Intervertebral hernia surgery - price at the Federal Scientific and Clinical Center of the Federal Medical and Biological Agency of Russia

Intervertebral hernia has become increasingly common in people of all ages. A disc herniation compresses the nerves and spinal cord, which is accompanied by severe pain and neurological symptoms (numbness, weakness in the limbs). If treatment is not started promptly, the disease can lead to permanent neurological deficits.

To understand how an intervertebral hernia occurs, you need to familiarize yourself with the structure of the spine. The spine is the main supporting structure of the body and consists of a chain of vertebrae (33-34). Between the vertebrae there are intervertebral discs, which are necessary for the flexibility and mobility of the vertebrae. The intervertebral disc in its structure has a core and a fibrous ring. Due to excessive physical exertion or injury, a microcrack may occur in the annulus fibrosus. During life, the crack grows and leads to “protrusion” of the core tissue beyond the spine. Thus, an intervertebral hernia begins to form.

Clinical picture

The doctor examining the patient must most accurately determine the level at which the hernia has formed. If the patient complains only of back pain, and this pain does not “radiate” to the arm or leg, then such a symptom cannot be attributed to a herniated disc. It is necessary to look for causes in the back muscles, intervertebral joints and ligaments. A herniated disc begins to develop, first of all, due to improper load on the spine, which leads to muscle overstrain. The muscles do not have time to rest and recover, they spasm and the patient develops back pain. In parallel with the breakdown of muscles and ligaments, degenerative changes occur in the joints and discs of the vertebrae. With constant pain, the inability of muscles and ligaments to withstand the load on the spinal column leads to rupture of the fibrous ring, and thus to the appearance of a hernia.

The presence of an intervertebral hernia requires immediate treatment. At the Federal Scientific and Clinical Center of the FMBA of Russia, operations for the treatment of intervertebral hernia have been carried out for more than 30 years. The extensive experience of neurosurgeons is extremely important when performing surgical intervention on the body; it guarantees the accuracy of the operation, reducing the risk of possible negative consequences. All operations at the Federal Scientific and Clinical Center FMBA are carried out in accordance with the protocols of the Russian, American and European associations of neurosurgeons.

Flaws

First of all, there is no large amount of scientific data that allows us to speak confidently about the long-term period, since the technique has been used relatively recently. No one knows how laser treatment will affect the patient's disc structure after 30, 40, or more years. Also:

this type of treatment is not radical.
So, if we talk about disc replacement, which is carried out with great success in Western European countries, for example in the Czech Republic, Germany, then we can assume that a person receives practically a new disc and a return to freedom of movement. After laser manipulation, he is left with an old disk, and often with a changed structure; Disc replacement.
the next disadvantage is the occurrence of relapses, and sometimes there is a need for repeated intervention. But almost always such residual phenomena and the need for re-treatment are associated not with incorrect surgical technology, but with non-compliance with the rules of a healthy lifestyle prescribed by the doctor;
sometimes, when a large volume of the disk is evaporated, the temperature of the surrounding tissues may rise too quickly. If the intervention is carried out too quickly, they can be thermally damaged. Such a burn can worsen the course of the healing period, and even lead to discomfort and pain due to fibrosis and adhesions;
quite high cost of treatment. But in the conditions of the Russian Federation, a drawback is the fact that patients turn to neurosurgeons so late that the hernias already exceed the maximum size and structure allowed for laser correction, which serves as the main contraindication to laser treatment.

Preparing for surgery to remove a herniated disc

FSCC FMBA has all the necessary diagnostic equipment, which makes it possible to prepare for surgery in the center in just one day. A comprehensive examination includes:

MRI;
CT;
X-ray with functional tests (to exclude instability of one of the vertebrae).
Lab tests:
Blood chemistry;

General blood analysis;

Analysis of urine;
Blood test for infectious group;
General urine analysis.

It is important to note that blood test results must be obtained the day before surgery. The list of laboratory and instrumental tests can be expanded based on the individual characteristics of the body and the state of health in general. Before surgery, consultation with a therapist and anesthesiologist is necessary. 8 hours before surgery you need to stop eating.

