reconstruct a damaged disk, or in conjunction with surgical removal hernias The process is carried out in the same way as with disk nucleoplasty: a low-power laser emitter heats the disk in several places to 70,̊ and this contributes to its restoration.

Conditions for a successful operation

The general conditions for the successful implementation of all these operations are the following requirements:

1. The operation must be preceded by a computer or magnetic resonance tomograph, consultations with other doctors and an anesthesiologist, passing the necessary tests
2. You should know that not every operation will suit your type of herniated disc. Great value have its position, size and other factors
3. After some types of operations there may be postoperative complications, so additional antibacterial therapy is required
4. After healing and removal of sutures, the treatment does not end: a long period of spinal recovery begins, which will include wearing corsets and special physical therapy to prevent the development of complications and relapse. Don't forget to go to your doctor for follow-up appointments

Many people are interested in the cost of surgery to remove a herniated disc.. This question is so individual and depends on what city or country the clinic is located in, that it is best to contact directly surgical center to find out the price. On various websites and forums you can find information from previous years, but everything flows, everything changes. Health to you and your spine!

In the modern era of high technology, with predominantly sedentary images life and work, total lack of movement and unfavorable environmental conditions external environment, spinal diseases are significantly common among almost all age groups population.

Unfortunately, not all spinal pathologies and their stages can be resolved with conservative treatment methods alone. In many cases, surgery remains the only chance to gain health, restore an active lifestyle, or get rid of pain. Despite the fact that spine surgery is considered one of the most complex and risky areas of orthopedics and traumatology, today innovative and microinvasive techniques of spinal surgery have brought it to a completely new level of development. Modern technologies and surgical techniques make it possible to solve the problem as safely as possible for the patient, significantly reducing intraoperative risks and shortening the postoperative recovery period.

Indications for surgical interventions

Most spinal diseases without treatment lead to severe consequences, a significant decrease in quality of life, chronic pain and even disability. Main indications for spinal surgery:

• compression (squeezing) of the spinal cord or its roots with a clinical picture of neurological insufficiency (for example, impaired sensitivity or motor functions), or a high risk of such complications, severe pain. Most often this happens with herniated intervertebral discs, spinal canal stenosis;
• scoliosis, with a curvature of more than 40 degrees;
• spinal deformities of various etiologies, which rapidly progress or disrupt the functioning of internal organs;
• neoplasms of the spinal cord and its membranes, vertebrae, vessels and nerves in the spinal canal area;
• spinal deformities with significant defects in appearance;
• injuries, the most common are compression fractures (occur when falling from a height);
• instability of individual segments of the spine due to various reasons;
• pain syndrome that is not relieved by alternative methods;
• ineffectiveness of conservative treatment within 6 months from its start;
• dysfunction of the pelvic organs;
• cauda equina syndrome;
• sequestration of intervertebral hernia and prolapse of the nucleus pulposus.

Main types of operations

In modern orthopedics, there are many methods of surgical interventions on the spine, as well as methods surgical access to the affected area. Until recently, in most cases only open method access to the vertebrae. Depending on the operated segment of the spinal column, there are:

• posterior approach, in which a skin incision is made from the back;
• lateral access, used only for operations on the cervical spine, the surgeon gets to the vertebrae on the right or left side of the neck;
• The anterior approach, where the spine is accessed through the abdominal cavity, is mainly used for the lumbar region.

The surgeon chooses which access to use depending on the location and level of damage, as well as the individual characteristics of the patient. Among the many existing methods and techniques for spinal manipulation, the following main types of operations can be identified:

Among the important advantages of epiduroscopy: harmless small access, minimal anesthetic load on the body, the possibility of direct transition from diagnostic procedures to therapeutic ones. For example, placement of catheters for long-term chemotherapy for spinal cord tumors, electrodes for coagulation of the nucleus during nucleoplasty procedures, removal of scar tissue, topical administration of medications (for example, painkillers or anti-inflammatory drugs). During this procedure, it is also possible to take a biopsy for histological examination material.

Endoscopic spinal surgery

This is a modern and safer alternative to open access to the operated parts of the spine and spinal cord. All manipulations are performed using special endoscopic equipment. To insert instruments into the patient’s body and guide them to the desired area of ​​the spine, only 3 skin punctures up to one centimeter in size are performed. The surgeon monitors all movements of the instruments through a special monitor in the operating room.

Such operations are most often used for protrusions and herniations of intervertebral discs, as well as other degenerative changes in cartilage tissue. Among the main advantages of endoscopic spinal surgery

• minimal trauma;
• short rehabilitation periods;
• shortened period of hospitalization (up to 3 days);
• minimal anesthesia load, and therefore less likelihood of anesthetic complications;
• less likely postoperative complications.

Rehabilitation after spinal surgery

Rehabilitation after spinal surgery no less than important process than the operation itself. The course of rehabilitation should be selected individually for each patient, depending on the disease, its degree and complications, as well as the type of operation. Most rehabilitation courses include:

• therapeutic exercises;
• massage;
• mechanical and kinesiotherapy;
• wearing orthopedic devices (bandages or corsets);
• physiotherapy and reflexology.

It is important to remember that all permissible loads and procedures are prescribed by a rehabilitation doctor or physiotherapist. And a properly selected course of rehabilitation is 70% of the success of surgical treatment of spinal diseases, so in no case should you neglect it!

Treatment of hernial protrusions of the PKOP in medical practice can be carried out using a conservative method and with the help of surgical correction. Surgery to remove a hernia of the lumbar spine is recommended by a specialist only after medications have not brought relief to the patient’s condition.

If the patient does not respond to conservative treatment methods, surgery is prescribed.

According to statistics, surgical correction of intervertebral disc herniation is indicated in approximately 10-18% of cases of the total number of diagnosed hernias. The effectiveness of such operations is about 95%.

You can learn more about the removal of a hernia of the lumbar spine, reviews, consequences and methods of its implementation in the article below.

Surgery for lumbar disc herniation is indicated in the following clinical cases:

• with the development of persistent pain (algic) syndrome with resistance to drug therapy for long period time;
• with a stable increase in neurological symptoms;
• in case of signs of damage to the cauda equina, which is manifested by a disruption in the functioning of the organ elements of the pelvic cavity, perineum, disorder of sexual function, etc.;
• For surgery, the size of the hernia of the lumbar spine must be more than 0.9 cm.

Types of surgical interventions

Removal of a hernia of the lumbar spine, the prices of which depend on the volume and overall complexity of the surgical intervention, as well as the need to use special equipment, is carried out using a variety of techniques, each of which has its own indications, positive aspects and negative effects.

The decision on the advisability of prescribing a specific method of surgical correction of a PKOP hernia should be made exclusively by the doctor, taking into account the course of the pathology in the patient, the individual characteristics of his body and the degree of neglect of the pathological process.

Reconstruction of intervertebral discs PKOP using laser

Laser reconstruction intervertebral disc is a minimally invasive method of restoring fibrocartilaginous tissue using a special laser. Surgery is performed under local anesthesia. Under the control of X-ray equipment, a needle is inserted into the intervertebral disc, it heats the cartilage tissue and promotes its rapid regeneration.

Watch the video to see how the procedure goes:

The procedure is well tolerated by patients of all ages. Laser reconstruction perfectly strengthens the disc and almost never has negative consequences in the form of complications or relapses.

Laser vaporization

Laser vaporization is the removal of a hernia of the lumbar spine with a laser by evaporating part of the affected intervertebral disc. Like laser reconstruction, vaporization is performed under local anesthesia.

During surgery, the surgeon inserts a needle into the cartilage, through which up to 60% of the disc tissue evaporates.

As a result of this, the intervertebral disc “melts”, the pressure inside it drops, which helps restore its normal shape. This procedure allows the patient to return to a healthy lifestyle within a few days after surgery.

Microdiscectomy and endoscopic microdiscectomy

Microdiscectomy - modern surgical method, thanks to which it is possible to unblock a nerve root compressed by a hernial protrusion by removing part of the affected disc. This minimally invasive operation to remove a lumbar intervertebral hernia requires general anesthesia. Surgery is performed using an operating microscope and microsurgical instruments. At the site of the projection of the disc herniation, the surgeon makes a skin incision up to 5 cm long. Then, without dissecting the spinal muscles, part of the nucleus pulposus is removed and the nerve is released from pressure.

