Traumatólogos especialistas de hernia discal en Madrid

Which is a lumbar disc herniation?

About a 95% of the herniated discs occur in the lumbar area between the L4-L5 and L5-S1 vertebrae.

Why does a lumbar disc herniation?

Lumbar disc herniation is caused by a intervertebral disc rupture, formed by an external annulus fibrosus and an internal nucleus pulposus. This pathology is spoken of when it occurs between the L1 to L5 vertebrae.

The minimally invasive microsurgery for lumbar disc herniation It is performed by specialist traumatologists, with the aim of alleviating the patient's pain.

All the details about lumbar disc herniation

The intervertebral disc is a cartilaginous structure located between two vertebrae that acts as an important connection point between them. This structure fulfills the essential function of cushioning and distributing the load to which the spine is subjected.

The vertebral disc is made up of two fundamental parts:

  • External fibrous ring: this ring is formed mainly by collagen, which surrounds the intervertebral disc and provides strength and stability.
  • Nucleus pulposus: located in the central part of the disc, the nucleus is a gelatinous structure whose main function is to absorb the forces and pressures that affect the spinal column.

In the case of lumbar hernia, it is important to highlight that disc extrusion can occur in any of the intervertebral spaces found between the 5 lumbar vertebrae, with the L4-L5 and L5-S1 spaces being most frequently affected.

Lumbar disc herniation is a condition that can be caused by a variety of causes and factors. Among the main causes are:

  • Aging of the spine: The natural aging process is one of the main causes of lumbar disc herniation.
  • Excessive overload on the intervertebral disc: Lumbar disc herniation may be related to excessive overload placed on the intervertebral disc. In particular, this condition manifests most frequently at the L4-L5 and L5-S1 levels, as these discs carry significant axial loading.
  • High-risk professions: Some professions that involve manual handling of heavy loads, repetitive movements, or exposure to spinal vibrations may increase the risk of developing lumbar disc herniations. In cases where conservative treatment, such as use of an orthopedic lumbar belt , does not produce significant improvements, lumbar hernia microsurgery may need to be considered.
  • Overweight, obesity and weight gain during pregnancy: Excess body weight, obesity, and weight gain during pregnancy can increase pressure on the intervertebral discs, which can contribute to the weakening of the annulus fibrosus and increase the risk of herniations.

Symptoms of a lumbar herniated disc can vary depending on the location and severity of the compression in the spine. Among the symptoms associated with different levels of compression of the nerve roots it is possible to mention:

  • Compression at L4 Level: When compression affects the L4 nerve root, symptoms may include difficulty walking on his heels, reduced sensation in the anteromedial part of the leg, and a decreased patellar reflex.
  • Compression at L5 Level: In the case of L5 nerve root compression, it is common to experience weakness in the big toe extensor muscles, the common digit extensors, the extensor digitorum brevis, and the gluteus medius muscle.
  • Compression at S1 Level: When compression is located on the S1 nerve root, symptoms may include weakness in the triceps surae muscles (gems and soleus), lateral peroneal muscles, and gluteus maximus. Loss of sensation occurs in the sole of the foot, and the Achilles reflex is usually affected.

In addition to these compressions, although less frequent, hernias can occur at upper lumbar levels. In these cases, when the nerve roots L1, L2 or L3 are affected, the pain is focused on the anterolateral aspect of the thigh and hip flexor and adductor muscles are affected.

In short, presenting tingling or weakness and numbness of the muscles are some of the severe symptoms that may indicate the presence of a herniated disc.

Diagnosis of lumbar disc herniation requires a thorough evaluation that includes a detailed patient history, a thorough physical examination, and the use of different diagnostic tests. Among the most used diagnostic tests are:

  • Magnetic resonance: This study plays a fundamental role in the diagnosis of lumbar disc herniation. It allows detecting herniation or disc protrusions and determining whether there is compression of the spinal cord or nerves in areas such as the centrolateral, foraminal or extraforaminal area.
  • Lumbar x-ray: Through this study it is possible to evaluate the degenerative state of the intervertebral discs, which can provide important information for the planning of possible surgical interventions. They are also useful to identify traumatic pathologies such as fractures or dislocations.
  • Electromyogram (also know as EMG or myogram): is a valuable tool used to define the level and intensity of involvement of the nerve roots or spinal cord in the compressed region.

