Herniated Disc - Surgery
Most people who have a
herniated disc do not need surgery because their
symptoms tend to improve over time. About 50% of people with a herniated disc
in the low back recover within 1 month. And within 6 months, 96%
recover. Only 10% of people with herniated disc
problems that cause noticeable symptoms eventually have surgery.1
When surgery is used to treat a herniated disc, it is done to decrease
pain and allow for more normal movement and function. It is considered if the
following conditions are present:
- You have a history of persistent leg pain that
has not improved with at least 4 weeks of nonsurgical treatment, as well as
weakness and limitation of daily activities.
- Results of a physical
exam find that you currently have weakness, loss of motion, or abnormal
- Diagnostic testing, such as magnetic resonance imaging
(MRI), computed tomography (CT), or myelogram, indicates that you have a
herniated disc that can be treated surgically.
Surgery is appropriate only for people who have specific
symptoms and conditions. A decision to have surgery should take into
consideration results from diagnostic tests and physical examinations, your
response to nonsurgical treatment, and discussions between you and your doctor
about your options and expected results. Other
factors include your age, overall health, the severity of symptoms, and what
impact the symptoms have on your life (such as the inability to work). For
example, you and your doctor may consider surgery if your job requires a rapid
recovery, and there is no time to wait for the herniated disc to heal itself.
If you are an older adult, you may be offered surgery if your herniated disc is
less likely to improve without surgery because of other spinal diseases.
Disc surgery is not considered effective treatment for low back pain that
is not caused by a herniated disc. Disc surgery is also
not done if back pain is the only symptom the herniated disc causes.
(also called open discectomy) is the surgical removal of herniated disc
material that presses on a nerve root or the spinal cord. It is also used for
bulging discs or
ruptured discs. Discectomy may be the most effective
type of surgery for people who have tried nonsurgical treatment without success
and who have severe, disabling pain.
Percutaneous discectomy is used for
bulging discs and discs that have not ruptured into the spinal canal. This
procedure inserts a special tool through a small incision in the back. The
herniated disc tissue is then removed, thereby reducing the size of the disc
herniation. Percutaneous discectomy is considered less effective than open
discectomy, and its use is declining. Unless future studies show that this
technique is safe and effective, percutaneous discectomy should be considered
Laminotomy and laminectomy are surgeries done to relieve pressure on the spinal cord
and/or spinal nerve roots caused by age-related changes in the spine.
Laminotomy removes a portion of the thin part of the vertebrae that forms a
protective arch over the spinal cord (lamina). Laminectomy removes all of the
lamina on selected vertebrae and also may remove thickened tissue that is
spinal canal , the opening in the vertebrae through which the spinal cord runs.
Either procedure may be done at the same time as a discectomy, or
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