You will learn all the details about this type of operation from the video:

Recovery after removal of a lumbar disc herniation using microdiscectomy lasts only a few days. The method has proven itself as effective way elimination of resistant pain syndrome with virtually no damage to integrity bone structures vertebra.

Microdiscectomy can be applied to such complex types of disc protrusion as sequestered lumbar hernia; reviews of the operation are mixed, but in most cases they are positive.

The main difference between minimally invasive endoscopic microdiscectomy is that during the operation the hernia is removed without classical surgical access by puncturing the skin. Surgical intervention is carried out under the strict control of endoscopic equipment.

According to reviews, this operation for lumbar disc herniation is effective in 85% of cases and allows one to avoid postoperative complications such as wound infection, recurrent disc herniation, and hematoma formation. Treatment after surgery for lumbar spinal hernia endoscopic method is not performed, since surgery is a self-sufficient method of therapy.

Laminectomy

Laminectomy is a decompressive surgical procedure to remove a hernial protrusion of the PCOP, which compresses nerve bundles or spinal tissue. The essence of the method is to remove part of the vertebral arch and hernial formation, which provokes compression of the nervous tissue and causes pain syndrome resistant to medications.

Watch the video to see how this operation is performed:

A similar operation on a hernia of the lumbar spine is performed in an operating room under general anesthesia. The surgeon makes a classic approach and exposes the nerve fibers. The progress of the surgical intervention is monitored by special and high-precision X-ray equipment.

Consequences of operations

Before removing a lumbar disc herniation, doctors assess the risks of developing possible complications.
The consequences of surgery for a hernia of the lumbar spine may be as follows:

• sharp progression, which occurs in 20% of operated patients;
• development of a purulent infectious process in subcutaneous tissue spinal cord - epiduritis, which is accompanied by fever, intense radicular pain, disorders in the pelvic organs, changes in tests, etc.;
• violation of pelvic functions as a result of a medical error, which cannot be corrected;
• the occurrence of paresis and paralysis due to spinal cord injury with surgical instruments;
• development of osteomyelitis and septic conditions;
• adhesions and postoperative scarring at the site of surgical access, which may require surgical correction.

Rehabilitation in the postoperative period

Rehabilitation after removal of a lumbar intervertebral hernia is carried out in almost all patients in postoperative period. Its duration depends on the method of surgical intervention, the development of complications and the reserves of the sick person’s body.

The rehabilitation course is prescribed on an individual basis qualified specialist and avoids the occurrence undesirable consequences operations, speed up the patient’s recovery and bring his return to a full life without pain in the lumbar and sacral region.

After surgery in mandatory conduct a rehabilitation course

Rehabilitation after removal of a hernia of the lumbar spine, as a rule, occurs in a hospital setting in three main stages:

• elimination of pain and neurological symptoms;
• strengthening the patient’s body;
• restoration of musculoskeletal function and the ability to endure normal physical activity.

The recovery of patients who have undergone surgical intervention in the postoperative period is facilitated by physical therapy, massage, physiotherapy and a well-designed diet. All these methods make it possible to reduce the rehabilitation time of patients, improve their health and effectively prevent relapses.

As of today, our country carries out a full range of surgical interventions for hernias of the protrusion joint.

The cost of surgery for a lumbar disc herniation depends on several factors: the complexity and volume of the operation, the use of special equipment during the procedure, and much more. Fortunately, the price of such a surgical procedure is quite affordable, so many patients suffering from chronic pain syndrome that is incurable by conservative methods can afford it.

As you know, surgical intervention on the spine in 99 cases out of 100 is only the elimination of the root cause, that is, any anatomical defects of the discs, vertebrae, compression fracture, narrowing of the spinal canal, compression of the roots, etc. Next, an equally important step is required - the correct organization of the rehabilitation period, the program of which is developed strictly individually for each individual person, taking into account the characteristics of his body, the course of the disease, the nature and duration of conservative therapy. The goal of the recovery stage is the elimination of all side effects, forced compensations from previously carried out conservative, symptomatic treatment, improper loads on both the axial and peripheral skeleton and, finally, pathological stereotypes formed over the years. This means that it is necessary to literally nullify the consequences of various destabilizing manipulations, tractions, blockades, taking non-steroidal anti-inflammatory drugs, physical activity, static overexertion, muscle asymmetries, secondary protective distortions and deformations of the body that preceded the operation.

Today, medicine has achieved significant results in the treatment of both spinal injuries and other diseases, in particular degenerative spinal diseases. But in addition to the treatment itself, rehabilitation also plays an important role. Without proper rehabilitation, the results of surgical treatment of the spine may be unsatisfactory. Rehabilitation is an important and difficult stage after treatment of spinal injuries and diseases. If treatment for spinal diseases is aimed at eliminating pathological mechanism and restoration of the integrity of the spine, then the goal of rehabilitation is to restore the patient’s lost functions, as well as restore mobility and the ability to self-care to the injured person.

The success of rehabilitation depends largely on both the diligence of the patient and the experience of the doctor. Without proper rehabilitation, the result of the operation may be insufficient, and the effect of the operation itself will be small.

Prolonged bed rest, in addition, can lead to nonspecific complications: congestive pneumonia, bedsores, infections urinary tract, spastic syndrome, sepsis and behavioral disorders.

The objectives of rehabilitation also include helping the patient adapt to disabilities, or changing his living space and conditions to make his daily activities easier and so that he does not feel handicapped. It is especially worth noting that early start rehabilitation helps to prevent deeper disability of the patient and quickly return him to a normal active life.

The rehabilitation process itself includes: learning new skills (to walk without legs, with one hand, etc.), retraining the patient’s skills and abilities, adapting to the physical, emotional and social consequences of an injury or surgical treatment of the spine.

Currently, the rehabilitation phase includes:

Mechanotherapy
Therapeutic massage
Reflexology

Physiotherapy.

Therapeutic exercise - exercise therapy - is probably the most commonly used method in rehabilitation after many diseases and surgical interventions. And this is true, because physical exercise is still the most effective method of restoring a person’s physiological activity. Exercise therapy can include a huge range of exercises and complexes of such exercises, so only a doctor must select the most suitable exercise therapy complex for a particular patient, and the exercises themselves must be carried out under the supervision of a specialist. Exercise therapy in the complex of rehabilitation after injuries and operations on the spine allows you to reduce pain and restore metabolic processes in the patient’s body, and in addition, physical exercise improves blood circulation. Exercise therapy allows you to maintain the tone of the muscle corset, which is especially important for people with limited mobility.

Mechanotherapy

Mechanotherapy is a variety of exercises using various devices and simulators. They allow you to restore mobility to the joints and improve the activity of the limbs through biological feedback. The results of rehabilitation with the help of devices and simulators are quite good. Mechanotherapy allows you to speed up the patient’s rehabilitation. Please note that all procedures and exercises on simulators must be selected by rehabilitation specialists and carried out under their supervision.

Therapeutic massage

Another popular method that is included in all rehabilitation programs is massage. Massage itself has a beneficial effect even on healthy person. Each of us would not refuse a relaxing massage after a hard day at work. Rehabilitation after injury or spinal surgery is not complete without therapeutic massage. Therapeutic massage can be classic, acupressure, segmental or hardware massage, when the massage is carried out using massage devices. The choice of this or that type of massage, its duration and intensity is selected by specialists.

Reflexology

Reflexology is a fairly popular method of influencing biological active points(so-called acupuncture points). Initially, reflexology originated several thousand years ago in the East, and at the moment this method has been preserved and is used in almost the same form. Reflexology includes a fairly large number of techniques for influencing acupuncture points: acupressure, acupuncture (acupuncture), vacuum massage (so-called cupping, or vacuum therapy), magnetic therapy, auriculotherapy (irritation of a certain area of ​​the skin of the ears), stone therapy (massage with stones), warming (moxotherapy, warming wormwood cigars), hirudotherapy (treatment with leeches), etc. Distinctive feature reflexology is the mobilization of the patient’s body’s own resources, which consists of active involvement simultaneously all organ systems into the healing process. This simultaneous participation of the vital forces of the patient’s body gives a fairly quick result and a fairly effective response of the body to the impact on these points. Another advantage of reflexology is that it can often reduce, sometimes significantly, the need for drug therapy.

