In Germany alone, around 150,000 herniated discs are treated surgically every year. For this reason, disc surgery is one of the most common procedures.
In particular, the living conditions of the person affected influence the development of a herniated disc and therefore the need for disc surgery. Too little exercise and sport, weakened muscles and being overweight can all contribute to a slipped disc, especially in people with sedentary jobs.
The direct herniation of an intervertebral disc is extremely rare nowadays and is usually caused by lifting a heavy weight. A herniated disc of this type causes immediate and severe pain and in most cases must be treated immediately.
Most herniated discs today are due to a gradual process, which allows the patient to think carefully about the upcoming disc surgery and to inform themselves about the options and experts for disc surgery.
As most people have a sedentary job and also have too little exercise, the muscles are weakened, which overloads the intervertebral discs.
If an intervertebral disc operation is necessary, in most cases the patient has already been in pain for a long time and has made many visits to the doctor in order to counteract this back pain and find relief. The following therapies can be used for the conventional treatment of a herniated disc:
However, these treatment approaches often do not provide lasting relief and in the end a disc operation must be performed to remove the herniated disc, which frees the pinched nerve roots and relieves the pain.
From Ortenau Klinikum - Ortenau Klinikum, CC BY 3.0, Link
Before a herniated disc operation is performed, a number of preliminary examinations must of course be carried out by the doctor to clearly confirm the herniated disc. In addition to a thorough medical history, this also includes a thorough physical examination to localize and determine the affected disc so that a further examination can follow.
Imaging procedures then provide further information about the type and location of the herniated disc. These include, for example
After such an examination, the treating spinal specialist or neurosurgeon has an image that enables them to clearly assess the affected disc.
Any disc in the spine can herniate and a distinction is made between cervical (in the cervical spine) and lumbar (in the lumbar spine) herniated discs. Herniated discs can also occur within the thoracic spine, although these are extremely rare due to the low mechanical load. More common, however, are herniated discs within the lumbar or cervical spine.
The level of a herniated disc can determine the technique used for disc surgery. As the anatomical conditions change over the course of the spine, disc operations must also be adapted accordingly.
Once the decision to operate on a herniated disc has been made, the doctors treating the patient must decide which procedure should be used.
In the past, it was common practice to remove a herniated disc through an approach on the front of the body if possible, for example through a neck incision in the case of a cervical disc herniation.
Today, attempts are made to avoid such incisions, as this can damage important ligamentous structures of the spine. In addition, there is a visible scar on the neck, which is a clear indication of the operation.
Nowadays, techniques for disc surgery are highly advanced and differ for each individual herniated disc. The optimal disc surgery procedure is chosen for each patient, which promises the best possible healing and the best aesthetic result for the patient.
While the conventional surgical technique is still used today for herniated discs, there have long been highly qualified specialists who can perform minimally invasive and very gentle disc surgery.
In some cases, it is even possible to perform disc surgery under local anaesthetic, meaning that the patient does not have to undergo a general anaesthetic.
There are also differences in surgical techniques for minimally invasive disc operations. Among other things, they depend on the location of the herniated disc, which means that different techniques may be used for a cervical herniation than for a lumbar herniation.
Minimally invasive techniques for disc surgery include microsurgical procedures and endoscopic procedures. It is also possible to use a laser to destroy the herniated disc and thus also the tissue that constricts the nerve roots and causes pain.
Minimally invasive disc surgery offers many advantages, such as the avoidance of general anesthesia and the use of very small incisions. All the necessary instruments can be inserted through the small incisions in the skin to operate on the affected herniated disc and free up the constricted nerve roots.
The incisions are simply sutured after the disc surgery. Minimally invasive disc surgery therefore damages less tissue, allowing it to heal more quickly. In addition, there is less scarring, which results in fewer complications. The incisions and resulting damage after disc surgery are therefore significantly smaller and associated with fewer complications .
