What is a lumbar discectomy?

腰椎间盘切除术是一种固定腰椎间盘突出的手术. 与开放式腰椎间盘切除术相比，该手术的切口更小.

你的脊骨，或脊柱，是由一串叫做椎骨的骨头组成的. Your spinal cord runs through the spinal column. The bones help protect the cord from injury. 椎间盘位于每个椎体之间，提供缓冲和支撑. 称为神经根的大神经从脊髓出发，穿过骨头之间的小孔，称为椎间孔. 这些神经根向身体发送和接收信号. 信号通过脊髓在大脑之间来回传递.

有时，其中一个椎间盘的外壁可能会随着年龄或损伤而变干和变弱. 当这种情况发生时，软盘的内部部分就会凸出. This is called a herniated or bulging disk. 这种突出的椎间盘会压迫神经根，有时也会压迫脊髓，引起疼痛等症状, tingling, or weakness in parts of the body.

During a minimally invasive lumbar discectomy, 矫形外科医生或神经外科医生取出部分受损的椎间盘. 这有助于缓解神经根或脊髓的压力. Your surgeon can use different methods to do this. With one method, 你的外科医生通过你背部的皮肤插入一根小管子, 椎体之间和椎间盘突出的空间. 然后他们通过管子插入微小的工具来移除磁盘的一部分. Or a laser may be used to remove part of the disk. Unlike an open lumbar discectomy, 外科医生只在皮肤上做一个很小的切口，几乎不切除任何骨头或肌肉.

Why might I need a lumbar discectomy?

如果你的下背部有椎间盘突出引起症状，你可能需要做这个手术. The symptoms may include lasting weakness, pain, or tingling in the back area and in one of your legs.

腰椎间盘切除术并不能治疗所有的背痛. 并不是每个椎间盘突出的人都需要做腰椎间盘切除术. 如果你已经尝试了其他治疗方法，但仍然有严重的症状，你的医疗保健提供者可能会建议你做手术. Other treatments to try first include physical therapy, epidural spinal injections (ESIs), and anti-inflammatory medicines.

与你的医生谈谈微创手术与开放手术相比的风险和好处. 微创手术可以减少疼痛，更快恢复. But not all surgery centers can use this method.

What are the risks of a lumbar discectomy?

Every surgery has risks. Risks for this surgery include:

• Infection

• Excess bleeding

• Blood clots

• Injury to nearby nerves

• Reaction to anesthetic agents

• 只有短期(暂时)缓解，需要再次手术

你的风险可能因你的年龄和整体健康状况而异. 与您的医疗服务提供者讨论最适用于您的风险.

How do I get ready for a lumbar discectomy?

询问你的医疗保健提供者你应该如何计划准备你的手术. 询问是否应该提前停止服用任何药物，比如血液稀释剂. 按照医生的指示，在手术前不要吃东西或喝水.

医生可能会要求对你的脊柱进行其他影像学检查，比如核磁共振成像.

What happens during a lumbar discectomy?

There are several options for the surgery. 你的外科医生可以帮你解释手术的细节. It may take about 1 hour. Here is an example of what you might expect:

1. 你将接受局部麻醉，这样在手术过程中你就不会感到任何疼痛或不适. And you will still be awake. 或者你可以全身麻醉，在整个过程中睡觉.

2. 在手术过程中，医生会仔细观察你的生命体征. 这包括心率和血压.

3. 你的外科医生会在你背部受影响的椎间盘上做一个小切口.

4. During the procedure, 你的外科医生会用一种特殊的x光片来确定正确的位置.

5. 你的外科医生将首先在椎间隙的顶部插入一根小棒. Your surgeon will push a slightly larger tube over this rod. 然后你的外科医生会把另一根更大的管子推到上面. They may even push a third tube over the second one. This will gently push apart the tissue down to the vertebra. 最后，你的外科医生会移除除了最大的管子以外的所有管子.

6. 你的外科医生会把特殊的小工具放进管子里，包括照相机和灯.

7. 你的外科医生会用小工具切除椎间盘突出的部分. They will also do any other needed repairs.

8. The tools and tube are removed.

9. A small bandage is placed to close your wound.

What happens after a lumbar discectomy?

The surgery is usually an outpatient procedure. This means you can go home the same day. 手术后你可能需要待上几个小时. Make sure you have someone who can drive you home.

你的医疗保健提供者会告诉你如何使用背部. You might need to limit lifting or bending. 你的医生可能会让你在手术后的一段时间内戴上背部支架. Most people can go back to work within a week or so. 手术后你可能需要物理治疗来帮助加强你的背部.

You may see some fluid draining from your small incision. This is normal. 如果从切口处有大量的分泌物，立即告诉你的医生. 如果你发烧或该部位疼痛，也要打电话给你的医生.

有时这个过程会在一段时间内引起轻微的疼痛. But you can take pain medicines to ease the pain. Usually this goes away quickly. 你的疼痛应该会比手术前减轻.

确保遵循医生的所有指示，并遵守后续预约.

Next steps

在您同意测试或程序之前，请确保您知道:

• The name of the test or procedure
• The reason you are having the test or procedure
• What results to expect and what they mean
• The risks and benefits of the test or procedure
• What the possible side effects or complications are
• When and where you are to have the test or procedure
• 谁来做测试或程序，那个人的资格是什么
• What would happen if you did not have the test or procedure
• Any alternative tests or procedures to think about
• When and how will you get the results
• 在测试或程序后，如果您有疑问或问题，可以打电话给谁
• How much will you have to pay for the test or procedure