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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.
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| 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
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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.
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Anatomy of the Lumbar Spine
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| The
Spinal Column and the Vertebrae |
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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| Support
for the Vertebral (Spinal) Column |
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. |
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| 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. |
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| 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. |
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| 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
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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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Last updated: 9/20/02
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