The minimally invasive surgical technique cannot be performed by just any surgeon. Many years of experience and qualified further training are required for this procedure. In addition, the specialist who performs minimally invasive disc surgery needs a specially equipped operating theater and an appropriately trained surgical team.
After disc surgery, it is important to avoid overloading and one-sided strain on the spine, for example during everyday work or during leisure and sports activities. It is also important to adopt a back-friendly sexual behavior after disc surgery.
Below you will find various tips on behavior and sex after disc surgery.
When doing heavy work, remember that the strain also spreads along the spine. If necessary, do not lift objects from a bent-over position. If you don't have a helper at hand, try to distribute the force, for example by lifting from the thighs. That's what a weightlifter does.
Leisure time is often the greatest strain on the spine. For example, watching TV every evening can be torture for the spine. It is important not to sit in the same position for hours on end:
The intervertebral disc thrives on movement. So remember to keep your spine moving and avoid prolonged one-sided strain. This also includes, for example, driving quickly to your vacation destination. Break up your journey regularly, get out of your vehicle and move actively during breaks.
If your back has to do the main work, take the secondary strain off it by "carrying" your body weight. Your body weight "pulls" on the spine. You should therefore reduce this pull by tilting the backrest when sitting. You can sit longer in a reclining chair than on a kitchen chair. The flatter you set your backrest, the less your body weight will be exerted downwards.
Back problems are also a good incentive to work on your own weight if necessary. This kills two birds with one stone: exercise brings you closer to your ideal weight and helps your spine on the way there.
The importance of the above advice lies in the reduction of one-sided strain on your spine with subsequent tension, which can ultimately lead to renewed pain. This pain can be persistent and may require medical treatment.
A few words about your sleeping position: Avoid mattresses that are too soft. Prefer a firm mattress, especially in the buttocks area. Try to lie on your stomach as little as possible. Lying on your back and side offers the best recovery for muscle relaxation and relaxation of the parts of the spine that are stressed when standing and working.
So what about exercise? No exercise at all is just as bad as too much! But the wrong type of sport also puts strain on your spine. A good goal is to compensate for the strain on your back by swimming. However, spending too long in cool water can again lead to tension in the back muscles. So-called warm water days are often offered in indoor swimming pools. Take advantage of these opportunities.
In general, it can be said that heat works very well when applied in any form. However, extreme temperatures (too hot or too cold) have exactly the opposite effect. Instead of loosening up, it causes tension. As is so often the case, the middle way is exactly the right one. The simplest form of therapeutic heat application is a bath in a comfortable temperature.
As far as sports are concerned, the following applies for the time after the operation: If possible, do not do any sports with strong swing-supported rotational movements or compression stress on the spine for the first 6 months. These include, for example
If you play any other sport, please consult your doctor.
The key question is: When and/or how can I have sex with my partner again? We have put together some information below that may provide some ideas on how sexual intercourse can be enjoyable and satisfying after disc surgery.
As a general rule: no sexual activity until the end of the 3rd week after the operation, cautious activity from the 4th week onwards. Only make gentle movements.
The following sexual positions can be used to protect your back if you have a slipped disc: Passively (sex position 1 applies to the man who has had surgery, positions 2 to 5 for the woman who has had surgery) you may have intercourse with your partner around 3 to 4 weeks after the operation. You can start being active (position 6) about 6 weeks after the operation.
These suggestions can and should of course only be a suggestion. With imagination, each couple will develop their own lovemaking.
However, you should prefer gentle togetherness - by this we mean tender massages and pleasurable stroking. Avoid practices where you have to tense your body and exert too much effort. Loose pelvic movements can even be seen as preventative gymnastics against back problems, and gentle lovemaking can be one of the best forms of relaxation.
It is also important to have a trusting conversation with your partner, who needs to know about any existing back pain or back pain that occurs during intercourse so as not to misinterpret any listlessness that may occur.
Together, the partners must look for ways in which they can both achieve satisfaction and in which the partner who is ill feels little or no pain.
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