Complications and consequences of spinal hernia surgery

As practical experience shows, 1/5 of the total number of patients with this diagnosis requires surgical treatment. Almost 50% of all existing interventions on the spine are performed specifically for the removal of intervertebral hernias. For example, in the USA, 200-300 thousand people undergo surgery annually.

Even with successful manipulations, in some patients (approximately 25%) the radicular syndrome remains or recurs after some time, and neurological and movement disorders persist or arise. A clinical examination of patients who fell into the group of people with unsatisfactory results found that the causes of unsuccessfully operated spine syndrome are mostly:

recurrence of hernia formation at the same level (8%);
narrowing of the spinal canal due to exostoses and arthrosis of the intervertebral joints (4.5%);
the appearance of a hernia on a disc adjacent to the operated segment (3.5%);
formation of pathological scars and adhesions in the spinal canal (3%);
scar-adhesive formations in the nerve roots (3%)
postoperative pseudomeningocele and spinal-epidural hematomas (1%).

Areas where pain may radiate.

As can be seen, relapses of the disease in the same place where the hernial tissue was resected are of particular concern. And quite often this is a consequence of mistakes and inaccuracies made during the rehabilitation period, ignoring in the long term the requirements and restrictions regarding everyday lifestyle. Those who, after high-quality rehabilitation, continue to recover in a sanatorium are less likely to face the consequences than others. Therefore, this fact should be taken into account by all patients, since consolidation of the achieved functional results immediately after the end of the main rehabilitation program plays a far from secondary role.

Healed surgical scar.

Regarding complications, the forum often receives letters where patients blame their occurrence on neurosurgeons who performed the operation poorly. Surgery itself is much less likely to cause complications. Modern neurosurgical technologies are superbly thought out from creating safe access to accurate visualization, they are well studied, mastered and honed to the smallest detail.

Foreign and Russian treatment: what is the prognosis

Domestic clinics sometimes do not have a well-functioning rehabilitation system.

Therefore, it is better to undergo surgery in foreign countries for spine and musculoskeletal surgery (in the Czech Republic, Germany, Israel). Even the most technically complex manipulations will be carried out “cleanly” here; the impeccability of the responsible procedure is ensured. It is very important to receive a high-quality and full rehabilitation benefit, but not all leading foreign countries can provide this part of the treatment process. In addition, the cost of a full-fledged Czech program of highly professional complex treatment is 2-3 times lower than the price in Germany and Israel for only one surgeon’s service. Forecasts for a successful postoperative outcome in the Czech Republic are 95%-100%.

Reminder after hernia removal: two important additions

We will not list all the points of the instructions; you know it, since it is always given to you upon discharge from the hospital. But we consider it necessary to inform about some requirements that are not covered in the issued instructions, which patients most often ask on forums. So, the two most common questions are: is a bath allowed after surgery and when can you have sex?

Somewhere you can read that the bath is effective against the adhesive-scarring process after removal of a vertebral hernia. Attention! This fact has no confirmation . Moreover, it is forbidden to go to the bathhouse after the operation for at least 6 months, or even better, a year. Temperature procedures are stimulants of metabolism and normalization of body functions, and if there is at least a small sign of internal or external inflammation in the area of the surgical field, they can also intensively stimulate the progression of the inflammatory reaction. The steam room can cause swelling of the surgical wound and divergence of “fresh” sutures. And this is a favorable environment for the entry of pathogenic bacteria and the development of purulent-infectious pathogenesis.
As for sex, it should be excluded for a while . Doctors usually do not advise resuming sexual activity for at least 14 days from the date of intervention. And even from this moment, until you finally recover, sexual contact should be as safe as possible. You must be a passive partner. In order not to cause injury to the operated part of the ridge, gentle sex is allowed, not characterized by high tension. The rule of no excessive load on the spine, in particular on the lumbosacral region (hernias are most often removed in this segment), should be observed for approximately 6 months.

Important! To achieve a full restoration of your quality of life and avoid consequences, strictly follow all contraindications and indications that are set out in the leaflet given to you upon discharge from the surgical hospital. And be sure to continue your recovery in the rehabilitation center. The standard period of mandatory rehabilitation, subject to positive dynamics, is 3 months.