Back problems: where is the best treatment?

The Federal Center for Neurosurgery, located in Novosibirsk, performs high-tech interventions on the spine. In terms of the profile of spinal surgery, the clinic occupies an honorable place within the Russian Federation. Surgeons operate on adults and children, and after the operation, reviews confirm what we have said, good rehabilitation care is provided under the patronage of exercise therapy methodologists.

If you are planning to travel outside Russian or Ukrainian territory, we advise you to undergo spinal surgery in the Czech Republic; it is rightfully called the “queen” of orthopedics and traumatology all over the world. In addition, in this country, with an exemplary system of orthopedic and rehabilitation medicine, the most affordable prices are noted: 2 times less than in Germany, 2.5-3 times than in Israel.

Performing surgery for intervertebral hernia

There are two ways to surgically treat a herniated disc: microsurgical removal of a herniated disc and endoscopic removal.

Microsurgical removal is carried out through a 3-centimeter incision using a microscope and microsurgical instruments.

Endoscopic surgery is performed through a 7 mm incision using an endoscope.

Depending on the size and location of the disc herniation, the operation is performed under general anesthesia or epidural anesthesia. With an epidural, the patient may feel discomfort at the surgical site and hear what is happening in the operating room. The duration of the operation is from 30 to 90 minutes. Endoscopic hernia removal is performed in the lateral or abdominal position. After making a skin incision, a special endoscope is inserted, through which you can see the area of the operated area and the “protrusion” that compresses the nerve roots. The device makes it possible to visualize the area where it is necessary to remove the hernia, and the image is displayed on the screen. When bleeding occurs, the surgeon stops it using coagulation (cauterization of blood vessels). The doctor removes the “bulging” and damaged disc structures, which prevents the herniation from occurring again.

In the neurosurgical department of the Federal Scientific and Clinical Center of the Federal Medical and Biological Agency, operations are actively carried out using endoscopic techniques, which significantly reduces the duration of the recovery period and the length of stay of patients in the hospital!

The essence of the technique

It must be remembered that laser therapy for the purpose of affecting a hernia is actually part of minimally invasive surgery. And those who think that by using this type of treatment you can do without surgery altogether are wrong. How can we talk about a conservative method of treatment when an intervertebral hernia or its fragments turn into steam, and this steam is released out under high pressure?

Evaporation of a hernia is a real surgical intervention. But laser methods for destroying disc herniations or changing their structure do not require the basic attributes of conventional operations, and proceed without incisions, without blood loss and pain, and therefore do not require endotracheal or intravenous anesthesia. Local anesthesia is quite sufficient.

Next, the treatment of intervertebral hernia using laser radiation will be discussed in detail. But first you should find out what advantages and disadvantages this method has.

Recovery after surgery

The pain syndrome after removal of the hernia disappears almost instantly - this makes it possible to quickly return to normal life. However, recovery after the manipulations requires special preventive measures that must be observed to avoid the development of complications.

Proper restoration includes several stages:

Monitoring the condition with the attending physician;
Attendance at necessary physiotherapeutic procedures (laser and magnetic therapy). They are prescribed 4-5 days after surgery and are carried out in courses of procedures.
Self-recovery at home, namely:
The first 1.5 months require wearing a fixation corset;

It is recommended to avoid sudden movements that can lead to spinal injury (sudden bending, lifting heavy objects);

It is necessary to avoid using public transport. If necessary, the position should be “reclining”.
Stretching of arms and legs from 7 days to 1.5 months.

Postoperative sutures are removed on days 7-10, then outpatient observation by a neurologist is required. You can sit down immediately after surgery for 5-10 minutes to eat food, followed by bed rest. If you feel normal, you can sit without restrictions for 1 hour 1 month after removal of the hernia with a 5-minute break. You can start working after 1 month, but full recovery of the body occurs approximately 2-3 months after the operation.

