How Bad Does a Herniated Disc Have to Be for Surgery 5 Variables

How Severe Does a Herniated Disc Have to Be for Surgery?

Herniated discs often respond well to conservative therapy, but caution is necessary when considering surgery. However, in cases where disc herniations lead to functional difficulties (such as muscle weakness and issues with bowel or bladder control), it is crucial to remove the extruded disc material promptly to prevent irreparable nerve damage.

Fortunately, there are multiple treatment options for disc herniations, including pain medication, physical therapy, and steroid injections. Surgical techniques can effectively alleviate herniated disc discomfort and potentially prevent further damage.

While surgery offers faster pain relief compared to other therapies, it may not be the best option for everyone. If you’re unsure about which treatment to choose, consult your doctor for advice.

Am I a Candidate for Herniated Disc Surgery?

Most people’s herniated disc symptoms improve with conservative therapy or without treatment at all. Many individuals can manage their symptoms with measures such as medication, physical therapy, or steroid injections. If these treatments fail, your doctor may recommend surgery to reduce pain and prevent additional harm.

If you’re uncertain whether you need surgery, here are five factors that help doctors determine the appropriate treatment:

  1. Persistent pain unresponsive to conservative care after four to eight weeks
  2. Weakened lower limbs affecting mobility
  3. Difficulty performing daily tasks due to severe pain
  4. Severe numbness or tingling in the limbs
  5. Inability to control bladder or bowel movements

Your doctor may recommend surgery based on the severity of your disability and pain. If you experience any of the listed symptoms, surgical treatment is strongly advised. In severe cases of disc herniations, surgery may be the only option when symptoms cause unbearable pain or affect bladder or bowel functions.

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What Are the Non-Surgical Treatment Options for a Herniated Disc?

A herniated disc may seem severe, but there are multiple treatment options available. In most cases, disc herniation improves within days or weeks, and surgery may not be necessary.

If you don’t have severe nerve compression symptoms or disability, conservative treatment is usually recommended as the initial approach. The goal of non-surgical treatment is to alleviate your symptoms.

Two Types of Non-Surgical Treatment for Herniated Disc

  1. Medication
  2. For mild to severe pain, anti-inflammatory drugs like ibuprofen and naproxen are commonly recommended.
  3. These over-the-counter drugs reduce inflammation and relieve discomfort.
  4. If you have severe or chronic pain lasting more than six weeks, your doctor may consider cortisone injections.
  5. Physical therapy
  6. After a physical examination, your physical therapist will create a rehabilitation plan tailored to your herniated disc treatment.
  7. The treatment aims to rebuild muscle strength and prevent reinjury.
  8. Therapy may include exercises to strengthen the muscles in your lower back, legs, and abdomen.
  9. You may also learn proper posture, walking, and lifting techniques. Additionally, stretching exercises can improve spine and leg flexibility.
  10. Rest regularly and avoid strenuous activity in your daily tasks. Nonsurgical treatment for herniated disc may take four to eight weeks for pain-free and full activity.


What Are the Surgical Treatment Options for a Herniated Disc?

If pain medication and non-surgical therapy fail to relieve chronic discomfort, your doctor may recommend invasive surgery for your herniated disc. Excessive pressure on the nerve roots can cause pain. An orthopedic surgeon or neurosurgeon can perform disc surgery to relieve the pressure or compression of a nerve root by an intervertebral disc.