Classes in special simulators (verticalizers)

A verticalizer is a device that allows you to give the patient’s body a vertical position in order to prevent and mitigate the manifestation of negative physiological and psychological consequences of a long stay in a sitting and lying position. There are front and rear verticalizers. Numerous studies have proven the importance of the patient's daily upright position for the proper functioning of the body. The systematic use of a verticalizer is one of important element in the process of rehabilitation of patients after spinal surgery, as it has a positive effect on the functioning of many organs and systems: improves the functions of the heart and circulatory system; improves lung ventilation and intestinal motility; prevents the occurrence of spasms of joints and muscles, improves joint mobility, prevents muscle degeneration (especially the spinal muscles); prevents stagnation in the urinary system, helps with the reduction of neurogenic bladder; prevents the appearance of bedsores; significantly improves mental state patient.

Physiotherapy

Physiotherapy is an integral part of medicine and serves the purposes of treatment, rehabilitation and prevention various diseases. Physiotherapy method is a treatment using natural and physical factors such as heat, cold, ultrasound, electric current various frequencies, magnetic field, laser, etc. Physiotherapy improves tissue microcirculation, normalizes metabolic processes, strengthens the body's defenses, stimulates regenerative processes, accelerates wound healing, and reduces the intensity of pain.

Don’t put up with pain, start solving problems now - Treatment of diseases of the spine and musculoskeletal system.

After spine surgery

Surgical intervention on the spine is aimed at eliminating the root cause, and rehabilitation therapy after it is designed to return a person to a normal lifestyle, rehabilitate him physically and psycho-emotionally.

Often, people who have undergone spinal surgery short terms after surgery (sometimes even literally immediately after it) they feel a good or excellent result of treatment. At the same time, they note a significant decrease in the severity of pain, improvement in movements, allowing them to cope with everyday needs, sit, walk, and drive a car. However, here it should be clearly understood that restorative treatment is by no means a luxury, but a necessity. The treatment, unfortunately, no matter how much one would like it, does not end with an operation that has been carried out, albeit very successfully. Its outcome largely depends on how the rehabilitation period goes.

Rehabilitation and restorative treatment of patients after surgical intervention is aimed at eliminating all the consequences and consequences that exist side effects, as well as forced compensation from symptomatic conservative therapy and from improper loads on the axial and peripheral parts of the skeleton, along with pathological stereotypes that have formed in the patient over the years.

Today, this process has been significantly eliminated thanks to the use of modern endoscopic techniques and the use of laser technologies, allowing to significantly reduce the duration of temporary disability of patients and the length of their stay in the hospital, greatly accelerating activation.

Rehabilitation treatment after spinal surgery takes place in three stages. The task of the first is to eliminate pain, paresis and numbness and compensate for distortions of the torso and pelvis. The second is aimed at combating household restrictions and stabilizing general condition the patient’s health, and the third - to completely restore normal biomechanical integrity and restore the strength of the musculoskeletal system, as well as remove any possible restrictions for physical education.

At the same time, the set of specific methods, actions and a list of techniques is determined by the course of the disease, the individual characteristics of the body and the duration of conservative therapy and its side effects. Since the latter, without eliminating the root cause of the disease, is always symptomatic and therefore leads to the development of compensatory pathological changes.

The rehabilitation process can take from three to twelve (depending on the complexity of the operation performed). Thus, on average, rehabilitation treatment for patients who have undergone surgery for a herniated disc usually takes about six months.

Rehabilitation measures include the prescription of medications, physiotherapeutic procedures, massage, mechanical unloading of the spine, therapeutic exercises, manual therapy, acupuncture and, finally, spa treatment. In addition, the patient needs to be healthy image life, limit lifting weights, avoid hypothermia, stress, prolonged monotonous work in the same forced position, control your weight, do not make sudden movements on cold, not yet warmed up muscles.

Treatment of the spine without surgery

A herniated disc is not just a complication of osteochondrosis due to the destruction of spinal column tissue. This is the natural end of development of this disease. An ending that can lead to disability and opportunity independent movement. A disc herniation most often means loss of ability to work, constant severe pain and the threat of surgical intervention.

All drug treatment that may be prescribed to you after such a diagnosis has been established does not lead to healing. This is statistics. The specialists who will observe you will then increasingly and more insistently talk about the need for surgical intervention. There's no need to rush. In this material we will try to tell you the whole truth about a herniated disc and how the operation is performed. We will also try to give you hope for recovery. After all, today thousands of people, using manual therapy to treat spinal hernia, return to a full life and forget forever about the existence of this disease. This happens without surgical intervention.

A herniated disc develops gradually. This occurs due to the destruction of the disc and vertebrae. The main factor predisposing to the development of a hernia is a metabolic disorder in the affected area of ​​the spinal column. Gradually, during the development of osteochondrosis, salts are deposited in the intervertebral disc, and it becomes calcified (its structure becomes clogged with calcium salts). As a result, the disc loses its shock-absorbing properties due to loss of elasticity and flexibility. After the loss of shock-absorbing properties, the pressure on the affected intervertebral disc continues to increase. Even greater structural changes are taking place. Disk on initial stage the disease becomes thinner and deformed. Subsequently, if no measures are taken to eliminate the cause of the disease, the disc protrudes from the intervertebral space. This is a herniated disc. Typically, a hernia forms in the posterolateral or posterior plane of the spinal column. This makes diagnosing this complication extremely difficult.

A herniated disc can lead to complete paralysis of those parts of the body that are innervated by the pair spinal nerves, emerging from the affected area of ​​the spine. Complications such as separation of a disc from a vertebra under extreme loads are also observed quite often. In this case, damage to the spinal cord quite often occurs. In this case, it is almost impossible to restore the functions of limb mobility.

In this regard, it is worth understanding that when a diagnosis such as a herniated disc is made, urgent and adequate treatment is required. To date, conservative methods of treating this disease are quite scarce and are rather symptomatic treatment. That is, they are aimed at eliminating the symptoms of the disease, and not at eliminating the cause that causes the pain syndrome. Most often in in this case painkillers, non-steroidal anti-inflammatory drugs, absorbable substances, vitamins that maintain the tone of the nerve roots, light massage and physiotherapy are prescribed. All this can only alleviate the patient’s condition, but in no way contributes to his healing. As a result of such therapy, the herniated disc remains in its place and continues to develop.

Medicine offers surgery as a radical treatment method. Spinal surgery is a rather risky undertaking, for the successful outcome of which no surgeon can guarantee. Surgery to remove a herniated disc poses a particularly high risk. This is due to the fact that modern surgery cannot offer any other way to restore a person’s ability to work, other than removing the affected disc.

What does this mean in practice? First of all, you must understand that by agreeing to surgical treatment of a herniated disc, you actually agree that your spine will be artificially deprived of its most important purpose: shock-absorbing properties. The shock-absorbing properties of the spinal column are directly related to the presence of elastic discs between the vertebrae. One of them will be completely removed from your spine during surgery. Can this be considered a successful cure for the disease? Not in any way.

During the operation, doctors will try to create all the conditions so that in the absence of an intervertebral disc, neighboring vertebrae will fuse together. We will not examine those cases where the vertebrae did not fuse, and the person simply remained disabled and confined to a wheelchair.

Let's consider a situation where the operation was successful and the vertebrae are fused. What happens in this case? The spine loses its flexibility when the vertebrae fuse. Now one of its sections becomes absolutely motionless. In this case, depreciation in this area is completely lost. The result is an increased load on other parts of the spinal column.

