![]() Small surgical tapes affixing the suture should be left in place. After the shower, patients should remove the bandage, and dry off the surgical area. Patients can shower immediately after surgery, but should cover the incision area with a small bandage and tape, and try to avoid water hitting directly over the surgical area. Occasionally, patients may be issued a small, soft lumbar corset that can provide additional lumbar support in the early postoperative period, if necessary. Patients are generally not required or recommended to wear a back brace after surgery. After sitting for 45-60 minutes, patients should get up and stretch or walk for a little bit, then sit down again if desired. Patients should try to avoid sitting in the same position for more than 45-60 minutes in the first few weeks after surgery. Patients are instructed to avoid bending at the waist, lifting (more than five pounds), and twisting in the early postoperative period (first 2-4 weeks) to avoid a strain injury or recurrent disc injury. Before patients go home, physical therapists and occupational therapists work with patients and instruct them on proper techniques of getting in and out of bed and walking independently. Most patients are able to go home the same day or early the next day after surgery. The total surgery time is approximately 1 hour. The skin can usually be closed using special surgical glue, leaving a minimal scar and requiring no bandage. The deep fascial layer and subcutaneous layers are closed with a few strong sutures. The wound area is usually washed out with sterile water containing antibiotics. All surrounding areas are also checked to ensure no additional disc fragments are remaining. Small dental-type instruments and biting/grasping instruments (such as a pituitary rongeur) are used to remove the protruding disc material. The nerve root and neurologic structures are protected and carefully retracted, so that the herniated disc can be removed. After the retractor is in place, an x-ray is used to confirm that the appropriate disc is identified.Ī few millimeters of bone of the superior lamina may be removed to fully visualize the disc herniation. Special retractors and an operating microscope are used to allow the surgeon to visualize the region of the spine, with minimal or no cutting of the adjacent muscles and soft-tissues. ![]() Sterile drapes are placed, and the surgical team wears sterile surgical attire such as gowns and gloves to maintain a bacteria-free environment.Ī 1-2 centimeter longitudinal incision is made in the midline of the low back, directly over the area of the herniated disc. The surgical region (low back area) is cleansed with a special cleaning solution. Patients are positioned in the prone (lying on the stomach) position, generally using a special operating table with special padding and supports. Preoperative intravenous antibiotics are given. A breathing tube (endotracheal tube) is placed and the patient breathes using a ventilator during the surgery. The surgery is performed utilizing general anesthesia. ![]()
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