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Operating techniques
About the treatment
Conventional open surgery
Procedure
Under general anesthesia, the patient is positioned on his or her stomach. The surgeon accesses the lumbar spine through a midline incision in the lower back. The damaged lumbar disc is removed and replaced by an implant (cage) filled with bone graft to maintain the spacing between the vertebrae, which are stabilized by screws and rods.
Steps and Benefits
- The lumbar disc is removed to decompress the nerves.
- An implant is placed to stabilize the vertebrae and prevent future compression.
- The technique provides long-lasting stabilization and effective pain relief.
About the treatment
Percutaneous minimally invasive surgery
Procedure
Minimally invasive percutaneous surgery allows nerves to be decompressed or vertebrae stabilized with minimal opening of the skin and muscles. Instruments are passed through tubular retractors that dilate the muscles rather than detach them.
Steps and Benefits
- Fewer incisions and less muscle trauma than conventional surgery.
- This technique is effective for certain pathologies, depending on the surgeon's opinion.
- This approach reduces post-operative pain and promotes faster recovery.
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Hospitalisation
Hospital stay: 3 to 7 days.
3 days for a simple arthrodesis, up to 7 days depending on pain.
A physiotherapist will help you get up for the first time.
Return Home
At the surgeon's discretion, with the possibility of a stay in a nursing home depending on comorbidities.
Return by car or taxi/VSL depending on distance.
Post-Operative Care
Daily home care by a nurse.
Daily anticoagulation to prevent phlebitis.
Dressing changed every 2 days.
Sutures or staples removed on day 12.
A follow-up appointment with the surgeon will be scheduled 1 month after the operation.
Back to school or back to work
Return to active life between 3 and 6 months, depending on recovery.
Rehabilitation/ Physiotherapy
Start: 1 month.
Duration: 1 to 3 months, depending on recovery.
Pace: 2 to 3 weekly sessions (30-60 min), with daily exercises.
Nature: Pain-relieving physiotherapy, muscle strengthening, relaxation, posture.
Respect for the no-pain rule.
No need for corset/lumbar support, except in special cases.
Neurological complications: Less than 5%.
Worsening of neurological condition, leading to neuropathic pain or temporary or permanent paralysis.
This risk remains below 5% for this operation.
Infection: 1-3
Early scar infection may require a return to the operating room for cleaning and prolonged antibiotic therapy.
Chronic or late infections may require re-operation to remove or change the implanted material.
Hemorrhagic complications
Significant bleeding during or after the operation may require a blood transfusion.
In the event of compressive hematoma (pain and/or neurological deficit), urgent revision surgery will be performed.
Mechanical Complications
Pseudarthrosis: failure of the bone graft to set, with increased risk for smokers, diabetics and obese patients.
Painful pseudarthrosis may require further surgery.
Adjacent syndrome: degeneration of a neighbouring vertebral level, which may justify an extension of the arthrodesis.
Risk of Pseudarthrosis or Adjacent Syndrome
Pseudarthrosis and adjacent syndrome are mechanical complications sometimes requiring further surgery to extend vertebral fusion.
FAQ
Answers for our patients
If you have any further questions, please do not hesitate to contact us.
How can I make an appointment?
You can book an appointment directly on our website or by telephone on 04 72 43 03 43 (choice 1).
How long does it take to get an appointment?
Appointments take around 1 to 2 months. In an emergency, your GP can contact us directly by email.
How does the first consultation work?
At your first consultation, you will complete an iPad questionnaire in the waiting room so the doctor has your information in advance. The consultation will then determine whether surgical or non-surgical treatment is needed.
What documents should I bring to my visit?
Please bring your carte vitale, your GP's referral letter, and any radiological examinations already carried out.