And everything starts all over again. According to statistics, which are extremely disappointing, 60% of those who have undergone surgery to remove a herniated disc develop another or several herniated discs within a year and a half after the operation. And that's not all terrible consequence such an operation. Quite often, traumatic avulsions of the vertebrae become a complication of surgical treatment of intervertebral hernia. This is a completely predictable result. After surgery, a person will not be able to wear a corset for the rest of his life. Over time, he forgets about the presence of contraindications to heavy physical activity and sudden movements. Meanwhile, their spinal column after surgery is no longer able to provide the required level of shock-absorbing properties. A spinal fracture occurs. This threatens complete or partial paralysis, depending on which part of the spine the intervertebral disc was removed from.

The surgical method of treating a herniated disc has an excellent alternative. These are manual therapy methods. In this case, you will be almost completely free from negative impact medications, which are prescribed to the patient in order to reduce his suffering. A doctor conducting a manual course of treatment is able to relieve pain without the use of chemicals. The main methods and methods of manual therapy in the treatment of intervertebral disc herniation will be aimed at eliminating the consequences of destruction of the disc and spinal column. At the same time, you will feel significant relief after the first session of manual therapy.

After the pain has been relieved, the chiropractor will direct all his efforts to restore the affected disc, which, as a result of destruction, has protruded from the intervertebral space. To do this, first of all, therapy will be carried out aimed at restoring the tone of the muscles and ligaments that support the spinal column in an upright position. After achieving a positive result with the muscles, the load on the affected disc will noticeably decrease. This will help slow down and reverse destructive changes.

Subsequently, the doctor will conduct manual therapy aimed at maintaining the ligamentous apparatus and improving blood supply to this area of ​​the spine. At the same time, he will do everything possible to ensure that the inflammatory processes stop and the process of resorption of the hernia and restoration of the disc to its normal state begins.

You may ask: is it possible that a herniated disc will resolve? Yes, this is possible and confirmed by numerous cases of complete healing in the practice of palmists.

Therefore, we urge you to think again about the question: is it worth agreeing to surgical intervention if there is a possibility of complete healing and restoration of the physiological normal functioning of your spine without this extreme method?

Spinal surgery rehabilitation

Spinal surgery eliminates the root cause, and restorative treatment of the spine is carrying out “major repairs”, “repair and restoration work” according to an individual program (estimate) after the event.
In 99% of cases, spinal surgery is to eliminate the root cause, especially if there are obvious anatomical defects of the vertebrae, discs, narrowing of the canal, compression of the roots, etc.

In the world practice of surgical treatment of the spine (intervertebral hernias, disc protrusions, cystic formations, narrowing of the spinal canal, compression of the roots of the spinal nerves, surgical treatment of compression fractures and vertebral displacements), the techniques have been brought to perfection, we can say that in the most operational technology no flaws. But there are points that cause complaints and can cause unsuccessful consequences of surgical treatment of the spine. First of all, this is a conservative treatment preceding surgical treatment with destabilizing manipulations, traction, blockades, anti-inflammatory non-steroidal drugs, physical activity through pain, displacement, excess, static tension, secondary protective distortions and deformations of the body, muscle asymmetries, pathological stereotypes, etc. p.
All of the above leads to deep tissue degeneration, intermuscular and intertissue adhesions, bone and functional deformations.
It is these secondary compensations in structure, form and function that do not allow the body to fully recover biologically, neurologically and metabolically after eliminating the root cause, even after the most skillfully performed spinal surgery in the best domestic and foreign clinics.

The root cause has been eliminated, which means “the strings are intact, but the guitar doesn’t sing”! And she will begin to sing only after properly carried out rehabilitation and restorative treatment of the spine after surgery, the purpose of which is to eliminate all side effects, forced compensation from conservative treatment, symptomatic treatment, from improper loads on the axial and peripheral skeleton, along with the pathological stereotypes formed over the years.

The operation eliminates the cause! Restorative treatment eliminates consequences and consequences.

Attempts to conservatively cure the cause and its consequences without eliminating the cause (etiofactor) are doomed to failure, these are just lost opportunities, wasted time and a pathological cascade of secondary compensations and side effects.

Restorative treatment of the spine after surgery is necessary, since it is rare to find such healthy organisms that carry out all this work independently, spontaneously.
Even those who are endlessly satisfied with the operation performed need to integrate the body to a qualitatively new level of life and physical activity.

In rehabilitation treatment after spinal surgery, there are three stages:

Elimination of pain, paresis, “numbness”, distortions of the torso and pelvis.
Elimination of household restrictions and stabilization of general health.
Complete restoration of the biomechanical integrity and strength of the musculoskeletal system, removal of any restrictions for playing sports.

The set of specific actions, methods, techniques depends
from individual characteristics body
from the course of the disease
from the duration of the conservative treatment and its side effects (after all, conservative treatment without eliminating the root cause is always symptomatic and leads to compensatory pathological changes; in everyday language this is called “we treat one thing, we cripple another”).

Methods of recovery after spinal surgery allow using physical and biomechanical techniques:

Restore those degenerated into fibrous connective tissue and muscles of the deep layers, due to an isolated eccentric load, which allows you to greatly increase blood flow, eliminate intermuscular adhesion, and optimize the drainage of interosseous and interstitial fluid.
Restore trophism, displacement, conductivity peripheral nerves and their branches.
Reanimate neurotrophic and neurocontractile functions.
Carry out afferentation in nerve structures ah, those affected by the toxic effects of drugs, compression, functional inaction, protective inaction.
Restore the consequences of chronic inflammatory processes in the membranes of the spinal cord, periarticular, perineural, perivasal tissues. Eliminate articular asymmetries, contractures, and misalignment.
Restore the topographic position of the body in space, pelvic tilt angles, physiological curves of the spine, mobility in the spinal motion segments.
Restore muscle balance layer by layer, in terms of strength and length.
Completely restore range of motion in joints and erase pathological habitual movement patterns.
Remove pathological stress attitudes and psycho-complexes.
Educate patients about an active lifestyle and maintaining health within stable parameters.
Understand the techniques and methodology of biomechanical methods of rehabilitation treatment, health improvement and prevention of risk factors.

By contacting us at I.PPC, you will not only find solutions to problems related to your health, but also change your attitude towards medicine.

We will teach you to distinguish between the verbs “treat” and “cure”. We will try to explain to you how etiopathogenetic treatment of the spine differs from symptomatic treatment. We will help you learn to navigate different areas of medicine, distinguish which diseases need to be treated in free public medicine, and when you need to look for “your doctor” in private clinics.

Rehabilitation after spinal surgery

Nowadays, operations to remove a spinal hernia are quite common. In any neurosurgical department such operations are performed every day. The next stage for these patients is rehabilitation - a comprehensive restorative treatment aimed at compensating for impaired functions in the body. The importance of the problem lies in the fact that the patient does not always receive complete and reliable information about the methods and timing of such rehabilitation.

The purpose of rehabilitation measures after surgery to remove a hernia of the lumbar spine is to reduce pain, strengthen the muscles in the lumbar region, prevent the formation of scar-adhesive process in the surgical area, and prevent recurrence of hernias. The rehabilitation complex for each specific patient must be individual, taking into account the peculiarities of the course of the disease, postoperative period, age, presence of concomitant diseases. We will consider the main provisions.

Drug treatment. In the presence of pain, non-steroidal anti-inflammatory drugs are prescribed. IN recent years preference is given to drugs of this group of selective action, such as movalis, airtal, nimesil. Used to improve blood circulation vascular agents(trental, picamilon, nicotinic acid). Often in the complex medical events include chondroprotectors (alflutop, teraflex, structum, piaskledin) and B vitamins (milgamma, combilipen). For numbness and weakness in the lower extremities, anticholinesterase drugs (prozerin, neuromidin) are used. Muscle tension is relieved with muscle relaxants (mydocalm, baklosan, sirdalud).

Mode. After surgery to remove a hernia, it is not recommended to sit for a month, the only exception being squats, for example, on the toilet. On the contrary, you should start walking as early as possible, from the first or second day after the operation. The main thing is not to overdo it; during the day you need to take several breaks of 20-30 minutes to relax in a lying position. In the first 2-3 months, wearing a semi-rigid corset is recommended to prevent recurrence of disc herniation and the formation of correct posture. During the same period, you cannot lift or carry weights over 3-5 kilograms, ride in public transport or ride a bicycle.