The best results can be achieved by following the plan of physiotherapeutic procedures prescribed by your doctor. On the basis of the Federal Scientific and Clinical Center FMBA there is a center for restorative medicine and rehabilitation, where every patient can receive qualified assistance from rehabilitation specialists. The patient may be prescribed physical therapy to relax the back and abdominal muscles, as well as manual therapy. For adequate muscle recovery, 10 massage sessions are necessary. The treatment plan is developed together with a physiotherapist and rehabilitation specialist, based on the indications, as well as the patient’s condition in the postoperative period.

Contraindications

There are a number of conditions where laser radiation may cause more harm than good. Laser methods for treating disc herniations are contraindicated if:

in this segment there is an anomaly of the bone structure of the vertebrae, for example, the presence of bilateral Schmorl hernias;
with significant narrowing or stenosis of the spinal canal at the site of the proposed intervention;
According to an X-ray examination, MRI, there are signs of discitis in the intervertebral disc, that is, inflammation, and in the surrounding bone tissue of the vertebrae there are signs of spondylitis.

Finally, laser technology is not used in cases of sequestered hernia. It is highly undesirable to use laser methods, as mentioned above, for large hernias exceeding 6 mm. Of course, no one forbids the patient to insist on this method of treatment, but there is a risk of incomplete removal of the hernia, and especially if the patient is over 50 years old and has tears in the fibrous ring, that is, there is a high risk of repeated protrusions and hernias in this segment.

An absolute contraindication to laser treatment of hernias is displacement of the vertebrae and their severe instability, a tumor in this segment, even a benign hemangioma. The patient becomes familiar with the full list of contraindications at the initial appointment with the neurosurgeon, when the type of surgical treatment is selected. How should you prepare for laser treatment?

Sequestrated hernia on MRI.

Cost of surgery for intervertebral hernia

The cost of surgery to remove a herniated disc depends on a number of factors:

The chosen technique and additional manipulations prescribed by a specialist;
Location of the hernia (lumbar/cervical/thoracic, spine)
Type of anesthesia used;
Duration of stay in the ward (staying in the ward takes several days, but according to the testimony of the attending physician, the period can be increased).

The exact cost of removing a spinal hernia can be found out at an in-person appointment with a neurosurgeon, when the doctor will review the results of the studies, study the medical history and prescribe treatment tactics.

Terms of rehabilitation

A rehabilitation program is drawn up immediately after the completion of surgery. Patients should take their first steps within 1-2 days. The rehabilitation period is from 4 months. It depends on:

Type of operation. After a minimally invasive intervention, rehabilitation will take a month, while after a discectomy it will take at least six months.
Patient's age. Rehabilitation for older people takes longer.
Health. Rehabilitation will be delayed if there is a history of chronic diseases (diabetes mellitus).
Weights. Obese people take longer to recover.
The nature of the vertebral hernia. This is its size, how long ago the disease was, what difficulties it caused.

Difficulties of cervical surgery

If you undergo a procedure for partial or complete removal of the affected cervical disc along with a hernia, you can count on a successful effect from the manipulations performed only if you correctly and strictly follow the individual rehabilitation program in the future.

In Russia, the price for surgery, which involves resection of a hernia at any cervical level, is an order of magnitude higher than for other areas of the spine. This fact is explained by the fact that carrying out manipulations in a department that is quite difficult in terms of anatomical parameters is a very responsible task of increased complexity and “jewel” precision. The approximate price range for a full intervention is from 100 thousand to 300 thousand rubles. It is easy to guess that the cost will increase when the removal procedure is combined with stabilization (installation of endofixers, prostheses, grafts, etc.) of the operated area.

Cervical spine implants on x-ray.

This section is literally permeated with nerve plexuses, as well as vascular branches that simultaneously feed both the brain and the spinal cord. The vertebrae of the cervical sector are small in size, their processes are equipped with openings that serve as pathways for the passage of the vertebral arteries, which in turn transport the required volume of blood to the brain. Damage to nerves, blood vessels, and the spinal cord in the cervical region causes quite serious consequences, since they have a direct relationship with the organs of the head, upper limbs, and respiratory center.

Both untimely surgery for a cervical hernia and surgeon errors during the surgical process are fraught with severe motor and coordination disorders, paresis and paralysis of the upper limbs, paralysis of the diaphragm, impaired hearing and vision, brain hypoxia, etc.