Disc Herniation: Challenges and Treatment Options

Q: Disc Herniation: Challenges and Treatment Options

Hello： The improvement rate after spinal disc herniation surgery is approximately 85%-90%. <br>If symptoms persist, it is advisable to undergo an MRI examination. <br>Medical centers should be equipped to perform endoscopic surgery.

Herniated disc

Hello, I remember experiencing pain in my right arm earlier this year.
I consulted a doctor and took medication, but there was no improvement.
After more than a month, I began to feel soreness in my right ankle.
I returned to the hospital for some tests (X-ray, CT scan, MRI), and the results indicated a herniated disc at the fourth and fifth lumbar vertebrae.
Following the doctor's advice, I continued taking medication and resting, but there was still no improvement.
The medication helped somewhat, but without it, the pain was so severe that I couldn't work.
I thought that to get better, I might need to address the herniated disc.
With a sense of unease, I underwent endoscopic discectomy surgery as recommended by my doctor.
I initially believed this would lead to improvement, but there was no progress at all.
When I returned for a follow-up appointment, the doctor said he found it strange.
Hearing that left me extremely disappointed.

1.
I wonder if it is still possible to perform endoscopic surgery to remove the herniated disc after having already undergone the procedure, and if there are any restrictions or if the success rate would be lower?
2.
What is the expected improvement from rehabilitation?
3.
Which hospitals in central and southern Taiwan offer endoscopic surgery?

Xiao Ye, 30~39 year old female. Ask Date: 2004/12/27

Dr. Qiu Yushu reply Neurosurgery

Hello: The improvement rate after spinal disc herniation surgery is approximately 85%-90%.
If symptoms persist, it is advisable to undergo an MRI examination.
Medical centers should be equipped to perform endoscopic surgery.

Reply Date: 2004/12/27

More Info

Understanding disc herniation and its treatment options can be quite complex, especially when patients experience persistent pain despite undergoing various interventions. Your situation, involving a herniated disc at the lumbar spine (L4-L5), is not uncommon, and many patients face similar challenges.

1. Understanding Disc Herniation
Disc herniation occurs when the soft inner gel of the intervertebral disc protrudes through a tear in the tougher exterior. This can lead to nerve compression, resulting in pain, numbness, or weakness in the affected areas, which in your case includes the right arm and ankle. The symptoms can vary widely depending on the location of the herniation and the nerves affected.

2. Treatment Options
Initially, conservative treatments such as medication, physical therapy, and lifestyle modifications are recommended. Medications may include anti-inflammatory drugs, pain relievers, and muscle relaxants. Physical therapy often focuses on strengthening the muscles that support the spine, improving flexibility, and teaching proper body mechanics to prevent further injury.

When conservative treatments fail, surgical options may be considered. The most common surgical procedure for disc herniation is a discectomy, where the herniated portion of the disc is removed. Minimally invasive techniques, such as endoscopic discectomy, are also available and can lead to quicker recovery times and less postoperative pain.

3. Your Experience with Surgery
It’s disheartening to hear that you did not experience improvement after your endoscopic surgery. While many patients do benefit from such procedures, outcomes can vary based on several factors, including the extent of nerve damage prior to surgery, the specific technique used, and the surgeon's experience.
If you are considering a second surgery, it is essential to discuss this with your surgeon. They can evaluate whether another endoscopic procedure is feasible and whether it would be beneficial in your case. Generally, previous surgeries do not preclude further surgical interventions, but they may complicate the procedure and affect the success rate.

4. Rehabilitation
Rehabilitation plays a crucial role in recovery after surgery. Engaging in a structured physical therapy program can help improve your strength, flexibility, and overall function. The extent of improvement varies among individuals, but many patients report significant benefits from consistent rehabilitation efforts. It is essential to follow a program tailored to your specific needs and limitations, ideally supervised by a qualified physical therapist.

5. Finding the Right Facility
Regarding your inquiry about hospitals in central and southern Taiwan that perform endoscopic disc surgeries, it is advisable to research and consult with reputable orthopedic or neurosurgery departments. Major medical centers often have specialized spine surgery teams. You can also seek referrals from your primary care physician or consult online resources for patient reviews and success rates of specific hospitals.

Conclusion
In summary, managing disc herniation can be a challenging journey, particularly when initial treatments do not yield the desired results. It is crucial to maintain open communication with your healthcare providers, explore all available treatment options, and consider a multidisciplinary approach involving pain management specialists, physical therapists, and possibly a second surgical opinion. Your persistence in seeking relief is commendable, and with the right support and treatment plan, there is hope for improvement in your condition.

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