Laser vaporization of herniated intervertebral discs - the illusion of recovery

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Spinal surgery
is a complex area of ​​practical medicine, located at the intersection of neurosurgery, traumatology-orthopedics and neurology, which deals with the surgical treatment of diseases and injuries of the spine, spinal cord and peripheral nerves. Nowadays, the importance and role of spinal neurosurgery has increased significantly, as the development and implementation of modern high-precision diagnostic methods and surgical techniques and technologies have made it possible to significantly expand the range of spinal diseases for which it has become possible to provide effective surgical care to patients.

Advantages of the method:

• Low trauma;
• No complications;
• Short operation time;
• Fast recovery;
• Local anesthesia;
• No need to stay in hospital for a long time;
• The functions of the spine and ligamentous apparatus are not impaired;
• You can work with multiple disks;
• The procedure takes place with virtually no blood loss;
• Can be used in patients for whom full-scale surgery is contraindicated.

Puncture laser nucleoplasty is an effective and low-traumatic manipulation that does not cause complications. Laser treatment of intervertebral hernia is effective if the disc is not damaged and the size of the hernia is small. A timely procedure will allow:

• Get rid of pain;
• Lead a normal lifestyle;
• Prevent future relapses.

Duration of the operation and time spent in the clinic

After a comprehensive examination, if there are no positive results after therapeutic intervention, surgical intervention is prescribed after observation. Laser removal is carried out taking into account possible risks. The manipulation itself lasts up to ten minutes. Since the procedure is gentle and as safe as possible for the patient, the period of hospital stay is, as a rule, no more than three days. In some cases, the patient is sent home after 24 hours. Strict bed rest is recommended for the first 12 hours. After discharge, the patient is prescribed anti-inflammatory and painkillers, and should also wear a support bandage. During the first time after surgery, the patient is strictly prohibited from exercising. During the recovery period, a decrease in physical activity is also indicated. The patient's activity should be limited in the first few weeks, and sitting is also contraindicated. In the early period, you should not walk or stand for a long time, or lift heavy objects. Despite the fact that after removal of an intervertebral hernia with a laser, the patient is quickly discharged, it will be long and difficult to restore the impaired functions of the spine. Following the restrictions and recommendations of the treating doctor allows you to eliminate possible complications and relapses. It is necessary to visit a doctor for a follow-up examination after a few months.

Indications and restrictions

Laser treatment of a spinal hernia is recommended if the patient:

• discogenic pain syndrome is diagnosed;
• there is a disc protrusion (diagnosis confirmed by MRI);
• Conservative therapy does not produce results for more than 3 months.

Laser nucleoplasty of intervertebral discs does not eliminate all types of intervertebral hernias. Its use is not recommended if the patient:

• There is no integrity of the annulus fibrosus;
• Protrusions exceed one third of the size of the spinal canal;
• The height of the ring has been reduced by half or more;
• There is a tumor in the spine;
• Stenosis is diagnosed;
• Instability or displacement of the vertebrae;
• There is an infection in the area of ​​the intended puncture;
• Chronic diseases in the stage of decompensation.

Rehabilitation

Any surgical intervention requires the patient to undergo further rehabilitation. A specialist will select rehabilitation measures for you. It must be remembered that rehabilitation is as important as the operation itself (if not more), so be sure to adhere to all medical recommendations and follow the rules.

The rehabilitation that the patient undergoes after laser treatment for a herniated disc also has a number of basic and general rules that are important to adhere to if you want to avoid relapse:

• 
  Familiarize yourself with the rules of rehabilitation after laser vaporization. You should take a course of NSAIDs (non-steroidal anti-inflammatory drugs), which your doctor will select for you;

• In addition to the medication course, it is necessary to undergo a course of physiotherapy. This therapy will allow you to launch regenerative processes in the body and relieve residual inflammation;
• Exercise therapy is one of the most important rehabilitation activities. Physical exercise will help restore normal mobility to your spine without overloading it or causing a relapse. A specialist will select exercises for you (the same applies to physiotherapy);
• A correct lifestyle will also be an important rule during rehabilitation and further existence. It is imperative to adjust your work and rest schedules, change your diet, get out into the fresh air and walk more often, give up smoking and alcohol;

These are general recommendations that are prescribed to all patients after laser surgery . Your attending physician will give you individual recommendations, depending on your specific clinical picture.

