What should I do for a disc prolapse?
Q: I have acute disc prolapse at L5-S1 area since I had fallen on my back and have problem in my buttock and left leg. There is no pain in my back but I am unable to sit, though I can walk and sleep without any pain. I have tried traction, physiotherapy, accupressure, physiotherapy but there is no improvement. I have also used massaging oil but it gives only temporary relief. Should I go for a surgery? Is it safe? Will they seal the space between L4 and L5?. People are saying that I might have paralysis if some thing goes wrong. How long is the operation and how many days bed rest will I require? Can the problem recur after the operation? Will I be a normal person after the operation or will I always need to take care?
A:Well, a clinical examination and your MRI report need to be considered before any exact answer can be given. Broadly, I can suggest you a few tips. You can still go in for conservative treatment which consists of:- 1. Any heating modality or TENS. 2. Spinal exercises (will depend on the type of disc herniation.) 3. Spinal Supports. 4. Ergonomic Principles for activities of daily living. 5. Sufficient Rest. Even if your surgeon has advised you a surgery, there is no need to panic. The type of surgery will again depend on the MRI report. Some surgeons prefer to do Laminectomy which consists of excision l of spinous processes and laminae from one or two discs and the disc is removed from the opening created. Some Surgeons prefer to do spinal fusion in addition to Laminectomy which will help to stabilize your spine further. Your surgeon will be able to tell you the approach he wants to use. Post operative physiotherapy will depend on the type of surgery. Basically, flexion exercises are started after 8 weeks if spinal fusion too is done. Spinal corset is gradually weaned off from 10 weeks and discarded after 12 weeks. If only Laminectomy is done, prone lying and hyperextension is initiated after 2-3 weeks. Sitting up from side lying can be done after 3 weeks and ambulation and other exercises can be initiated after 4 weeks. Always see to it that normal physiological lumbar curve is maintained during all static and dynamic postures. You can gradually get back to your daily routine. There is no need to worry about the paralysis part. With Competent Surgeons, this not the complication to worry about. This kind of spinal surgery is the most common type of spinal surgery that surgeons perform. Regarding your question whether this can relapse, I do not think it should happen if you are going to perform your exercise well, follow ergonomic principles in your activities of daily life ,keep a check on your weight and the most important part-not to allow negative thoughts to bother you.