Adaptation period after surgery

After the patient is discharged home, his adaptation begins. At home, it is necessary to follow a number of rules so that the process goes faster. The patient needs:

Wear a corset that fixes the spine in the correct position and protects from injury.
Avoid standing or sitting for long periods of time.
Avoid sudden movements, strong turns, bends, and lifting heavy objects.
It is not recommended to travel in public transport in the first months after surgery. If necessary, the patient should take a reclining position.
Four weeks after discharge, physical therapy exercises can begin.
Any exercises or loads must be agreed with your doctor.

Active rehabilitation can begin in 2-4 months.

Pain after removal of a spinal hernia

First of all, any surgical intervention performed for a herniated disc aims to decompress the nerve structures in order to relieve the patient from neurological deficits and excruciating pain in the back and limbs. If sensitivity has not resumed and the pain has not been eliminated, we can talk about either residual symptoms or consequences. Pain in the area of the wound in the early period is observed in almost everyone, as a normal reaction of the body to surgical trauma. When the suture heals well, which usually happens within 3-7 days, local painful signs are eliminated.

Lumbar hernia.

A postoperative complication is considered to be a recurrence of the hernia, the occurrence is 11.5% of 100% of cases. It can occur both in the operated segment (8%) and at completely different segmental levels (3.5%). No operating surgeon, even the most successful, will give you complete guarantees that a hernial protrusion will not occur in the near or distant future. However, you can protect yourself as much as possible from the next formation of an ill-fated process in the spinal discs.

You must understand that full medical rehabilitation after the removal procedure significantly reduces the likelihood of the pathology returning, and therefore you should not deviate one step from the individual postoperative treatment program proposed by the rehabilitologist and surgeon. Intensive physical methods - exercise therapy, physiotherapy, a strictly dosed regimen of physical activity, etc. - help prevent this consequence to the maximum.

Rehabilitation periods: goals, therapy, duration

At each stage of rehabilitation, different therapeutic and recreational methods are used with different periods:

The early period is 1-2 weeks

. The main goals are to relieve swelling and pain, prevent complications, and speed up wound healing. During the first days, it is necessary to remain in bed, take antibiotics and neurometabolic drugs, and treat the surgical suture. Mandatory actions: wearing a corset, breathing exercises, gentle exercise therapy.

Main services of Dr. Zavalishin’s clinic:

consultation with a neurosurgeon
treatment of spinal hernia
brain surgery
spine surgery

The late rehabilitation period lasts up to 2.5 months

. During this time, the ligamentous-muscular system is strengthened, the functions of the spine are restored, and the patient gradually returns to normal life. Drug treatment is prescribed only if necessary; therapeutic exercises, physiotherapy, and special exercises in the pool are indicated. During active activities, it is possible to wear a corset.

The deferred period can last up to 9 months (the terms are determined individually). Particular attention is paid to strengthening the body, complete restoration of vital functions, and prevention of relapses. The plan of activities consists of exercise therapy, aqua gymnastics, manual therapy, mineral baths and mud therapy.

Rehabilitation is complemented by sanatorium-resort treatment, which is preferably done once a year. If the recovery process for some reason did not go as planned and did not produce the expected results, the patient is sent for a medical examination. Having the examination and analysis data in hand, the specialist decides on a course of further action.

When can you sit down?

In addition, a person should know when to sit down, since premature lifting of the ban on the “sitting” position is a common cause of the development of repeated deformations of the cartilaginous structures of the disc. It is usually prohibited to sit for 4-6 weeks, but the length of the period must be determined by the doctor in any case. You are also required to wear a spinal corset, which will help the problem area recover faster and contribute to the prevention of consequences. But as to how long the orthopedic device will have to be used, it is also determined by a purely competent specialist, taking into account clinical data on the dynamics of recovery.

Some recover according to plan - after 3 months, while others may need to increase the duration of the recovery period by several more months. The timing directly depends on the individual characteristics of the body for functional recovery, the preoperative condition of the patient, the volume and complexity of the operation performed. But even after recovery, exercise regularly and follow all precautions. Do not expose yourself to unacceptable stress, as even lifting a heavy object can bring back the disease.