Rules for preparing for nucleoplasty

The selection of patients for this operation occurs according to certain criteria. The neurosurgeon needs to have complete information about the pathology:

• Localization of the defect;
• Condition of the fibrous core, spinal cord, spinal canal and joints;
• Dimensions of protrusion.

MRI can provide this information. If necessary, clarifying examinations are prescribed:

• Discography;
• MRI with contrast agent;
• Myelography.

To obtain information about the functioning of vital organs, a standard examination is carried out:

• ECG;
• Blood and urine analysis;
• Fluorography;
• Examination by a therapist.

Approximate cost of laser surgery

The price for this therapeutic intervention varies. Typically, variability is associated with the experience of the surgeon, the fame and reputation of the clinic, and accompanying diagnostics (sometimes consultation with doctors from different fields is required).

The cost of a hernia reduction procedure in different hospitals can vary significantly. Approximate cost of the operation in Moscow:

• Central Railway Hospital No. 1 will charge 20 thousand rubles or more ;
• Center for Clinical Diagnostics named after. I.M. Sechenova will present the patient with a check of 85 thousand or more ;
• The Central Hospital of the Russian Academy will ruin you for 65 thousand or more ;
• A neurosurgical minimally invasive clinic will request more than 55 thousand rubles .

These are just approximate prices for services of this kind . For specific figures, you will have to contact the relevant clinics directly, but it is not a fact that they will immediately give you accurate data, since during the examination and consultations, points may be revealed that influence the price change both up and down (which happens less often) .

Features of the operation

The day before, the patient is given a cleansing enema. Before the operation, anti-inflammatory and sedative drugs are administered. Typically, local anesthesia is used, but this is not necessary. It is important that the patient does not move for 20 minutes. If the fulfillment of this condition is in doubt, the issue of intravenous anesthesia is resolved.

The needle insertion site is selected individually in each individual case.

Laser nucleoplasty of intervertebral discs is performed under X-ray supervision. During the laser operation, the disc tissue is heated and evaporated and decompressed - this eliminates excess pressure. Reducing the pressure in the disc starts the recovery process:

• Its volume becomes smaller;
• The fibrous ring takes its previous position;
• The pathology is eliminated.

Treatment of spinal hernia with laser

According to modern surgeons, laser is a technology that can save a person from many ailments, including spinal hernia, with a minimum of trauma..

Video: “Use of laser surgery to remove a hernia”

The essence of the method and technique of execution

Before the operation begins, the patient must undergo a series of tests and diagnostics. This will allow you to take into account all the features of the course of the disease in a specific clinical case, as well as avoid an incorrect diagnosis. If, after all the measures taken, the surgeon does not find any contraindications to the use of the laser, then the day of the operation can be scheduled.

12 hours before the start of the operation , the patient is admitted to the hospital so that the attending physician can conduct the necessary consultations, tell the patient how to eat before and after the operation, and also explain the peculiarities of behavior after anesthesia. 10 hours before the start of the operation, the patient should not drink or eat .

The process itself will be carried out under local anesthesia , since general anesthesia is not required in this case.

When the anesthesia takes effect, a needle of a special diameter will begin to be inserted into the disc that has undergone deformation. After this, the doctor will bring a flexible light guide . A special flow of energy will flow through this sevtoduct, which will act on the liquid of the damaged disk and, as it were, “evaporate” it .

Laser vaporization evaporates moisture from the disc, reducing its volume and, consequently, the pressure on the nerve endings

Steam will escape through the needle, and the hernia will decrease in size . The smaller the hernia becomes, the less pressure there will be on the nerve roots adjacent to it, and this in turn will relieve the patient from pain. The entire operation process will be monitored using X-ray equipment with minimal radiation exposure.

