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Operating techniques
About the treatment
Microsurgery (conventional technique)
Procedure
An incision of around 4 cm is made at the level of the herniated disc to be treated. The muscle covering the spinal column is gently peeled back and pulled apart. The surgeon then opens the spinal canal under microscopic control to visualize the nerve structures and minimize the risk of neurological complications.
Steps and Benefits
- The herniated disc is removed after complete nerve decompression.
- The skin is closed with a few stitches or staples.
- No drain is usually required, which facilitates the recovery process.
- This technique offers efficient nerve decompression, minimizing the risk of complications.
About the treatment
Mini-Invasive Surgery
Procedure
Minimally invasive surgery is an advanced method used to treat herniated discs with minimal impact on surrounding tissue. A tubular retractor is inserted to access the spinal canal, preserving muscles and reducing damage. This technique allows the hernia to be removed while minimizing bleeding and scar size.
Steps and Benefits
- Access to the hernia site via a tubular retractor, reducing muscle damage.
- Removal of the herniated disc under direct visualization, decompressing the nerves.
- Small incision closed with stitches or surgical glue.
- Reduced post-operative pain, faster recovery and discreet scarring.
- This technique is often performed on an outpatient basis, enabling a rapid return home.
About the treatment
Endoscopy
Procedure
Endoscopic surgery is an alternative to microsurgery and minimally invasive surgery for treating herniated discs. It reduces operative bleeding and post-operative pain, and minimizes scar size.
Steps and Benefits
- An incision of less than 1 cm is made at the level of the hernia.
- A camera is inserted into the spinal column, with a working port for the instruments used to remove the herniated disc.
- Advantages: less bleeding, reduced pain, minimal scarring, no dressing (glue on the skin).
- Carried out on an outpatient basis, enabling patients to go home the same day after being monitored for a few hours.
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Hospitalisation
Microsurgery (conventional technique): One day and one night.
Minimally invasive/endoscopic surgery: No hospitalization, the operation is performed on an outpatient basis.
When you return to your room, a physiotherapist will help you get up for the first time.
Back home
Microsurgery (conventional technique): Next morning.
Minimally invasive/endoscopic surgery: Same day.
By private car or taxi/VSL.
Post-operative care
Microsurgery (conventional technique): Nursing care at home: dressings and removal of sutures/staple after 12 days.
Minimally invasive/endoscopic surgery: No nursing care required: scar closed with 2 stitches of absorbable thread and absorbable glue.
No dressing required.No anticoagulation (phlebitis prevention).
Rehabilitation physiotherapy to begin 1 week to 1 month after surgery.
Back to school or work
Microsurgery (conventional technique): Return to normal life in 1 to 3 months.
Minimally invasive/endoscopic surgery: Return to normal life in 1 to 2 months.
Rehabilitation / Physiotherapy
Start: 1 month (or earlier for minimally invasive/endoscopic surgery).
Duration: 1 to 3 months, depending on speed of recovery.
Pace: At least 2 weekly sessions (30-60 min), ideally 3, with daily exercises.
Nature: Pain-relieving physiotherapy, muscle strengthening, relaxation, posture.
No corset/lumbar belt, except in special cases.
Neurological complications: Less than 1%.
In back surgery, there is always a risk of neurological aggravation, ranging from chronic neuropathic pain to motor deficits, with more or less severe, temporary or permanent paralysis.
This risk is estimated at less than 1% for this type of operation.
Infection: Less than 1%
Early infection requiring surgical cleaning and prolonged antibiotic therapy.
Hemorrhagic complications
In case of compressive hematoma (pain/neurological deficit), emergency surgical revision.
Breche Durale
If the dura is damaged, repair and bed rest for 48 hours, with a few days in hospital.
Risk of new hernia estimated at around 10%.
A patient operated on for a herniated disc may develop a new herniation in the future, regardless of the surgical technique used.
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.
