Book contents
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- Part II Surgical procedures and their complications
- 42 Tracheostomy
- 43 Thyroidectomy
- 44 Parathyroidectomy
- 45 Lumpectomy and mastectomy
- 46 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- 47 Small bowel resection
- 48 Appendectomy
- 49 Colon resection
- 50 Abdominoperineal resection
- 51 Anal operations
- 52 Cholecystectomy
- 53 Common bile duct exploration
- 54 Major hepatic resection
- 55 Splenectomy
- 56 Pancreatoduodenal resection
- 57 Adrenal surgery
- 58 Lysis of adhesions
- 59 Ventral hernia repair
- 60 Inguinal hernia repair
- 61 Laparotomy in patients with human immunodeficiency virus infection
- 62 Abdominal trauma
- 63 Coronary artery bypass procedures
- 64 Cardiac rhythm management
- 65 Aortic valve surgery
- 66 Mitral valve surgery
- 67 Ventricular assist devices and cardiac transplantation
- 68 Pericardiectomy
- 69 Pulmonary lobectomy
- 70 Pneumonectomy
- 71 Hiatal hernia repair
- 72 Esophagogastrectomy
- 73 Colon interposition for esophageal bypass
- 74 Carotid endarterectomy
- 75 Abdominal aortic aneurysm repair
- 76 Aortobifemoral bypass grafting
- 77 Femoropopliteal bypass grafting
- 78 Lower extremity embolectomy
- 79 Treatment of chronic mesenteric ischemia
- 80 Inferior vena cava filters
- 81 Portal shunting procedures
- 82 Breast reconstruction after mastectomy
- 83 Facial rejuvenation
- 84 Liposuction
- 85 Repair of facial fractures
- 86 Flap coverage for pressure sores
- 87 Muscle flap coverage of sternal wound infections
- 88 Skin grafting for burns
- 89 Abdominal hysterectomy
- 90 Vaginal hysterectomy
- 91 Uterine curettage
- 92 Radical hysterectomy
- 93 Vulvectomy
- 94 Craniotomy for brain tumor
- 95 Intracranial aneurysm surgery
- 96 Evacuation of subdural hematomas
- 97 Stereotactic procedures
- 98 Transsphenoidal surgery
- 99 Treatment of herniated disk
- 100 General considerations in ophthalmic surgery
- 101 Cataract surgery
- 102 Corneal transplantation
- 103 Vitreoretinal surgery
- 104 Glaucoma surgery
- 105 Refractive surgery
- 106 Eye muscle surgery
- 107 Enucleation, evisceration and exenteration
- 108 Arthroscopic knee surgery
- 109 Total knee replacement
- 110 Total hip replacement
- 111 Fractures of the femoral shaft
- 112 Surgery for hip fractures
- 113 Lumbar spine surgery
- 114 Surgery for scoliosis or kyphosis in adults
- 115 Surgery of the foot and ankle
- 116 Lower extremity amputations
- 117 Surgical procedures for rheumatoid arthritis
- 118 Otologic surgery
- 119 Myringotomy and tubes
- 120 Tonsillectomy and adenoidectomy
- 121 Uvulopalatopharyngoplasty
- 122 Endoscopic sinus surgery
- 123 Cleft palate surgery
- 124 Facial surgery
- 125 Tracheotomy
- 126 Surgical management of head and neck cancer
- 127 Anterior cranial base surgery
- 128 Surgery for syndromic craniosynostosis
- 129 Nephrectomy
- 130 Cystectomy and urinary diversion
- 131 Radical prostatectomy
- 132 Transurethral resection of the prostate (TURP)
- 133 Interstitial laser thermal therapy for benign prostatic hyperplasia
- 134 Management of upper urinary tract calculi
- 135 Female urinary incontinence surgery
- Index
- References
99 - Treatment of herniated disk
Published online by Cambridge University Press: 12 January 2010
- Frontmatter
- Contents
- Editor biographies
- List of contributors
- Preface
- Introduction
- Part I Medical management
- Part II Surgical procedures and their complications
- 42 Tracheostomy
- 43 Thyroidectomy
- 44 Parathyroidectomy
- 45 Lumpectomy and mastectomy
- 46 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- 47 Small bowel resection
- 48 Appendectomy
- 49 Colon resection
- 50 Abdominoperineal resection
- 51 Anal operations
- 52 Cholecystectomy
- 53 Common bile duct exploration
- 54 Major hepatic resection
- 55 Splenectomy
- 56 Pancreatoduodenal resection
- 57 Adrenal surgery
- 58 Lysis of adhesions
- 59 Ventral hernia repair
- 60 Inguinal hernia repair
- 61 Laparotomy in patients with human immunodeficiency virus infection
- 62 Abdominal trauma
- 63 Coronary artery bypass procedures
- 64 Cardiac rhythm management
- 65 Aortic valve surgery