Six Surgical Treatment Options

  1. Open diskectomy
  2. An incision is made in the midline of your lower back during an open diskectomy to remove the herniated disc.
  3. During this open back surgery, the surgeon may also remove bone spurs and bony protrusions that could cause joint injury.
  4. Open diskectomy is highly recommended and successful for treating lumbar disc herniation patients.
  5. Microdiscectomy or endoscopic spine surgery
  6. Microdiscectomy is a less invasive version of open diskectomy. It requires a 1.5-inch or smaller incision to remove the herniated disc.
  7. An endoscope, a long, thin tube, provides improved visualization of your nerve roots and surrounding tissues.
  8. Microdiscectomy is preferred due to less tissue damage, blood loss, noticeable scars, and lower infection risks.
  9. Spinal disc core surgery
  10. Spinal disc core surgery involves treating the herniation from the core of the intervertebral disc.
  11. An incision is made in your back to access the damaged disc, and suction is used to remove its core.
  12. This reduces the size of your intervertebral disc, relieving strain on your nerves.
  13. Disc core surgery is only recommended if the outer layer of the disc remains intact.
  14. Laminectomy
  15. Laminectomy is a popular surgical procedure for treating disc herniation, particularly in the back and neck.
  16. In a laminectomy, a surgical incision is made in the midline of your back to remove all or part of the lamina (a spine bone).
  17. This relieves pressure on your nerve roots and spinal cord, allowing them to decompress.
  18. After removing the lamina, the surgeon can perform a diskectomy to remove the herniated disc.
  19. Laminectomy relieves leg pain and other symptoms associated with disc herniation.
  20. Spinal fusion
  21. Spinal fusion stabilizes the spine, especially after surgeries like laminectomy.
  22. After a discectomy, screws or rods can be used to connect two or more of your vertebrae.
  23. During the recovery period, the vertebrae fuse together, creating a strong and stable structure.
  24. This surgery is commonly performed on patients with lumbar degenerative disc disease caused by deteriorating discs in the lower back.
  25. Recovery may take up to a year, and limited spinal mobility is possible.
  26. Artificial disc replacement
  27. Artificial disc replacement surgery is an alternative to spinal fusion. It involves removing the herniated disc and replacing it with an artificial disc.
  28. Compared to spinal fusion, this procedure allows for greater spine movement, reduces stress on surrounding discs, and has a shorter recovery period.
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With advances in medicine, surgery has become a preferred option for achieving better short and long-term outcomes. Various disc herniation surgeries have been proven to safely and effectively treat chronic back and neck pain.

Four Benefits of Surgical Treatment for Herniated Disc

Surgery is recommended for disc herniation that doesn’t respond to conservative treatment. Different surgical methods directly target the source of your pain.

  1. Rapid pain relief
  2. Conservative therapy typically takes weeks to months to provide full benefits.
  3. Surgery can immediately alleviate pain by relieving the excessive pressure on your nerves.
  4. Lasting effects
  5. During disc surgery, the herniated disc is removed, relieving the stress on your nerves.
  6. Research suggests a higher likelihood of having little to no herniated disc symptoms following surgical treatment.
  7. Improved mobility
  8. Removing a herniated disc through surgery allows for freer movement of the vertebrae in your spine.
  9. Activities like bending, extending, and lifting become easier.
  10. Quicker recovery
  11. Patients who undergo early disc surgery experience a shorter recovery period and improved mobility within a few weeks.

In cases of excruciating pain or bladder/bowel dysfunction, surgery may be the only viable option. Given the high success rate of herniation procedures, seeking a long-term solution for lumbar disc herniation has become increasingly beneficial.

What Is the Prognosis for Patients with a Herniated Disc?

The prognosis for patients with herniated discs depends on the recommended treatment option.

  • Nonsurgical treatment
  • Nonsurgical methods can provide pain relief and alleviate discomfort associated with disc herniation.
  • Continuous treatment can lead to symptom improvement within six weeks.
  • In many cases, conservative therapy may not be successful.
  • Surgical treatment
  • Surgery can effectively treat a herniated disc, providing significant pain reduction and improved physical function.
  • The success rate of herniated disc procedures has increased over time. Studies have found a 94% long-term success rate for neck herniation surgeries and a 78.9% success rate for lower back herniation surgeries.
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Remember that delaying treatment can make your path to recovery more challenging. If you’re in pain and unable to enjoy life fully, consult your doctor to determine the best treatment options for you.

Remember that delaying treatment can make your path to recovery more challenging. If you’re in pain and unable to enjoy life fully, consult your doctor to determine the best treatment options for you.


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