Pay attention to the structure and composition of the tissues of the intervertebral disc

After the operation is completed, the patient will remain in the hospital for another day . Doctors will constantly monitor his condition. Walking will be allowed only in the evening after the operation; until this moment the patient should only lie down.

A day later, the doctor will conduct the necessary examination and diagnostic measures, and if no violations are detected, the patient will be sent home for rehabilitation. Rehabilitation measures should be carried out for a month.

Video: “Technique for performing laser vaporization of a disk”

Pros and cons of laser surgery (risks)

Laser treatment methods came to our medicine not so long ago, so many people wonder what the pros and cons of this method of eliminating the disease have.

Recommendations for laser surgery can only be given to you by your attending physician, and after conducting extensive diagnostics and prescribing a large number of tests. You cannot make such a decision on your own, and no surgeon will take on a patient who has personally decided to resort to this type of operation. Therefore, be sure to consult your doctor.

Where to get nucleoplasty done in Moscow?

Nucleroplasty is performed at the RAS clinic in Moscow. The price is determined taking into account the qualifications of the doctor and the equipment used. Patient reviews indicate that:

• The operation is painless;
• The pain syndrome is eliminated within a short time;
• You can do without a sick leave;
• The cost of the operation corresponds to the cost of many years of conservative treatment.

You can make an appointment with a specialist on the website or use the contact information.

Consequences of laser therapy and recovery time

Despite the fact that the technique is one of the most modern and effective, complications cannot be excluded. Mostly the consequences are moderate and do not pose a particular threat to the patient. Possible risks include recurrence of the pathology or persistence of pain from several months to several years. The experience and qualifications of a neurosurgeon are the key to eliminating complications. An experienced doctor takes into account all factors to ensure that the operation is effective. Removal of a spinal hernia in Moscow is performed competently and painlessly in our neurosurgical department.

After the manipulation, the patient needs rehabilitation:

• periodic monitoring by the attending physician;
• diet therapy to reduce excess weight;
• physical therapy according to an individual plan;
• maintaining a moderately active lifestyle.

A recovery plan is assigned to the patient individually. Gymnastics, swimming, participation in sports games and staying active contribute to a speedy return to normal life.

Diagnostics

As a rule, when an intervertebral hernia begins to develop, it is not much different from osteochondrosis. Most often, doctors refer you for radiography, where they take a picture of the spine. Thanks to it, doctors can detect the following points:

• presence of osteochondrosis;
• curvature of the spinal column;
• abnormalities in the development of the spine;
• pathologies of bones and their structures.

However, something else is interesting: in this way, an intervertebral hernia cannot be detected.

Diagnosing a hernia is not as simple as it seems at first glance

The presence of a hernia can be determined (but not confirmed) by studying the nature of the pain and its development. This will help doctors such as a neurologist and vertebrologist determine whether the characteristics being studied are signs of a herniated disc or any other diseases from the following list:

• Schmorl's hernia;
• plexitis;
• hematoma;
• myositis;
• spondyloarthrosis;
• tumor.

If doctors require a picture of an intervertebral hernia, the patient is prescribed a magnetic resonance or computed tomography scan of the spine.

It should be noted that when choosing between CT and MRI, you should prefer the latter option, since this procedure is more informative. It provides a three-dimensional image of soft tissue structures. Also, with the help of this type of procedure, it becomes possible to trace the development of the hernia, identify its exact location, determine the stage, as well as how much the spinal canal is narrowed.

Both magnetic resonance imaging and computed tomography are both mandatory diagnostic procedures for suspected intervertebral hernia

If it is not possible to undergo an MRI or CT scan, then the doctor may prescribe contrast myelography.

For an intervertebral hernia located in the cervical region and compressing the vertebral artery, vascular diagnostics are prescribed. It comes in two types:

• Ultrasound Dopplerography (Doppler ultrasound) of the spinal arteries;
• REG (rheoencephalography).