- 66 Mitral valve surgery
- 67 Ventricular assist devices and cardiac transplantation
- 68 Pericardiectomy
- 69 Pulmonary lobectomy
- 70 Pneumonectomy
- 71 Hiatal hernia repair
- 72 Esophagogastrectomy
- 73 Colon interposition for esophageal bypass
- 74 Carotid endarterectomy
- 75 Abdominal aortic aneurysm repair
- 76 Aortobifemoral bypass grafting
- 77 Femoropopliteal bypass grafting
- 78 Lower extremity embolectomy
- 79 Treatment of chronic mesenteric ischemia
- 80 Inferior vena cava filters
- 81 Portal shunting procedures
- 82 Breast reconstruction after mastectomy
- 83 Facial rejuvenation
- 84 Liposuction
- 85 Repair of facial fractures
- 86 Flap coverage for pressure sores
- 87 Muscle flap coverage of sternal wound infections
- 88 Skin grafting for burns
- 89 Abdominal hysterectomy
- 90 Vaginal hysterectomy
- 91 Uterine curettage
- 92 Radical hysterectomy
- 93 Vulvectomy
- 94 Craniotomy for brain tumor
- 95 Intracranial aneurysm surgery
- 96 Evacuation of subdural hematomas
- 97 Stereotactic procedures
- 98 Transsphenoidal surgery
- 99 Treatment of herniated disk
- 100 General considerations in ophthalmic surgery
- 101 Cataract surgery
- 102 Corneal transplantation
- 103 Vitreoretinal surgery
- 104 Glaucoma surgery
- 105 Refractive surgery
- 106 Eye muscle surgery
- 107 Enucleation, evisceration and exenteration
- 108 Arthroscopic knee surgery
- 109 Total knee replacement
- 110 Total hip replacement
- 111 Fractures of the femoral shaft
- 112 Surgery for hip fractures
- 113 Lumbar spine surgery
- 114 Surgery for scoliosis or kyphosis in adults
- 115 Surgery of the foot and ankle
- 116 Lower extremity amputations
- 117 Surgical procedures for rheumatoid arthritis
- 118 Otologic surgery
- 119 Myringotomy and tubes
- 120 Tonsillectomy and adenoidectomy
- 121 Uvulopalatopharyngoplasty
- 122 Endoscopic sinus surgery
- 123 Cleft palate surgery
- 124 Facial surgery
- 125 Tracheotomy
- 126 Surgical management of head and neck cancer
- 127 Anterior cranial base surgery
- 128 Surgery for syndromic craniosynostosis
- 129 Nephrectomy
- 130 Cystectomy and urinary diversion
- 131 Radical prostatectomy
- 132 Transurethral resection of the prostate (TURP)
- 133 Interstitial laser thermal therapy for benign prostatic hyperplasia
- 134 Management of upper urinary tract calculi
- 135 Female urinary incontinence surgery
- Index
- References
Summary
Herniated disks usually occur in the cervical and lumbar spine. The thoracic spine is relatively non-mobile and thus rarely affected by disk herniations. Herniated disks typically occur in younger patients between ages 30 and 50 years and present primarily with appendicular pain (arm, leg) as opposed to axial pain (neck, back). Cervical and thoracic disks may present with myelopathy but more commonly with radiculopathy. Ninety percent of patients with disk herniation obtain relief with conservative treatment. Herniated disks are initial manifestations of the continuum of degenerative disk disease later manifested by development of osteophytes.
Cervical level
Patients with cervical disk herniation typically come to operation because of arm and periscapular pain, often with weakness, numbness, or paresthesias in a nerve root distribution. Since the majority of patients improve with non-surgical therapeutic options such as cervical collar, active rest, and physical therapy, patients should be considered for operation only if they have failed a reasonable trial of conservative therapy.
Central disk herniations are treated via an anterior approach. Foraminal disk herniations can be treated by either an anterior or posterior cervical approach. Anterior cervical diskectomy and fusion is the most common procedure performed for cervical disk herniations. After cervical diskectomy the disk space may be replaced with allograft or autograft. Studies have shown that using allograft leads to fusion in approximately 90% of patients. Addition of a cervical plating system increases the fusion rate to 96%.
- Type
- Chapter
- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 688 - 692Publisher: Cambridge University PressPrint publication year: 2006