When medical treatment with analgesics, anti-inflammatories, antineuritics and muscle relaxants does not produce sufficient pain relief and the pain is sustained over time or is very intense, surgical decompression of the nerve or spinal canal is usually required.

The surgeries for lumbar disc herniation most frequently used today are:

  • Advanced spinal endoscopy: This surgical approach is the least aggressive and tends to have fewer intra- and post-operative complications. It has a quick recovery and the patient is usually discharged from the hospital on the same day. Extensive training and experience in the advanced spinal endoscopy technique is required to achieve an excellent result, as well as in the different approaches to extract the herniated disc.
  • Microdiscectomy: Microdiscectomy involves a slightly wider approach compared to endoscopic treatment, approximately 3 centimeters. This can result in greater aggression to the muscles and ligaments, which can lead to a more painful postoperative period.
  • Laminectomy and discectomy by open surgery: Open spine surgery is the option is generally the least recommended option as long as it is not necessary. It involves a wider opening and represents the most aggressive technique among the three possibilities to recover the lumbar disc herniation.

At our center, our traumatologists specializing in lumbar disc herniation surgery in Madrid They always prioritize minimally invasive microsurgery to treat lumbar hernia.

When suffering from a lumbar disc herniation, it is crucial to avoid certain activities and behaviors that can aggravate the condition. Among them it is possible to highlight:

  • Ignore pain or symptomss: Pay attention to signs of worsening or new symptoms to seek medical attention as soon as possible.
  • Lifting heavy objects: Carrying heavy objects can put additional pressure on the spine and increase the risk of worsening a herniated disc.
  • Making sudden movements or twisting your back: Sudden movements or twists of the back can cause increased pressure on the affected disc and worsen the condition.
  • Staying in the same position for a long time: Maintaining a static posture for prolonged periods can increase pressure on the spine and aggravate lumbar disc herniation.
  • Neglecting body weight control: Excess weight can increase the load on the spine.

It is essential to treat lumbar disc herniations, since they can have serious consequences for health and quality of life. Among the possible consequences of not seeking treatment for this condition it is possible to mention:

  • Pain aggravation: An untreated herniated disc can result in chronic, debilitating pain.
  • Neurological complications: Herniated disc can compress the nerve roots or spinal cord, causing symptoms such as numbness, muscle weakness, tingling, and difficulty moving the limbs.
  • Long term damage: The continued pressure caused by the hernia on the nerve structures and spine can cause long-term damage if not treated in time.
  • Reduced quality of life: Hernias can cause pain and limitations, and if left untreated they can have a significant effect on quality of life.

Failure to take steps to treat a lumbar disc herniation can have a negative impact on long-term health and well-being. It is essential to seek medical attention and follow doctors' recommendations to address this condition effectively and minimize its consequences.

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Important announcement

The ICAC, now at Teknon in Barcelona

This month of June, We have begun our collaboration with the prestigious Barcelona clinic TMEH to offer spine services at the famous Teknon Medical Center, one of the leading healthcare hospitals in Europe. Thanks to this alliance, we provide a comprehensive and specialized approach with the best solutions for those suffering from back problems.

The ICAC human team, known for being at the vanguard of innovation in traumatology, now brings his talent and advanced ultra-minimally invasive surgery techniques to Barcelona.

This collaboration with TMEH at Teknon Medical Center not only allows us to treat more patients more effectively, but also reinforces our commitment to innovation and excellence in healthcare.

We are excited to be able to offer these services in one of the most important cities in Europe and continue leading the field of traumatology and, in this specific case, in the treatment of the spine.