Physiotherapy. Two weeks after the operation, physiotherapy is prescribed. Laser therapy, lidase electrophoresis, SMT or DDT are used (in the presence of persistent pain), and later hydrocortisone phonophoresis. The choice in favor of one or another method of physical treatment depends on the clinical picture and other factors that I have already mentioned above. If the postoperative suture has not yet healed well enough, I first prescribe a laser; in other cases, you can immediately start with lidase electrophoresis to prevent the formation of adhesions and scars. In any case, rehabilitation after removal of a hernia is a long process, so I recommend a course of at least 2-3 procedures in a row. As for the method of electrophoresis of karipazim, which is popular these days, I would note that this is not a panacea. You can try (but as part of a set of rehabilitation measures), especially if you have money (karipazim is a fairly expensive drug).

Massage. Light massage of the limb on the affected side can be performed already in the first week after surgery. This is necessary in the presence of numbness, weakness in the leg, decreased reflexes, that is, in the clinical picture of a typical radicular syndrome. Massage of the lumbosacral spine is prescribed 1-1.5 months after surgical treatment, when the healing processes in the operation area have passed certain stages. In this case, there is no need to rush; the first commandment of a doctor is to do no harm.

Therapeutic exercise. Prescribed after surgery to remove a hernia of the lumbar spine as early as possible. True, in the first ten days the patient is shown only measured walking with mandatory rest breaks of at least half an hour, contraction of the muscles of the limbs and torso for a few seconds in a lying position, breathing exercises. Subsequently, during the first month, you can perform more active exercises while lying on your back and stomach. A month later, the patient is allowed to visit the physical therapy room. I recommend that such patients engage in physical therapy under the supervision of an instructor, since the wrong approach can worsen the rehabilitation prognosis. In accordance with what has been said, I will refrain from publishing any complexes, because an individual program must be selected for each specific patient. You can start swimming in the pool 6-8 weeks after surgery.

Acupuncture. Can be prescribed at any stage of rehabilitation. I still recommend needles a month after the surgical treatment, when the main stages of healing have passed. It should be taken into account that it is undesirable to simultaneously combine acupuncture with electrotherapy (electrophoresis, SMT, DDT).

The literature also contains information about the use of traction (traction) of the spine after operations to remove lumbar hernias. However, in our Rehabilitation Treatment Center such techniques are not used.

Rehabilitation after surgery to remove a herniated disc in the lumbar spine is a long process, includes a whole range of restorative measures, requires doctors to have good knowledge and an individual approach to each patient, and from the patient - strength and patience.

Cervical spine surgery

Our spine is the basis of the musculoskeletal system and combines two main properties - mobility and stability. Vertebral mobility depends on the structural features and strength of the vertebrae, the properties of the intervertebral disc and other factors. Spinal stability is the ability to withstand deformation under load.

Spinal instability is indicated by displacement of the vertebrae and the development of kyphotic curvature of the spine (kyphosis is observed in 40% of cases of degenerative instability). In case of injury, post-traumatic instability may develop in the form of fractures and dislocations of the vertebrae.

In case of instability cervical spine spinal column, the doctor may consider necessary operation on the cervical spine. Surgical procedures Such a plan is performed to stabilize the spine, as well as to eliminate decompression of the nervous structures. The decision to undergo spinal surgery must be made and performed by a highly qualified specialist. Surgical intervention is preceded by a diagnostic examination: radiography, MRI, consultation with a neurologist and other measures. This allows you to confirm the need for intervention, accurately determine the damaged area and the extent of surgical intervention.

Spinal surgery makes it possible to eliminate decompression and create the necessary conditions for ankylosis (fusion of the vertebrae). Indications for surgery on the cervical spine if it is unstable are:

Long-term unsuccessful treatment of pain syndrome or its frequent exacerbations;
characteristic radicular and spinal symptoms, which are caused by disc herniation and compression of nerves by exostoses;
subluxation due to instability;
intolerance to conservative treatment methods.

The choice of treatment method and type of intervention depends on the characteristics of a particular case of cervical instability. Cervical spine surgery can be performed using an anterior or posterior approach.

The posterior approach for the treatment of cervical dislocations, as established by research, has a number of disadvantages, which is the reason for limiting the indications for this type of access. On the contrary, operations from the anterior surgical approach have a number of advantages, which include low trauma, low blood loss, short duration of the operation, and a comfortable position of the patient on the operating table.

In case of severe post-traumatic instability with subluxation best way stabilization of the spine is possible with a combination of anterior and posterior approaches. This combined intervention allows for the full benefits of these approaches. The posterior approach is used to perform laminectomy to decompress the nerves, and the anterior approach is used to perform spinal fusion to stabilize the damaged spine (spinal fusion is a surgical procedure performed to ensure immobility between the vertebrae).

A common cause of cervical spine surgery is a herniated disc. A pathology of this kind may be indicated by pain in the upper limb, which occurs due to irritation of the nerve roots associated with the cervical spinal cord. Except pain, there is a feeling of numbness, tingling, goosebumps, and muscle weakness may occur.

Operations for a herniated disc in the neck are as follows:

Anterior discectomy and spinal fusion are the most common type of intervention. The bottom line is that the surgeon removes the damaged disc through a small (no more than 3 centimeters) incision on the front surface of the neck. After the disc is removed, bone tissue is implanted into the space between the vertebrae.
Anterior discectomy without spinal fusion. The difference from the first method is that the space between the discs grows together gradually naturally (it takes more time to achieve the result).
Posterior discectomy. The operation is performed using a posterior approach and has many limitations.

Surgery of the cervical spine is in constant development - improving existing methods operations and new ones are being explored. In the field of operations on the cervical spine, Czech medicine is among the leaders.

Cervical spine surgery

Almost every person experiences neck pain in their life. A banal pinched nerve ending can cause a person a lot of problems, at least for several days. As a rule, such ailments go away on their own, but in some cases they become chronic, which is caused by instability of the cervical spine. Conservative treatments in this case only temporarily alleviate the condition of the patient, who, in addition to pain, may experience severe dizziness, up to loss of consciousness. Therefore, the only way out of the situation is surgery on the cervical spine.

It is indicated in a number of cases when it comes to serious orthopedic problems. In addition to spinal instability, this can be due to injury or unsuccessful treatment with conservative methods, which does not allow to get rid of pain symptoms. However, in each specific case, the decision to perform surgical intervention is made by the attending physician, who not only determines the degree of damage to the cervical vertebrae, but also the method of their surgical restoration.

Surgery on the cervical spine can be performed using the anterior or posterior access. In the first case, it is much more convenient for the surgeon to work, so the process of restoring the cervical spine takes less time. In addition, this technique allows you to avoid subsequent serious complications during the rehabilitation period of patients. For the same reason, the posterior approach technique is used extremely rarely, and only in situations where, due to complex injuries of the cervical spine, it is most convenient and safe to access the damaged vertebrae from the back.

In addition, there are two types of surgical interventions that allow you to restore the functions of the cervical spine. If the damage is minor, then, as a rule, an anterior disectomy without spinal fusion is performed - i.e. the damaged disc is partially or completely removed, and the integrity of the spine is restored without the use of implants. In cases where the damage is quite significant and requires the removal of several vertebrae, anterior disectomy with spinal fusion is most often performed, which involves replacing the damaged areas of the cervical spine with artificial implants. In particularly difficult cases, when the injuries are traumatic, it is possible to combine surgical techniques with the simultaneous use of posterior and anterior disectomy.

Surgery on the cervical spine is classified as a complex type of surgical intervention. This is due to the fact that access to the deformed areas of the spinal column in this case is limited, and there is a danger of damage to the spinal cord. Depending on the type of pathology, such an operation can last from one to five to six hours. But even if it went well, patients will need quite a lot of time to restore the functions of the cervical spine. This is due to the very problematic process of fusion of bone and cartilage tissue, which even in the absence of an implant takes several months.

Thus, it is possible to talk about the patient’s complete recovery after surgery on the cervical spine no earlier than six months later. And then only on the condition that the mobility of the spinal column in the neck area is completely restored, and the patient does not experience pain when turning and tilting the head.

