The Lumbar Hernia: Anatomy, Symptoms, Treatment, Surgery and Repair

Back pain is such a ubiquitous symptom it can be grueling to pinpoint the source. Potential conditions range from a mild sprain to a literal ripping of the tissue (hernia). Organs like the kidneys, gall bladder, and stomach can also permeate pain to the back and need to be plugged into the equation.

A specialist in backs and hernia should be on your list if you find yourself with considerable and chronic back pain. A hernia is nothing to mess with, so please educate yourself with this article here.

A Lumbar Hernia Anatomy Lesson

Before we can discuss the complexity of this kind of hernia, it is helpful to outline the names and functions of the body parts involved. For starters, you need to recognize where the superior lumbar triangle is on the body. Lumbar refers to muscles in the lower back. The lumbar triangle is nestled into the abdominal muscles near the obliques and attached to the 12th rib.

In lumbar hernia anatomy, this is the section that can herniate, collapse, and sometimes obstruct the bowels. It is deep set in the body, causing extra challenges in treatment options and is one of the most commonly misdiagnosed conditions. The rarity of a ruptured hernia compounds the diagnosis problem and increases morbidity rates. It is frequently diagnosed incorrectly as muscle strain, lipoma, and fibroma.

Lumbar Hernia Symptoms

The superior lumbar hernia, also known as a flank hernia or Grynfeltt-Lesshaft hernia, is a result of weakness in the posterolateral abdominal wall. These are the muscles that run along the side and the back of the abdomen. Lumbar hernia symptoms include:

  • A bulge on the back or side of the torso
  • Back pain
  • Stomach pain
  • Pain with coughing, breathing, or sudden movements

Muscle atrophy or weakness is the underlying cause of a lumbar triangle hernia. You are more likely to develop the condition in older age ranges, high risk is 50 to 70, and men are afflicted more often. Sedentary lifestyles and obesity exacerbate the hazards.

Who is At Risk for a Lumbar Disc Hernia?

On top of the muscles herniating, the discs in the lower part of the spine can bulge as well. Spinal discs are filled with fluid to keep them flexible, but as we age, our bodies start to lose hydration. This makes the discs brittle and vulnerable to breaking, splitting, or tearing from the bone. It doesn’t have to be a major trauma to cause a herniated disc either. Simple, everyday movements can tear a disc, like picking up a bag of groceries, twisting around when someone calls your name, or swinging a golf club.

Lumbar disc hernia risk factors include:

  • Age. Being between the age of 35 and 50. After 80 years old, herniated discs are rare.
  • Gender. Males are at a higher risk.
  • Career. Manual labor jobs carry the risk of back injuries, particularly if you perform repetitive motions of pushing, twisting or pulling.

Lumbar Hernia Surgery Options

Fixing an inferior lumbar hernia is a complicated surgery. There are so many muscles and vital organs to work around and trying to establish a foundation for muscle-on-muscle tears is challenging. Lumbar hernia surgery is performed laparoscopically, which means with a laparoscopic camera through a small incision.

Surgery for a petit hernia starts with a slight cut on or below the navel (belly button). The operational team then blows air into the abdomen to make space for the camera and surgical tools. Other small cuts are made in the lower stomach to insert the tools.

Muscles are then reattached to the abdominal wall with sutures. A mesh is often used to reinforce the abdominal wall and prevent the area from re-tearing by providing a solid foundation. The patient does have to undergo general anesthesia (being “put under”) for the procedure. Recovery time is anywhere from 1 to 4 weeks. Mild activity can be reintroduced after one to two weeks.

The good news about laparoscopic procedures is the recovery time is significantly shorter than larger incision surgeries (open heart, for example). Pain is also minimized with the tiny lacerations.

Non-Surgical Lumbar Hernia Repair & Treatment

Since surgery is accompanied by risks, pain, and time off the clock, many victims prefer to avoid it. If you seek a full lumbar hernia repair, surgery is the only viable option.

But many people are unsymptomatic and live harmoniously with their hernias, while others prefer to address the pain and forgo the knife. The last group opts for surgery, but would like some non-surgical treatment options to manage pain and return mobility.

Some pain management strategies for lumbar hernias and herniated discs include:

  • Physical therapy
  • Rotating ice and heat
  • Chiropractic care
  • Oral steroids
  • Pain relievers, both over-the-counter and prescription
  • Epidural Injections

Many surgeons will recommend a regimen of four to six weeks of non-surgical tactics before deciding to go into the operating room. If pain can not be effectively managed with other options, then surgery can be scheduled. Conservative treatments can continue post-surgery to aid in recovery and forward-thinking pain management. A focus should be given to prevention, as well, to minimize the risk of re-injury.

 

 

Article References:

  1. https://radiopaedia.org/articles/superior-lumbar-triangle?lang=us
  2. https://www.sciencedirect.com/science/article/pii/S2214854X17300213
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992605/
  4. https://my.clevelandclinic.org/health/diseases/15008-lipomas
  5. https://www.webmd.com/a-to-z-guides/qa/what-are-fibromas
  6. https://www.medstarwashington.org/our-services/surgery/conditions/hernia/flank-hernia/
  7. https://en.wikipedia.org/wiki/Grynfeltt-Lesshaft_hernia
  8. https://www.spine-health.com/conditions/herniated-disc/lumbar-herniated-disc-causes-and-risk-factors
  9. https://www.uwhealth.org/health/topic/surgicaldetail/laparoscopic-inguinal-hernia-repair/hw170282.html
  10. https://www.spine-health.com/conditions/herniated-disc/treatment-options-a-herniated-disc

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