This complex is performed both before and after surgery.

Residual pain may persist for some time, especially in people who were initially admitted to a medical facility with serious vertebrogenic disorders that have progressed for too long. As the nervous tissue and muscle structures are restored, unpleasant symptoms that did not disappear immediately after the intervention will gradually subside. But please note that on their own, without proper postoperative treatment, they not only will not go away, but can also acquire a persistent chronic form, sometimes irreversible.

Be carefull! If you are concerned about pain after removal of a hernia, you need to consult a neurosurgeon! Do not try to contact online doctors via the Internet; they will not help you in any way, since they do not have the slightest idea about the peculiarities of your clinical case, the nuances of surgical intervention, or the specifics of your recovery.

The most effective treatment for numb toes

Correction of the patient's condition in the vertebrology clinic of Dr. Oleg Savyak depends on the nature of the disease of the spinal column or joints, which caused numbness of the foot. Typically, therapy includes manual manipulation and spinal traction aimed at relaxing compressed nerve roots. Arthrotherapy is also used - the author's soft technique without discomfort, jerks or impacts.

Manual massage, physiotherapy, therapeutic exercises and taking safe supportive medications help to consolidate the beneficial results .

Take care of your health on time: if you have repeatedly noticed that your toes are going numb, contact Dr. Savyak’s spinal rehabilitation clinic for an examination!

Complications after removal of a spinal hernia

Everyone wants to get an answer to the most exciting question: is surgery for a herniated disc dangerous? Absolutely every surgical treatment method has risks of possible complications. In our case, the danger of the operation is also not excluded, and in the dominant quantity it consists in the appearance of a relapse, which is solved by repeated intervention. Of course, the quality of the intraoperative session also plays a special role, but, as a rule, in successful clinics the operation goes well.

What may be the intraoperative consequences? Mostly they are associated with injury to the nerve or dura mater of the spinal cord.

The first complication will be manifested by pain and loss of sensitivity in the legs or arms, depending on the location of the injured nerve. If the nerve structure is severely damaged, the prognosis for its recovery is, unfortunately, disappointing.
If the dura spinal membrane is damaged, if the surgeon detects the defect in a timely manner, he will suture it. Otherwise, cerebrospinal fluid will leak. Impaired circulation of cerebrospinal fluid will cause problems with intracranial pressure and, as a result, the patient will experience severe headaches. The dura can heal on its own in about 2 weeks.

Negative reactions can be postoperative, early and late:

Early complications include purulent-septic processes, including epiduritis, osteomyelitis, suppuration of the suture, and pneumonia. In addition, the group of early postoperative consequences includes deep vein thrombosis of the lower extremities and pulmonary embolism.
Late negative reactions are repeated relapses, secondary degenerative pathologies. This also includes rough scar-adhesive growths, which in turn compress nerve formations, which, as with intervertebral hernias, is manifested by pain and/or paresthesia spreading along the pinched nerve.

If the operation is carried out efficiently, all preventive measures are followed and medical recommendations are flawlessly followed, the likelihood of any consequences occurring is reduced to the very minimum.

Why is proper rehabilitation important?

The spinal cord performs 2 functions: conductive and reflex. In the first case, we are talking about the movement of nerve impulses to the brain and the transmission of commands from the brain to the working organs. The reflex function allows you to perform the simplest motor reflexes.

In case of unprofessional surgical intervention, violation of rehabilitation rules, or injury, the listed functions are not performed or are not performed 100%. Consequences can be of two types:

physiological (impaired motor functions, changes in the functions of the pelvic organs, even paralysis of the lower or upper extremities is possible);
psychosocial (discomfort, loss of interest in life, depression, slow adaptation to new living conditions, feeling of uselessness to others).

It is difficult to say which of the consequences is more dangerous for a person, but the recovery stage after surgery must necessarily be accompanied by psychological rehabilitation. The help of a qualified psychologist will allow you to maintain optimism, endure painful sensations more steadfastly, increase the patient’s involvement in the rehabilitation process, and adapt to living conditions with irreversible physiological changes.