Spine surgery for scoliosis

If after appropriate conservative treatment there is no improvement and the curvature continues to progress, surgical intervention on the spine is recommended.
Who needs spine surgery?

Surgical treatment of scoliosis is a last resort measure associated with a significant risk of complications. Therefore, deciding whether to have surgery or not is necessary after carefully weighing all the factors for each individual patient. Here are the main reasons for which patients are indicated for spinal surgery.

1. Constant pain in the spine that cannot be eliminated by conservative methods, for this reason approximately 85% of operations for scoliosis are performed.

2. Increased curvature of the spine. If the spinal deformity exceeds 40 degrees, then doctors recommend surgery. If the curvature exceeds 60 degrees, then surgery is simply necessary, since in this case there is a disruption in the functioning of the heart and lungs.

3. Sometimes spinal surgery is performed due to a cosmetic defect, which manifests itself with severe skeletal deformation.

Surgery has several purposes.

1. Eliminate spinal deformity as much as possible.

2. Stop the progression of scoliotic disease.

3. Eliminate compression of the spinal cord.

4. Protect nerve structures from further damage.

Most often, the operation is performed when the growth of the spine is close to completion, but before the moment when the development of the skeleton is complete. If the spinal deformity is life-threatening, then the operation can be performed at other times.

Here are the main types of surgical interventions for severe spinal deformity.

1. To limit asymmetry of vertebral growth.

2. To stabilize the spine.

3. For correction and stabilization of scoliosis.

4. Cosmetic surgeries.

The dangers of surgical treatment of scoliosis

First of all, we must remember that there will be interference in the functioning of a vital organ - the spine. Any error or inaccuracy can lead to disability and serious complications. During the operation, the spine is forcibly straightened, which is a huge stress for the body. As a result, there are serious complications that can only be avoided with professional organization of the operation.

What should you pay attention to? Choose a clinic and surgeon independently and carefully, find a well-known specialist, consult with him and try to communicate with people who have operated on him.

Preparing for surgery

Surgeries for spinal deformity are rarely performed spontaneously and without preparation. Proper preparation The operation must take place from both sides - on the patient’s side and on the doctor’s side. The patient, first of all, must prepare psychologically and focus on the fact that the operation is the door to a new life, more interesting and fulfilling. The patient also needs to rest, since after surgery he will need strength for recovery and rehabilitation.

The doctor needs to collect as much information as possible about the body of the person being operated on. To do this, X-rays are taken in different positions - standing, sitting, lying, sideways, this is necessary in order to more accurately determine the functional state of the spine. A number of standard studies are also being carried out.

Life after surgery

Every patient who needs to undergo surgery for skeletal deformity must understand that the postoperative period is very important for establishing a full life.

For the first 3–4 days, a person must observe strict bed rest. Then small movements within the bed are possible. Around the 7th day you can get up and learn to walk in new conditions. During the same period, control X-rays are taken and, based on them, therapeutic and restorative physical education classes begin. Exercises should prepare a person to walk on crutches. 5-10 days after the operation, a foot massage is prescribed.

For people with severe forms of deformity, support corsets are made that must be worn for about a year.

After about 2 to 4 weeks, the patient is already discharged for rehabilitation treatment in a sanatorium or clinic.

After 3–4 months, a tomographic or x-ray examination, on the basis of which further restoration procedures are planned.

In adolescents, the recovery period takes approximately 4–6 months, and in adults 6–12 months. At this time, you should avoid sharp turns and bends, as well as lifting weights, but you must definitely perform exercises to restore the spine.

During the first 6 months of rehabilitation, you must follow strict movement rules, avoid prolonged sitting, perform special exercises, avoid jumping from heights, hanging on the crossbar, carrying heavy objects and prolonged vertical loads. General massage and physiotherapeutic treatment during this period are carried out according to strict indications and not earlier than 3 months after the operation.

For a harmonious recovery after surgery, it is very important to systematically perform special gymnastics exercises, since it is necessary to develop strong muscles backs.

When does it end recovery period, normal life begins, but with certain restrictions.

Recovery after spine surgery

Today, medicine has achieved significant results in the treatment of both spinal injuries and other diseases, in particular degenerative spinal diseases. But in addition to the treatment itself, rehabilitation also plays an important role. Without proper rehabilitation, the results of surgical treatment of the spine may be unsatisfactory.

Rehabilitation is an important and difficult stage after treatment of spinal injuries and diseases. If treatment for diseases of the spine is aimed at eliminating the pathological mechanism and restoring the integrity of the spine, then the goal of rehabilitation is to restore the patient’s lost functions, as well as restore mobility and the ability to self-care to the affected person. The success of rehabilitation depends largely on both the diligence of the patient and the experience of the doctor. Without proper rehabilitation, the result of the operation may be insufficient, and the effect of the operation itself will be small.

In addition, it is worth considering that the result of treatment depends on the severity of the injury and disease. For example, with mild injuries, complete disappearance of pain may be observed. For severe injuries good result is the restoration of at least some ability for self-care in everyday life.

The main mechanism in spinal injury, as well as in many spinal diseases, is compression of the tissues of the spinal cord and nerve roots. In case of injury, such compression can be caused by a vertebral fragment or hematoma. The severity of a spinal injury is determined by the level of damage to the spinal cord. For example, the higher the level of damage to the spinal column or the level of the pathological process, the more pronounced the neurological disorders. There may be disturbances in urination and defecation, as well as pain.

Prolonged bed rest, in addition, can lead to nonspecific complications:

Congestive pneumonia
the appearance of bedsores
urinary tract infections
spastic syndrome
sepsis
and behavioral disorders.

In addition, there may be psychological disorders- emotional lability, sudden fluctuations in mood, depression, irritability, causeless laughter or crying are noted. All this may be accompanied by loss of appetite.

It should immediately be noted that main goal rehabilitation of patients after injuries or diseases of the spine is their integration into normal life. The patient should not feel inferior or disadvantaged. If treatment has not helped to fully restore movements in the limbs, for example, walking, and the patient is forced to move in a wheelchair, then rehabilitation should help restore other lost functions as much as possible, and help teach the patient to make do with those skills that have been preserved so that he can lead a relatively active lifestyle.

Rehabilitation

Currently, there is various evidence in medicine that even with complete disruption of the anatomical integrity of the spinal cord, there is a chance for partial restoration of functions lost due to injury. Recovery in such patients depends on factors such as the level, severity and duration of the spinal injury, age, timely treatment and recovery program.

As you know, the main consequence after injury or surgery on the spine is impaired movement in the extremities, most often in the lower ones. In such patients, the main goal of rehabilitation is to restore motor activity. The activities of the rehabilitation program can be carried out both on an outpatient basis and in a hospital setting.

If rehabilitation measures are not carried out, then the patient will never be able to fully return to active life, which will also affect his psychological state, and can also affect the general psychological atmosphere in the family of such a patient.

The objectives of rehabilitation also include helping the patient adapt to disabilities, or changing living space and conditions in order to facilitate his daily activities and so that he does not feel handicapped.

It is especially worth noting that early initiation of rehabilitation helps to prevent deeper disability of the patient and quickly return him to a normal active life.

The rehabilitation process itself includes:

Learning new skills (walking without legs, using one hand, etc.)
Retraining the patient's skills and abilities
Adaptation to the physical, emotional and social consequences of injury or surgical treatment of the spine.

Rehabilitation is a complex process and doctors of different specialties take part in it - neurologists, psychologists, chiropractors, physiotherapists and other specialists if necessary, which allows us to achieve the maximum level of recovery after spinal injuries.

Currently, the rehabilitation phase includes:

Exercise therapy (physical therapy using a set of exercises aimed at strengthening the muscles of the limbs)
Mobilization of limb joints
Mechanotherapy
Therapeutic massage
Reflexology
Classes on special simulators
Physiotherapy

Pain after spinal surgery

In neurology, pain after spinal surgery is usually referred to as “operated spine syndrome.” It came to us from Western literature where the term Failed Back Surgery Syndrome - FBSS (lit. Failed Back Surgery Syndrome) is widely used. Also in foreign literature you can find the term Failed Neck Surgery Syndrome - FNSS (literally, Failed Neck Surgery Syndrome). Postlaminectomy syndrome is also a synonym for these terms. In the future we will use the term “Operated spine syndrome”

Operated spine syndrome is a condition of a patient who, after undergoing one or more operations aimed at reducing lumbar or radicular pain (or a combination of both), continues to have persistent back pain after surgery.

