The intervertebral disc is the structure that separates the vertebrae, cushioning impacts and allows the movement of the column. Like any material, suffers from the effort, traumatisms and repetitive stress, break due to fatigue. The rupture of the disc content is called disc herniation.

It is called sciatica pain the pain that radiating from the buttock to the thigh and leg. It is usually caused by inflammation or compression of the sciatic nerve and the nerve roots in the exit of the column. The main cause of sciatica or sciatica pain is the herniated disc compression.

For sure, the best care is always prevention. We must keep in good physical shape, ideal weight and avoid injuries with exaggerated efforts in the wrong positions. Maintaining good posture and the consequent correction of poor posture is the key.

Both the method of conservative treatment (non-surgical) or surgical, can be adopted in this pathology. Conservative treatment with rest, anti-inflammatory drugs, analgesics, physiotherapy, acupuncture and locks are typically used at the beginning of symptoms with a high percentage of success. If the patient continues with pain for 4 to 6 weeks, despite the conservative measures mentioned above or as it is nerve damage, assessed by neurological examination, treatment should be discontinued and the patient should be send to surgery.

The rupture disc is a very common problem and the vast majority of patients who need surgery are satisfied with the results. However, it is essential in the post-operative the rehabilitation to prevent recurrence of symptoms and disease recurrence in the same place or at adjacent levels to the already operated. Therefore, the results in the medium and long term rely heavily on the lifestyle of the patients and preventive care already mentioned, and this is the only way we can assure better results.

Normally, in the immediate post-operative period, patients report a significant relief of pain. Relief of compression allows a normal operation and recovery of the nerve and nerve root. It is common for small residual pain intensity post-operatively that gradually improved. This recovery is partial or total, depending on the degree of nerve damage caused by compression, time of onset of symptoms, smoking (tobacco), among other factors. The development of scarring and fibrosis involving the nerve (root) is one of the causes of persistent symptoms after surgery.

The surgical procedure for treatment of disc herniation is called a discectomy. It's a simple surgery with low complexity and very secure thanks to the technology available and to the continuing development of new techniques and anesthetic drugs. Careful clinical, laboratorial and through imaging, in the preoperative period, is even more crucial to mitigate the low risk of the procedure.

The spinal fusion surgery is a complex and sometimes it is necessary to treat some diseases and disorders of the spine. The most common situations of this method are in cases of spine fractures, spondylolisthesis and instability caused by wide decompression or degenerative causes.

Thanks to advances in medicine and biotechnology surgical procedures are currently performed with low complication rates. The main additional clinical risk factors for complications are high blood pressure, emphysema, previous infarction, smoking (tobacco), osteoporosis, treatment with cortisone for a long periods, diabetes, obesity and infection. The correction, preparation and proper treatment of these changes allow mitigate the potential risks in trans and post-operatives complications.

Due to the great complexity of diagnosis and treatment of disorders of the spine as well as the difficulty of professionals to remain fully updated, this branch of medicine has evolved into a subspecialty. The specialist in spinal surgery is a professional in the areas of orthopedics, traumatology and neurosurgery that is dedicated exclusively to this branch of medicine. It is often common the work of the multidisciplinary team in procedures of this size. The important thing is the choice of professional confidence, good doctor-patient relationship and its capacity for implementing the proposed treatment.