A small herniated disc in your back can cause life-disrupting pain throughout your body. Though not everyone needs surgery, if your doctor has recommended this procedure for your back pain, you need to learn more about it. Surgery on a herniated disc can get you back on your feet and ease your pain.
Between each of the vertebrae in your spine is a compressible disc. These discs absorb shocks and allow you to move your back in multiple directions. Each intervertebral disc has two parts. The outer ring, called the annulus fibrosus, is tough and fibrous. The interior of each disc, the nucleus pulposus, has a gelatinous consistency.
When a disc herniates, the interior portion pushes through the more robust outer ring or causes the outer ring to bulge out. The altered shape of the disc presses on nerve roots and the spinal cord. The disc itself also produces chemical irritants from the damage. Some people call herniated discs slips, ruptures or bulged.
The most common cause of this condition is age. As people grow older, their discs naturally wear thinner, leading to an increased chance of herniation. However, accidents can also cause the disc to experience this type of change.
You can have any disc in your spine herniate, but the condition more often happens in the lower back. The symptoms depend on the location of the disc. For disc ruptures in the lumbar region of the spine, you may feel an electric shock that brings tingling and pain down one leg. Neck disc slips can lead to pain, numbness or tingling in between the shoulders and down an arm. If you experience any loss of bladder or bowel control, seek immediate medical attention.
Doctors may use any of several treatment options to help your back pain. If your condition does not cause severe pain or loss of function, your doctor may suggest more conservative options such as any of the following:
If none of the above work, or if you have severe symptoms, you may need surgery.
The majority of people do not need surgery. For nine out of 10 patients, conservative treatment eases their pain. For those who do not get relief after other options, surgery may be the solution.
For a few patients, the severity of the condition may prompt some doctors to bypass more conservative options and suggest surgery quickly. Some signs you may need surgery due to condition severity include:
Talk to your doctor about whether you need to try other options first. If none of them have helped you, you might qualify for surgery, especially if you are otherwise in good health.
There is not one single type of back surgery to repair slipped discs. Instead, surgeons have several options to choose from. The doctor will make the best choice based on your condition, the location of the problem and if you have any other complications in the area.
The most common type of surgery for a slipped disc is microdiscectomy. During this procedure, doctors use a small set of incisions to remove the herniated portions of the disc, easing pressure on the nearby nerves. A microdiscectomy may be an outpatient surgery, allowing you to go home the same day. When a doctor performs this surgery with more extensive incisions, it is a discectomy.
Sometimes, you may need other procedures in conjunction or instead of microdiscectomy. One of these is a lumbar laminotomy or laminectomy. This operation may happen with a microdiscectomy. During the process, the doctor either cuts through (laminotomy) or cuts out (laminectomy) the bone surrounding the vertebrae. Because the lamina bone surrounds the spinal cord, cutting it can ease pressure and make it easier for the doctor to reach the damaged disc.
You may need artificial disc surgery if your doctor wants to replace the slipped disc with an artificial one. If you have multiple slipped discs or osteoporosis, you likely will not be a good candidate for this type of operation. Very few patients will qualify for or need this type of surgery.
Another surgical option is spinal fusion, wherein the surgeon connects the vertebrae on either side of the repaired disc. Based on your spine’s condition, the surgeon may use bone grafts from a donor or your body. To improve the strength of the bond, the doctor may also choose to insert rods and screws into the area. This operation will stop the vertebrae from moving and improve your spine’s stability.
The recovery time depends on the type of surgery you had. For example, spinal fusion and artificial disc surgery typically require recovery of several days in the hospital. If you have a desk job, you may be able to go back to work within two to four weeks. However, if you have a physically demanding job, you may need to take up to eight weeks to recover before you return to work.
To improve your recovery time, follow all instructions from your doctor about taking pain medications and following up with physical therapy to strengthen your back. After recovery, protect yourself from future damage to the spine by using safe lifting techniques and keeping your weight under control.
Generally, disc surgery is very safe, especially those performed on an outpatient basis. As with any surgery, there are always inherent risks. Talk to your doctor about any concerns you have. Complications may include bleeding, infection, spinal fluid leaks and pain in the repaired disc. For a small minority of patients, around 5%, the disc may rupture again, requiring another operation.
If you have pain in your back or have received a diagnosis of a slipped disc from your doctor, visit us at NJ Spine and Wellness. We have a comprehensive set of solutions for those in pain, including surgery. Make an appointment with us, and we will do everything we can to help you get to better faster.