Such examinations require examination of the arteries and veins from different points of view, for which the patient makes head movements in the form of various turns and tilts.

Those who have such a hernia in the chest need to consult with the following doctors:

Diagnostic methods to help recognize symptoms of intervertebral hernia

Back pathologies such as intervertebral hernia are within the competence of a neurologist. The main methods for diagnosing pathology are palpation of the spine, assessment of muscle strength and sensitivity of the skin. After the initial diagnosis, the doctor prescribes additional tests, which include: magnetic resonance imaging, radiography, computed tomography, discography, myelography. The purpose of the examination is to assess the condition of the nerve roots in the area of ​​discomfort and pain.

How is the treatment process for intervertebral hernia?

At the initial consultation at our medical Center, based on your symptoms and examination results, the doctor will be able to diagnose a hernia and the cause of its occurrence. If you have not yet undergone any examinations in our Center, you can have a modern ultrasound of all parts of the spine.

Next, depending on the stage of the disease and the nature of the symptoms, you will be prescribed a comprehensive two-stage program.

In the acute period, our doctors focus on eliminating the main symptoms that need to be eliminated first: pain, swelling, displacement of the vertebrae (if any). In pain therapy, blockades and the introduction of hyaluronic acids and platelet-rich plasma into the affected disc provide a quick effect.

To effectively reduce swelling, improve tissue regeneration of a damaged vertebra, and restore back muscles, our Center uses Khivamat therapy, as well as manual therapy and taping methods, which show excellent results in restoring muscle resources, improving lymphatic drainage and capillary blood flow.

At the next stage, massage, kinesitherapy, and infrared sauna sessions are included, which help not only to strengthen the spine, but also to feel the overall tone and surge of vitality.

Upon completion of the course of hernia treatment, our doctors give recommendations on how to prevent the appearance of hernias in other parts of the spine, and are always in touch with all questions.

The article was reviewed by osteopath and chiropractor A.V. Strakhov.

Symptoms of the disease

Intervertebral hernia has a large number of symptoms. They differ significantly from each other. They usually depend on the location and size of the hernia.

If the nerve is not compressed by a hernia, then the course of the disease will be asymptomatic. The maximum that a sick person can feel is mild pain in the lower back. It is worth noting that such a case is rare.

For the most part, damage to the spine by intervertebral hernia is accompanied by irrepressible pain and muscle spasms.

If compression of the nerve endings does occur, then there will be pain. In addition, the patient will feel weak or have decreased sensitivity in the limbs or other parts of the body, which include pinched nerve endings. For example, if a hernia has formed in the lower back, the pain radiates to the buttocks and legs, including the knees and feet. This is due to pinching of the sciatic nerve. If we talk about the legs, then in most cases only one of the two hurts. The pain is not constant - it increases gradually and goes away after some time.

The symptoms of an intervertebral hernia are quite clear, but this is only if the nerves are compressed

If the nerve roots in the lower back are too compressed, the person loses control of the bladder or bowels.

Provided that the hernia was found in the area of ​​the lower ribs, the patient will feel pain in the thigh.

The negative impact of a hernia, which is located in the thoracic spine, extends to the chest, shoulders and arms. They usually hurt and, after a while, begin to go numb.

Pain due to intervertebral hernia increases with the following factors:

Indications for microdiscectomy. Advantages of the method

Microsurgical removal of a hernia is possible in the presence of pathological formations in any part of the spine. Most often, hernias in the cervical and lumbar regions are treated in this way. The purpose of the neurosurgical operation is to relieve the pressure of the hernial protrusion on the nerve roots. This allows you to relieve progressive pain, relieve swelling, and normalize motor functions. The risk of postoperative complications when performing microdiscectomy is minimal.

Other advantages of the treatment method include:

• High efficiency.
  In 95% of cases, it is possible to achieve complete recovery of the body.
• Rapidity.
  The operation usually lasts only 20–30 minutes. Prolonged hospitalization is not required.
• Gentle pain relief.
  Epidural anesthesia is usually performed, which is easier for the body to tolerate than general anesthesia.