Causes of back pain after surgery

The progression of the operated spine syndrome is determined by the fact that each repeated operation in the form of decompression and so-called meningoradiculolysis often only intensifies the pain syndrome due to the worsening of the scar-adhesive process in the operation area. Often the reasons for the recurrence of back pain after surgery or the deterioration of the patient’s condition are the following: prolapse of the hernia at a new level, prolapse of the remnants of the sequestered disc, unresolved compression of the nervous structures in the area of ​​the radicular funnel, or, not always diagnosed, destabilization of the spinal segment, which leads to dynamic or constant compression of the ligaments and roots of the spinal cord. However, operations with complete removal of the sequestered disc under the control of intradiscal endoscopy, decompressive operations with foraminotomy and stabilizing operations also do not always eliminate back pain after surgery.

Unfortunately, in more than 20% of cases, the cause of pain in the lumbar region and radicular pain in the legs remains unidentified, despite sufficient high possibilities diagnostic methods.

Treatment of pain after spine surgery

From the above, an obvious conclusion follows: further operations to relieve pain after spinal surgery should not be performed, since this not only will not correct the situation, but, on the contrary, may cause harm.

The question arises - what can be done in this case.

First of all, you should contact standard scheme treatment of chronic pain syndromes.

You should start with complex conservative treatment, which should include both drug therapy, and all possible methods non-drug therapy(physiotherapy, manual therapy, psychotherapy, etc.).

However, it should be noted that in this case, due to the delay in starting treatment, the pain after spinal surgery has time to become chronic and may turn out to be incurable, i.e. not amenable to treatment. That is why the operated spine syndrome is one of the most common indications for the use of spinal cord neurostimulation (SCS).

Exercises after spine surgery

Exercise therapy is a whole range of physical exercises aimed at restoring motor activity after various diseases and operations. Exercise therapy is used in the rehabilitation complex for many conditions, but mainly when it is the motor activity, for example, for strokes, heart diseases, as well as for diseases of the musculoskeletal system, surgical interventions on the joints and spine, as well as in the complex of conservative treatment of degenerative diseases of the spine.

Classes therapeutic exercises help improve microcirculation in tissues, blood circulation in muscles, and normalize metabolism. A properly selected set of physical exercises allows the patient to develop a muscular corset, and in addition, the tonic effect of exercise therapy on the patient’s psyche is known.

All exercises from the exercise therapy complex should be performed carefully and slowly, without any sudden movements. The load should be increased gradually, under the supervision of a rehabilitation physician. An individual complex is selected for each patient physical therapy exercises.

When doing exercise therapy, exercises should be carried out until mild pain appears; the patient should not experience any discomfort or severe pain when doing exercise therapy. Physical exercises are carried out without stress on the intervertebral discs.

Correct execution of a set of physical therapy exercises allows you to strengthen the spinal muscles, which plays an important role in the stability of the spinal column. A rehabilitation doctor will explain to you mistakes when performing certain exercises.

The main principle of exercise therapy after spinal surgery is the gradual and regularity of exercises. You should not rush to start new, more complex exercises. Strictly follow the sequence of exercises and increasing load that your doctor has determined for you.

All exercises from the exercise therapy complex are performed 2-3 times a week, and in some cases daily.

General provisions when performing exercises of the exercise therapy complex

Proper breathing during exercises, inhalation is carried out through the nose, and exhalation is 2 times longer than inhalation, carried out through the mouth (lips “tube”)
after each movement you should return to the starting position
the exercise load increases gradually due to the number of repetitions of each exercise, but not the intensity
exercises begin with 1 - 2 approaches, gradually adding approaches to 10 - 15
monitoring the correctness of the exercises - this is pain in the back, exercises should be carried out until the pain appears, but not cause the pain itself
if possible, perform the exercises 2 times a day, replacing the second time with exercises of the next period
Some types of exercises are not recommended after spinal surgery, for example, simply hanging on a horizontal bar, bending the spine back, bending to the side, sharp turns of the body along the axis.

Surgery for spinal fracture

In case of a spinal fracture, surgery is performed to decompress the spinal cord and its roots, fix and stabilize the spinal column, restore the spinal axis in three planes, as well as to prevent possible deformation in the fracture area in the future, prevent damage to the spinal cord and the development of persistent pain.

Indications for surgery for a spinal fracture are:

Unstable spinal injuries and conditions that threaten the occurrence of such instability;
complicated fractures with damage to the spinal cord, severe neurological symptoms and their increase, as well as complete or partial block of cerebrospinal fluid dynamics, indicating compression of the spinal cord;
lack of effect from reposition using conservative treatment methods.
spinal injuries in patients who place high demands on the restoration of spinal functions and strive to maintain the highest possible quality of life in the future, as well as in cases where long-term conservative treatment and immobilization in bed are unacceptable for the patient.

It should be noted that in case of stable injuries of the spine (fractures and separations of the vertebral angle, compression fractures of the vertebral bodies with loss of their height from 1/3 to 1/2, etc.) in some cases it is indicated surgical treatment, since this allows you to restore the anatomical integrity of the vertebra, reduce the treatment time and the patient’s time in the hospital.
Most often, surgery for a spinal fracture is indicated for kyphotic deformity of more than 25 degrees, which significantly reduces functional characteristics spine, especially its supporting function, but in late dates After injury, surgery may also be necessary for smaller angles of kyphotic deformity in case of failure of conservative treatment, significant limitations of mobility and severe pain.

The essence of stabilizing operations for spinal fractures is reclination, i.e. forcible correction of vertebral deformation in the direction opposite to the application of force that caused it and fixation of these vertebrae with the creation of spinal fusion - a fixed articulation between the damaged vertebra and one or two adjacent vertebrae. The vertebrae can be connected with a bone graft or metal structures.

Spinal fusion can be permanent or temporary. Permanent spinal fusion is achieved by fusion of the vertebral bodies with each other. For this purpose, osteoplastic surgeries are performed aimed at forming an anterior or posterior bone block between the vertebrae. As a rule, auto- or allograft is used as a plastic material. Temporary spinal fusion provides stabilization of the damaged spine and its unloading only for a certain time necessary for consolidation of the fracture and healing of damaged spinal structures. Once the fracture has healed and the spine has been stabilized, the metal anchors are removed.

Depending on which supporting complex of the spine is fixed, anterior and posterior spinal fusion are distinguished; respectively, anterior and posterior spinal fixation systems are used. Anterior stabilization systems include plates, rods, systems for endoprosthetics of vertebral bodies and corporedesis, as well as systems for introducing an implant into the area of ​​the intervertebral disc (“cages”). Posterior stabilization systems are parallel vertebral plates, systems based on transpedicular (through the bony pedicles of the vertebral arch) insertion of screws and sublaminar insertion of wires, corrective systems based on fixation by the arches and spinous processes of the vertebrae (ties, simple complex hook systems, rod systems ), as well as complex spinal systems.

Currently in clinical practice Minimally invasive operations for spinal fractures such as vertebroplasty and kyphoplasty are increasingly being used. During vertebroplasty, bone cement is injected into the damaged vertebra using a special needle and under fluoroscopic control, which hardens in 15 minutes and prevents further destruction of the vertebra. When performing kyphoplasty, a deflated balloon is inserted into the area of ​​the vertebral defect, which is inflated in the vertebral body and thereby restores the normal height of the vertebra; For fixation, bone cement is also introduced into the cavity. The advantage of balloon kyphoplasty is that it can not only correct the shape and restore the height of the damaged vertebra, but also eliminate the deformity of the entire spinal column.

Since spinal surgery is very serious, it would be wisest to put yourself in the hands of real professionals.

