Clearing up the confusion! Are the treatments for herniated discs and spinal disc slippage different?

Dr. Thanawat Unachoke, a spine specialist at S Hospital, explained that lumbar spondylolisthesis is a condition where one vertebra shifts forward or backward more than normal. It is most commonly found in the 4th and 5th lumbar vertebrae because these vertebrae bear the majority of the body's weight.

The severity of symptoms varies. Most patients experience lower back pain that worsens after exercise, especially lumbar stretches, and may be accompanied by other symptoms. The symptoms can be categorized into two parts:

Symptoms in the back area.

Chronic back pain often occurs during movements that involve a lot of back movement, such as bending, straightening, or walking.

Symptoms in the legs

Pain, numbness, fatigue, and heaviness in both hips or thighs are common symptoms. These symptoms worsen when walking and improve when bending over or sitting down. Some patients may notice their walking distance gradually decreasing. Severe spinal stenosis can lead to loss of bladder and bowel control.

While a herniated disc occurs when the intervertebral disc between two vertebrae bulges out and compresses the spinal cord, causing neck or back pain. If the compression is severe, it can lead to disability.

The most prominent symptom is pain, which varies in location from patient to patient. For example, pain in the lower back, lumbar region, or hips radiating down the legs; numbness or tingling sensations like an electric shock radiating down the legs; neck pain; pain in one or both arms; difficulty bending to lift objects or maintaining balance. If the nerve is compressed for a prolonged period, it can lead to muscle weakness and problems with bowel and bladder function.

Although the symptoms of these two conditions are almost indistinguishable, S Spine & Nerve Hospital has a method for accurately diagnosing intervertebral disc herniation, or spinal slippage. Our spine specialists will conduct an initial physical examination, take a patient history, and perform X-rays and MRI scans. These tests allow us to accurately diagnose and confirm the abnormality, as well as plan precise and targeted treatment.

Treatment for herniated discs: When a patient experiences back pain that doesn't improve with pain medication for more than a month, the doctor may consider endoscopic spinal surgery. This can be done using the PSLD (Percutaneous Stenoscopic Lumbar Decompression) technique in the back or the PSCD (Percutaneous Stenoscopic Cervical Decompression) technique in the neck. Both techniques utilize a high-magnification lens attached to the end of the endoscope, acting like the doctor's eyes. This allows for clear, precise, and safe visualization of the abnormality, enabling treatment of only the problematic area without cutting away healthy muscle. The result is smaller incisions, less pain, increased safety, and faster recovery. MIS-Spine treatment is a relatively simple and effective option, allowing patients to return to their normal lives after only one night's recovery.

Currently, the treatment of spinal disc herniation or sciatica using the TLIF (Transvertebral Interbody Fusing) technique involves fusion of the spinal vertebrae to stop spinal movement and replacement of the intervertebral disc with an artificial one in patients with degenerative disc disease. Previously, this required open surgery. Later, medical science developed the MIS TLIF technique, which involves inserting a tube and partially dissecting the muscles before inserting the artificial disc. However, the latest technology has significantly improved the efficiency and effectiveness of spinal disc herniation treatment, reducing patient pain compared to traditional methods. The Full Endoscopic TLIF technique uses an endoscopic camera to insert the artificial disc and perform interbody fusion using percutaneous screws. This method minimizes muscle cutting, damages the spinal structure, and has low risk, significantly reducing the size of the incision and improving outcomes.

Full Endoscopic TLIF (Full Endoscopic TLIF) is a surgical technique that utilizes a highly specialized camera with slots for inserting instruments to perform the treatment. This allows for the removal and replacement of the damaged intervertebral disc with an artificial one, minimizing muscle damage and scarring compared to traditional two-hole methods. The surgeon can see the instruments throughout the procedure, and the treatment takes approximately two hours. Patients recover quickly, the incision is small, and they can regain mobility within a week. S Hospital is the first in Thailand to fully utilize this Full Endoscopic TLIF technique. Because it requires extensive internal structural modification, such a procedure is rarely performed by highly skilled and experienced spinal specialists. However, S Hospital, the first and only specialized spinal hospital in Thailand, boasts a unique strength in its team of specialized doctors and nurses for spinal and neurological pain, enabling them to provide precise and targeted treatment. Furthermore, the hospital incorporates cutting-edge innovations from around the world to enhance treatment outcomes. To meet the needs of patients with limited time, this method allows for faster and less painful recovery, and is suitable for patients who fear surgery.

S Hospital. For consultation, call 02 034 0808.

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Phuwanat Chaowanno 092 270 9228