When Is It Necessary To Operate On A Herniated Disc?

Operating on a herniated disc is an option when other treatments have failed, such as pain relievers or corticosteroid injections. We explain everything you need to know about the procedure below.
When do I need to operate on a herniated disc?

A herniated disc is a common pathology that significantly affects the lives of those who suffer from it. The option to operate on a herniated disc always arises when this situation has a major impact on the patient’s daily activities or when other types of approaches have failed.

Today, there are numerous techniques for operating a herniated disc. Each is better adapted to the characteristics of the lesion and the patient, as well as the surgeon’s experience and preferences.

Thanks to this intervention, the quality of life can improve. However, it is not easy and it also involves several risks. In this article, we explain everything you need to know about the subject.

What is a herniated disc?

To understand what a herniated disc is, you must first know the anatomy of the spine. The spine is made up of vertebrae, which are individual bones. Among them are disks of cartilaginous tissue whose function is to cushion the impact. They are the intervertebral discs.

Discs consist of a nucleus pulposus and a fibrous ring. The ring is the outermost part that surrounds the core. As explained by Mayo Clinic experts, a herniated disc occurs when the nucleus protrudes outward through a rupture in the fibrous annulus.

Hernias can occur anywhere in the spine. Then the disc can irritate some nerves. Symptoms vary depending on the location and severity of the protrusion.

Disc herniations are very common. It is estimated that they affect between 5 and 20 of every 1000 adults under 49 years of age. The most common is that they occur in the lumbar or cervical region and are accompanied by pain or changes in mobility and sensitivity.

Cervical disc herniation
Herniated discs can appear anywhere in the spine, although they are more common in the lumbar and cervical regions.

Herniated Disc Treatments

Before operating a herniated disc, different less aggressive treatments are usually proposed. It is normal to start with a pharmacological treatment to relieve pain and discomfort. First, if the pain is mild, pain relievers such as ibuprofen or naproxen are recommended.

If pain control cannot be achieved with these types of medications, corticosteroids may be chosen. They are injected into the affected area, near the spinal nerves. In some cases, even opioid medications are prescribed.

The problem is that these medications tend to create tolerance, dependency and addiction. Also, they have several side effects. Therefore, they must be used with caution. Any of the medical treatments must be combined with physiotherapy and personalized exercises.

When do I need to operate on a herniated disc?

Operating a herniated disc becomes one of the options when other treatments fail. The truth is, most patients don’t need surgery. They tend to improve after days or weeks with the medical approach.

However, if symptoms persist for months, operating on a herniated disc is almost a priority. Disability can be a consequence of disk damage to a nerve. Mobility or ability to control sphincters may be affected.

Furthermore, there are currently  different techniques for operating a herniated disc. In some cases, intervention can be considered using a minimally invasive technique, with smaller incisions and faster recovery. Usually the results are very good.

Preparing to Operate a Herniated Disc

To operate on a herniated disc, it is important that the patient is aware of the risks and precautions prior to surgery. Adopting healthy habits is recommended.

For example, the ideal is for the patient to lose weight and get in shape before surgery. Being overweight can put more strain on your spine than recommended. That’s why the recovery process can be slowed down.

Strengthening the back muscles is recommended for any condition that affects the spine. Exercises guided by a specialist should be performed to prevent further damage.

As with any other surgery, it is important to stop smoking. Tobacco increases the risk of surgical complications, in addition to interfering with the healing process.

What are the options for operating a herniated disc?

As we explained throughout the article, today there are numerous options for operating a herniated disc. In the following sections, we’ll explain what the main techniques are and what they consist of.

Operate a disc herniation by discectomy

Discectomy is the most widely used technique to operate on a herniated disc. It consists of removing the damaged part of the disk or the entire disk. When the problem is in the cervical spine, it is done anteriorly.

In this case, a small incision is made in the front of the neck and the disc is removed. The space it leaves must be filled, replacing it with a small bony plug in most cases. An artificial disk can also be used.

Laminoplasty and Laminectomy

Laminoplasty is a technique used to operate on a herniated disc in the neck. It consists of opening a space inside the vertebral canal, through a kind of hinge. The idea is to create more space for the herniated disc and thus alleviate the symptoms.

Laminectomy involves trimming or removing a part of the affected vertebra. Thus, it is possible to expand the spinal canal space and decrease the pressure on the spinal cord, in addition to opening more space for the nerves.

Cervical Corpectomy

Cervical corpectomy is similar to the prior technique. It is a process whereby part of the vertebra is removed, along with part of the adjacent intervertebral discs. An attempt is made to stabilize the spine using metal plates, screws or bone grafts.

spinal fusion

Spinal fusion is also a technique often used to operate on a herniated disc. It consists of joining the two vertebrae that contain the herniated disc.

Recovery from surgery

Herniated disc surgery has a relatively short recovery time. Most people go home the day after the procedure. However, it is important to avoid certain activities for the next month.

Do not exercise very strenuous or lift heavy objects. Driving or sitting for long periods of time is also not recommended. Squatting is also not beneficial to recovery.

However, a rehabilitation program may be indicated, which promotes faster recovery and improved mobility.

Exercises for herniated disc
Guided rehabilitation with post-operative exercises can reduce the time to convalescence.

Risks and complications after operating a herniated disc

Operating on a herniated disc is something that, in the vast majority of patients, is very favorable. The risk of complications is low and patients often notice a marked increase in their quality of life.

However, that doesn’t mean there aren’t complications. For example, there may be infections or bleeding, especially in elderly patients. Postoperative fibrosis also appears, which interferes with mobility recovery.

The patient may not feel satisfied after surgery. This usually occurs in people where the damage prior to the operation has not been well established. Since there are no obvious signs that the symptoms are due to nerve compression, the signs are maintained and surgical failure is considered.

Herniated disc usually improves with medical treatment.

While operating on a herniated disc is a good option, the truth is that most patients do not need surgery. With medical treatment and therapy, they improve significantly.

However, if the procedure is done, it is important that the patient is aware of all risks and possible complications. However, the results are generally good and the patient’s quality of life improves.

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