Discs are the cushion between the vertebrae in the spine. They can be damaged by tear, wear and disease associated with injury or aging. A herniated disc is also called a ruptured or slipped disc. Surgery for a herniated disc is for people who experience nerve damage, excessive pain, numbness, weakness and when more conservative treatments such as physical therapy have failed.
Unfortunately, some people do not know what their surgery options are. Having some knowledge of the different types of back surgery that are performed can help them prepare and have a much shorter recovery time.
Type of Surgeries
Laminotomy is a minimally invasive spine surgery procedure. As a matter of fact, a healthy patient can have this herniated disc treatment option done on an outpatient basis with a stay of no more than a single day. During the procedure, a small incision is done in the part and back of the lamina. The lamina is the bony covering on the nerve root. It is removed to relieve the pressure that the herniated disc causes. If necessary, part of the disc may also be removed.
- Lumbar Laminectomy
Lumbar laminectomy is a surgery for leg pain related to a herniated disc in the lumbar or lower area of the spine. It relieves pressure in the nerves or spinal cord by widening the spinal canal. The surgeon removes a portion of the lamina of the vertebrae to create adequate space for the nerves. This can be done in conjunction with spinal fusion if extra spinal support is needed.
- Spinal Fusion
Spinal fusion is another surgical option for people who are suffering from a herniated disc in the back. It is performed to give stability to the vertebrae by grafting bone onto the spine. Rods and screws are inserted to give additional support to the spine. It is often performed in conjunction along with laminotomy. This procedure will not limit flexibility of the spine because it only involves the fusion of a small segment.
Microdisectomy is performed to remove the herniated disc material to relieve pressure on the spinal cord and nerves. During the procedure, the surgeon removes the lamina, a small piece of bone in the back, in order to see the area of disc herniation more clearly. Any loose fragments on the bone will also be removed. The surgery can be done as an outpatient procedure because it is minimally invasive.
Herniated Disc Surgery or Conservative Treatment
Unlike conservative treatment, herniated disc surgery has a higher success rate in relieving back pain. In a recent study published in the New England Journal of Medicine, 63 percent of people said that they had a major improvement in their condition as opposed to those who chose to obtain nonsurgical treatment options such as epidural injections.
In terms of physical function and self-reported pain, both groups improved over the two-year period although the final scores for patients who had surgery to relieve sciatica were in the 60-point range while scores for people who stuck with non-surgical procedure such as physical therapy and chiropractic treatment were in the low 40s. Although non-surgical treatments are much cheaper, these results offset the cost of having herniated disc surgery.
However, people should bear in mind that herniated disc surgery has its own share of pros and cons. Although it offers people a number of advantages such as increased productivity at work, better physical fitness and increased activity, there are a number of risks such as infection, bleeding, nerve damage that can result in paralysis, weakness, sexual dysfunction, loss of bladder or bowel control and reaction to anesthesia and other drugs.
Preparation for Herniated Disc Surgery
Spinal surgery should always be taken seriously to reduce the risks involved in a surgical procedure while helping to shorten a patient’s recovery time. Before having back surgery, people should eat right as good nutrition is important in keeping their immune system healthy. This also reduces their risk of getting an infection later on.
Aside from that, they should get in shape. Low cardiovascular endurance and weak muscles make recovery time from surgery more difficult. People should talk to their doctor about how to start a physical fitness program that is right for their condition after and before spine surgery. If they already exercise regularly, they should also make sure that their doctor approves their exercise routine.
People should also not forget to lose weight. Back pain can make weight maintenance or losing weight a challenge. If a person is overweight, it is a good idea to slim down before surgery. This is because more body weight strains the spine and may increase post-operative pain and slow the healing process.
At the same time, people should not smoke. If they are a smoker, being told to quit may be the last thing they want to hear. However, it is the most important step that they can take to help ensure a successful and safe surgery. Quitting at least a month before their back surgery can decrease their chance of experiencing serious complications such as post-operative pneumonia and problems with anesthesia. If a person thinks quitting may be hard for them, they should talk to their physician about smoking cessation programs in their area.
What to Expect After Surgery
A few hours after a person awakens from anesthesia, they will no longer be groggy, and their doctor will ask them to try getting out of bed and taking a few steps by themselves. Often, a patient will notice a marked decrease in their level of pain. The injured nerve is free and therefore no longer inflamed. The majority of patients are usually released from the hospital within a day after their surgery.
The Recovery Period
Because herniated disc surgery frequently involves moving the muscles surrounding the nerve, a person may feel a little soreness there as well as at the incision site. However, that soreness will go away with proper care. Their doctor will also prescribe pain medication to help them during their recovery period.
For the first two weeks, a person may find it hard to sit for more than 30 minutes at a time. Walking should be their primary means of exercise. It will help prevent the formation of too much scar tissue around the nerve. It will also keep a person’s lungs and heart healthy.
If a person has surgery in the lumbar area region, they may find that walking with a cane can be very helpful. Their physician may also advise gentle stretches. These will assist their back muscles in healing quicker and help them regain the mobility that they lost before surgery.
If an individual works in an office and does not do much lifting, they can return to work in about two to four weeks. However, if their job involves working with heavy machinery and heavy lifting, they may return to their work in four to eight weeks.
The Bottom Line
With its uncomplicated recovery period and high rates of success, herniated disc surgery is much better than undergoing conventional treatment for cervical and lumbar pain. Although it is more expensive than non-surgical treatment options for back pain, the benefits far outweigh the cost.