There are small, spongy discs to provide cushioning to the individual bones (vertebrae) that form your spine. A herniated disc refers to a problem to one of those discs. Your spinal disc has a softer center surrounded by a tougher exterior. Sometimes, due to an injury or another issue, the softer "jelly" pushes itself and comes out through a crack in the exterior. This results in a herniated disc, sometimes called as a ruptured disc or a slipped disc as well. This herniated disc can cause severe pain when it compresses nearby nerves – this may also cause weakness or numbness in your arm or leg.
You may or may not require herniated disc surgery depending on your symptoms. Some people don't require any treatment because they don't experience any pain or other symptoms. Keep reading to learn more about the surgery for herniated disc if you're considering this option.
When Is Herniated Disc Surgery Necessary?
In most cases, you don't require herniated disk surgery. That's usually when your condition responds well to other treatment options such as muscle-relaxant medications, physical therapy, anti-inflammation medications, pain medications, and a local injection of cortisone.
Your doctor will usually consider your clinical situation, including certain factors such as the severity of symptoms, the amount of pain you experience, etc. In some cases, you don't require any treatment, and that's usually when a disc herniation is present but doesn’t irritate a nerve root. It usually depends on your spinal canal, which can be small or large. Sometimes, it's quite small and even a small disc herniation will exert pressure on a nerve root.
Your doctor will first use a conservative treatment to resolve issues related to leg pain caused by a lumbar herniated disc. They continue with the treatment for about 6-12 weeks. If the pain persists, then they will recommend surgery. It is, however, more important to consider the disc space instead of considering the amount of disc herniation when you have back pain. You may consider opting for a spinal fusion if 6-12 weeks of aggressive non-surgical treatment has not improved your pain.
When Are Different Types of Disc Surgery?
It is worth mentioning that if you're considering herniated disk surgery, you should take some time and learn more about the benefits and side effects of different surgical procedures. Not every surgical procedure will suit your situation, which is why it is important to work with your doctor and know all your options before taking the plunge.
In most cases, you will have to select one of the following surgical procedures.
Laminotomy/Laminectomy
The procedure involves making a small opening in your lamina to ensure it doesn’t irritate your nerve roots. Your surgeon will use a microscope and make a small incision to perform the procedure. In some cases, your surgeon may decide to remove the lamina – that's why it is called a laminectomy.
Disketomy/Microdiskectomy
It is the most common herniated disc surgery,especially for a ruptured disc in your lumbar spine. The procedure involves removing the portion of your disc that may be putting pressure on your nerve root. The surgeon will make an incision in your back to gain access to the disc. In some cases, it is enough to make a smaller incision and use specific instruments to complete the procedure. This is especially true in case of a less invasive procedure called microdiskectomy.
Artificial Disk Surgery
You will be under a general anesthesia throughout the procedure. It is a suitable choice when treating a single disk only in your lower back – you may want to avoid this option though if you have osteoporosis or arthritis. Again, the procedure involves making an incision, but this time it will be in your abdomen and not in the lower back. The surgeon will then replace your damaged disc with an artificial disc, usually made from metal or plastic. This herniated disc surgery requires a few days stay in the hospital.
Spinal Fusion
Spinal fusion will also require general anesthesia. The procedure involves fusing two or more vertebrae together through bone grafts from another part – another person can also donate bone grafts for this surgery. Your surgeon will also use plastic or metal rods and screws to provide additional support to your spine. This may relieve pain, but the procedure will permanently immobilize that particular section that has been fused together.
What Are the Risks of Herniated Disc Surgery?
Considering the severity of pain, it is common to see people think there is no better way to resolve the issue than go for a surgical procedure. You should, however, avoid making a hasty decision and first understand more about the risks of different herniated disc surgery options.
Just like other types of surgeries, there are always risks, including bleeding, infection, and nerve damage. If your surgeon doesn't remove the disc, it may slip again. You may notice problems in other discs if you are suffering from degenerative disc disease.
After a spinal infusion, you should expect a certain amount of stiffness, which in most cases is permanent. You will not be able to return to your normal life soon after your surgery. In fact, you will get instructions from your doctor about when you can resume normal activity. Physical therapy may help you go back to your routine life early.
It is important to point out that though most people recover well after herniated disc surgery, it's not the same for everyone. The details of your surgery, your general state of health, and certain complications arising during surgery are some of the factors determining how long it takes you to recover after your surgery.