Spinal diseases pose a danger, which consists in further complications, including the development of irreversible pathologies. Thus, osteochondrosis of the spine leads to such dangerous consequences as the formation of a hernia - protrusion of the nucleus pulposus. Treatment often ends with surgical intervention, since conservative methods and physiotherapeutic procedures do not always provide positive result.

What is a vertebral hernia

A hernia is a displacement of a vertebra, which gradually provokes protrusion of the nucleus pulposus as a result of rupture of the fibrous ring. The pathology itself develops due to degenerative changes intervertebral disc, which is facilitated by age-related changes, injuries, lack of tissue nutrition and other factors.

In most cases, it is the lumbar region that suffers, since it bears all the load during movement and normal life. The thoracic region suffers much less frequently. Recently, there has been an increase in the occurrence of hernia localized in the cervical region, and in young people. This is due to low head mobility and prolonged stay in a static position. As a rule, office workers, drivers and simply fans of computer games suffer.

Important! In order not to lead the situation to the formation of a hernia, it is necessary to consult a doctor even at the stage of the onset of pain. full examination. After all, an operation to remove a hernia of the spine, the consequences of which can be the most unpredictable, does not provide a guaranteed result of a complete cure.

Symptoms

The symptoms of this pathology must be monitored carefully and consult a doctor at the initial stage of development. Symptoms of a spinal hernia include:

1. Pain syndrome forms in the affected area with every movement.
2. Pain leads to restriction of movements and muscle spasms. In the absence of timely treatment, the pathology can lead to partial or complete immobility.
3. In addition to pain and discomfort, the patient complains of fatigue and drowsiness, which is caused by poor circulation in the affected area and throughout the spinal column.
4. As a result of impaired blood circulation, the patient experiences dizziness, headaches and sudden surges in blood pressure.
5. Depending on the location of the hernia, pain may radiate to the limbs, buttocks, shoulder blades and other parts of the body located near the affected area.
6. Also, depending on the location of the pathology in the upper and lower extremities, numbness, loss of sensitivity, and tingling may occur.
7. In advanced cases, doctors diagnose dysfunction of internal organs - loss of vision, heart failure, impaired urination or defecation.

Important! If you do not seek help from a doctor in time, there is a high risk of developing paralysis of the limbs. Here, spinal surgery is required to remove a hernia, the consequences of which, unfortunately, can lead to complete immobility of the limbs.

Types of hernias

Spinal hernias are divided into three types depending on the location of the displacement and protrusion of the nucleus pulposus. So, they distinguish:

1. Cervical hernia - formed as a result of injury or degenerative changes in cartilaginous tissue. Surgery for a herniated cervical spine, the consequences of which can lead to the development of paralysis on one side or pinched nerve endings, is performed only in cases of severe pain and loss of former mobility. The patient may first be prescribed the use of a collar to stretch the spine.
2. A hernia of the thoracic region is formed extremely rarely and is a consequence of osteochondrosis. It can lead to paralysis of the arms, but in most cases, simple traction of the spine with corsets or special stretching helps.
3. Lumbar hernia - develops as a result of prolonged wearing of heavy objects, back injury, long and frequent stay in a static position, due to age-related changes. A hernia of the lumbar spine, the operation and consequences of which can significantly correct the situation, is the most dangerous. In the absence of timely treatment, the patient's condition may become disabled - paralysis of the lower extremities or muscle atrophy will develop.

Important! If pain occurs, it is necessary to urgently consult a doctor and begin timely treatment so as not to lead the situation to partial or complete immobility.

Prescription of operations to remove spinal hernia

Of course, initially they try to treat a spinal hernia using conservative methods, but in case of ineffective treatment they resort to surgical intervention. In what cases is the operation used:

1. If no medications have led to a positive result, namely the elimination of pain.
2. If the patient experiences difficulties with the functioning of the internal organs of the small pelvis, there is a pathology of urinary and fecal incontinence.
3. In case of paralysis of the limbs, where doctors almost immediately resort to surgical intervention, without wasting time on ineffective conservative treatment.
4. In case of disruption of the innervation of the leg muscles, which often begins with loss of sensitivity, former mobility and the development of atrophy of the limbs.

Surgeries to remove intervertebral hernia are performed in case of ineffective treatment, but only after 3 months of taking medications. As a rule, doctors are guided here by the results of the examination, and not by the personal preferences and wishes of the patients.

Consequences of the operation

Despite the fact that the treatment in question brings a positive result in most cases, complications after surgery for a spinal hernia occur with a fairly high probability.

The most common problems include:

1. Scarring and adhesions occur in 100% of cases. Any operation leads to injury to healthy tissue. As a result, the operated spinal disc is incompetent for further human life. Adjacent bones and cartilage try to protect the affected area by growing tissue. If the body begins to reject new cells, the inflammatory process continues to cause inconvenience.
2. Impaired urination and defecation - occurs due to a pinched nerve root, which is formed as a result of complications arising from the scarring process. The danger of such a violation is the practical impossibility of restoring the functions of the pelvic organs.
3. Epidurit is a pathology characterized by inflammation of the spinal cord tissue. It often presents as a purulent lesion, which leads to an inflammatory process. By enlarging the tissue, the nerve roots are pinched - this can lead to paralysis of the limbs.
4. The development of arthrosis processes is presented in the form of fusion of two vertebrae and the lack of their mobility with the complication of the development of arthrosis. The patient quickly begins to complain of back pain.
5. Osteomyelitis is an inflammation of bone tissue, which leads in a short time to a septic process. Treatment is carried out only in a hospital setting.

Spinal hernia, the consequences after surgery of which can be much more serious than the disease itself, is why it is operated only in extreme cases. Therefore, if doctors prescribe complex treatment, all instructions must be followed for the benefit of the patient himself.

Treatment after surgery

Surgery always involves hospital treatment. Hernia of the spine is no exception to this. Medical treatment after surgery in a hospital is carried out only in cases of complications that were described above. This involves the use of painkillers and anti-inflammatory drugs that are administered intravenously or intramuscularly.

The types of medications and dosage are determined only based on the results of postoperative examinations. Decongestant and restorative drugs in the form of chondroprotectors are also used here.

At the initial stage, the patient must wear a special corset on his back. This helps prevent pain and also keep a weakened spine in normal condition.

Rehabilitation

Rehabilitation programs for the postoperative period include the following procedures:

1. The use of physiotherapy - electrophoresis, mud therapy, ultrasound treatment, interstitial electrical stimulation and other types of useful procedures are used here. The principle of treatment using the presented method involves improving blood circulation and restoring cartilage tissue through the additional consumption of vitamins and minerals.
2. Exercise therapy is prescribed by the attending physician at a certain stage, when the patient’s mobility has been restored and does not cause pain. Gymnastic exercises are aimed at restoring muscle tone and strengthening the corset, as well as improving the elasticity of the ligaments. All exercises are performed slowly and in the initial stages under the supervision of an instructor.
3. Kinesiotherapy is special gymnastics using orthopedic devices. The purpose of the presented exercises is to stretch the spine so that a vacuum is formed between the operated vertebrae. As a result of the formed vacuum, the load on the nerve roots is reduced.
4. Hydro procedures - various baths are used, but only under the guidance of the attending physician or instructor. Special solutions are used for baths, aimed at removing pain and inflammation, as well as improving blood circulation and accelerating metabolism.
5. Traction therapy – traction on dry and under water. The main procedure during the rehabilitation period, aimed at relaxing muscles, increasing range of motion and mobility of the spine.

Long-term rehabilitation after surgery to remove a spinal hernia is often carried out in a sanatorium - this is not only useful, but also simply convenient. At first, the patient should not make sudden movements or move a lot. Moreover, a certain diet is also prescribed here, which helps to cope with short-term disturbances in the functioning of the internal organs of the small pelvis. Through a proper diet, people undergoing surgery can prevent intestinal gas formation and heaviness in the stomach - this also acts as an advantage for the entire recovery period.

Operations to remove a herniated disc are extreme measures in the entire treatment of spinal pathology. Take care of your health immediately, resort to spinal restoration conservative treatment. This is the only way you can protect yourself from complications, both untimely intervention and post-operative ones.