Understanding each surgery

Types of surgeries

1. Surgery to remove herniated pulp.
2. Spine fusion surger
3. Drug injection treatment 

1) Surgery to remove herniated pulp (laparatomy, laser, laparoscope, etc.)

In "surgery to remove herniated pulp", the herniated disc compressing the adjacent nerve is removed. While a patient is lying face down, the affected area is confirmed using X-ray and MRI. A 2~3cm vertical incision is then made in the middle of the waist. When the spinal bone is approached from the incision, a portion of the spinal bone surrounding the affected nerve is removed to expose the spinal bone. Usually, the removed bone is around the size of a little fingernail. Once the bone is removed, the nerve that has been compressed by herniated disc appears. The nerve is then placed to the side, and the herniated disc is removed. It is the most representative and definite surgery among many spinal surgeries. The procedure is categorized into regular laparotomy or laparoscope surgery depending on how  skin incision was performed. It is also classified into regular surgery ( removal of pulp using scalpel) or laser surgery depending on how the herniated pulp is removed.

Surgery and treatment

Because the "surgery to remove herniated disc" removes the pulp that compresses the nerve, it is undoubtedly a radical treatment for herniated disc. Since the annulus fibrosus that has been damaged by herniated pulp cannot be repaired, however, the vertebral pulp frequently deviates from its position through this hiatus again. Moreover, the surgery can easily damage the fascia, muscle, or ligament surrounding the bone. Because of these issues, there are practical limits in this procedure wherein a patient may suffer from continuous pain even after the successful removal of the vertebral pulp. 

2) Spine fusion surgery

In "spine fusio surgery", two bones affected by a problematic disc are fused into a single bone. Spine fusion surgery is usually performed to stabilize an "unstable spine". Examples of unstable spine include spinal stenosis and spondylolisthesis.
Moreover, when a nerve is severely compressed in spinal canal stenosis, removal of a large amount of bone to treat the condition may destabilize the spine. In such case, spine fusion surgery is performed especially when a disc is herniated again after the initial treatment using other surgeries.

Surgery and treatment

The advantage of spine fusion surgery is that it prevents unstable spine. Note, however, that it is a major surgery with disadvantages such as complications and expensive metal fixtures. Furthermore, the prevention of unstable spine does not guarantee complete relief from lumbar pain, and many patients actually experience severer pain after the surgery. 

3) Drug injection treatment

There has yet to be a drug that can directly cure a disc disease. The drugs used in hospitals do not relocate the herniated disc to its original position: they are just pain relievers. The most common drugs in treating disc disease are "analgesics and anti-inflammatory drugs". Analgesics and anti-inflammatory drugs relieve pain and inflammation. Almost all of the injection treatments used in spinal diseases involve the delivery of these analgesics and anti-inflammatory drugs to the area inflamed by herniated disc or bulge. Depending on the treatment method, injection can be categorized into "general injection" or "neuroplasty"wherein a thin pipe is injected into tail bone to find the affected area. Although this treatment reduces pain and inflammation of the affected area, the condition will usually recur in a few months or a year because injection cannot fix the fundamental cause of problems.