Lumbar
Microdiscectomy
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| The Purpose of this
Information |
This
information is being provided to you in order to prepare
you to make decisions about your own health care. If
you should ultimately decide that surgery is the best
treatment option for you, this section will help you
understand what happens during a lumbar microdiscectomy and
will help you prepare for your role in the healing
and recovery process. Read it thoroughly and answer
the questions before making your final decision
about your treatment options. |
| The Health Care
Team's Role |
The
duty of your health care team is to:
- evaluate
your condition;
- establish
a diagnosis;
- present
the various treatment options;
- offer
a specific treatment recommendation;
- provide
you with the information you need to make a decision;
and then
- support
you in the decision you make.
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| The
Patient's Responsibilities |
You
are the only one who can decide to have surgery. It
is important that you take ownership of this
decision, recognizing the limitations your particular
physical condition places on the potential success
of each of the treatment options.
If
you choose to have surgery, your physical condition
and your mental attitude will determine your body's
ability to heal. You must approach your surgery with
confidence, a positive attitude, and a thorough understanding
of the anticipated outcome. You should have realistic
goals-and work steadily to achieve those goals.
The
decision to have or not to have surgery includes
weighing the risks and benefits involved. You will
make the final decision, so ask questions about
anything you do not understand. |
| The
Spinal Column and Vertebra |
Your
spinal column consists of 24 separate bones, called vertebrae,
plus the five fused bones of the sacrum and
the four fused bones of the coccyx (often referred
to as the "tail bone") (Fig. 1, below). The
vertebrae are stacked one on top of another and can
be divided into:
- The cervical (neck)
spine: the top seven vertebrae,
- The thoracic (chest)
spine: the middle 12 vertebrae, and
- The lumbar (lower
back) spine: the bottom five vertebrae.
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Attached
to the vertebrae are muscles, tendons and a group of
strong bands, called ligaments. Together, they support
the spinal column and help to protect its delicate nerves. |
| The
Role of the Vertebral (Spinal) Column |
Your
spinal column enables you to walk upright. It is the
central support for your upper body and carries the weight
of your head, chest and arms. The vertebrae in the lumbar
(or lower back) portion of your spine carry the majority
of this weight. The constant pressure from this weight,
even when you are simply sitting in a chair, is what
usually leads to problems associated with the lower back. |
| The
Role of the Intervertebral Discs |
The
bony vertebrae of your spinal column are separated from
one another by "pads" of tough cartilage, called intervertebral discs
(Fig. 2, above). These discs act like "shock absorbers" during
activity, allowing the spine to move freely. How a disc "ruptures" (bulges
outward) is shown in the drawing to the right (Fig.
2, above) and will be discussed in detail on the
following section. |
| The
Intervertebral Disc Nucleus |
The
center of each intervertebral disc is made up of a
gelatin-like substance (the nucleus ), surrounded
by a fiber-like outer lining (the annulus) (Fig.
3). As your body ages, the disc's nucleus begins
to stiffen. This reduces flexibility and increases
the chances that a disc may "rupture," especially in
the lumbar spine which carries so much of your body's
weight.
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The
Spinal Canal
|
The spinal
cord, which begins at the base of the brain and
runs within the spinal canal, ends in the lumbar
spine area in a bundle of nerves known as the cauda
equina (Figs. 3 & 4). The spinal
canal runs through the center of the spinal column
and protects the spinal cord and other delicate spinal
nerves.
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| The
Spinal Nerve Roots |
At
each vertebral level, a pair of nerves branch off from
the spinal cord or the cauda equina (one to the left
and one to the right). These spinal nerve roots are part
of the body's "electrical" system, carrying "current" (for
sensation and movement) to specific parts of the body (Fig.
4). The nerve roots are protected by an "insulated" covering
in the same way a "live" electrical line is coated to
prevent direct contact with the bare wire. A nerve root
damaged by a ruptured disc may have all or part of its "insulation" rubbed
off at the point of injury. Prior to surgery there is
no way of telling how much has been rubbed off or how
much damage has been done to the nerve (the body's "live
electrical wire"). |
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Related links:
Lumbar
microdiscectomy - page 2
Lumbar
microdiscectomy - page 3
Lumbar microdiscectomy
- page 4
Lumbar anatomy
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