[Click! Health] "Surgery is scary... Do I really need surgery for a disk?"

As we enter the "100-year life era," the number of patients with degenerative diseases is rapidly increasing. Intervertebral disc herniation, commonly known as "disk," and spinal stenosis are representative degenerative diseases. The main symptoms are back pain and radiating pain extending to the legs, but in severe cases, they can cause walking disabilities, reducing the quality of life. Accurate diagnosis and optimal treatment to control pain are crucial.

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Intervertebral disc herniation and spinal stenosis differ in their causes and symptoms. Intervertebral disc herniation is commonly called a lumbar disk. The nucleus pulposus of the herniated disc, caused by degeneration or trauma, presses on the nerves going to the legs, causing pain. Pain worsens when bending the back, standing or walking is more comfortable, symptoms worsen when one leg feels pulled or when sitting, and it is difficult to raise the leg while lying down. It mainly appears in people aged 20 and above.

Conversely, spinal stenosis mainly occurs in people aged 50 and above. It is a condition where structures around the spinal canal, such as ligaments, bones, and joints, thicken or grow, narrowing the spinal canal through which nerves pass and irritating the nerves. Pain worsens when bending backward, bursting pain occurs when walking, and the legs feel cold and numb. It is also characteristic that squatting is comfortable and raising the legs does not worsen the pain.

Disk treatment is divided into medication, non-surgical treatment, and surgical treatment depending on the type, duration, and intensity of pain. In many cases, conservative treatments such as medication and non-surgical treatments improve symptoms. However, if symptoms persist despite conservative treatment, or if urinary or fecal incontinence occurs, or if muscle weakness accompanies the symptoms, surgery may be necessary. Since the timing and method of surgical treatment are very important, a clear diagnosis by a specialist is essential.

Professor Bae In-seok, Department of Neurosurgery, Nowon Eulji University Hospital.

There are two main surgical treatment methods. The traditional open spine surgery, which has been mainly performed, has the advantage of safely and clearly improving symptoms, but it has the disadvantages of long surgery time and large incision scars. Damage to surrounding tissues such as muscles and bones is significant, causing severe postoperative pain and a long recovery period. To compensate for this, minimally invasive spine surgery, including endoscopic surgery, has recently been actively performed. Compared to open surgery, it causes less wound and less damage to surrounding tissues such as muscles, allowing for a faster return to daily life after surgery. Especially, through an endoscope with an enlarged screen, surgery can be performed precisely, clearly showing even areas difficult to access with traditional open surgery, enabling definite nerve decompression. However, since not all patients are candidates for minimally invasive endoscopic surgery or procedures, selecting the optimal treatment method according to the patient's condition is important.

Professor Bae In-seok of the Department of Neurosurgery at Nowon Eulji University Hospital explained, "Not all spinal diseases can be treated with endoscopic surgery. However, for elderly patients in their 70s and 80s who have severe back and radiating pain but fear surgery, spinal endoscopic surgery can be considered." He added, "Since it can be performed under local or sedation anesthesia, it can also be a hope for patients with chronic diseases such as hypertension and diabetes who find general anesthesia burdensome."

This content was produced with the assistance of AI translation services.