When Is it Necessary to Operate on a Herniated Disc? - Step To Health
 

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.
When Is it Necessary to Operate on a Herniated Disc?

Last update: 25 October, 2021

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

Nowadays there are numerous techniques to operate on a herniated disc. Each is better tailored to the characteristics of the injury and the patient, as well as the experience and preferences of the surgeon.

Thanks to this intervention, the quality of life may improve. However, it isn’t an easy procedure and it also involves several risks. In this article, we’ll 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. Between them are cartilaginous tissue discs whose function is to cushion the impact. They are the intervertebral discs.

Discs are made up of a nucleus pulposus and an annulus fibrosus. The annulus is the outermost part that surrounds the nucleus. As explained by specialists from the Mayo Clinic, a herniated disc occurs when the nucleus protrudes outward through a tear in the annulus fibrosus.

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

Herniated discs are very common. It’s estimated that they affect between 5 and 20 of every 1000 adults under the age of 49. The most common thing is that they occur in the lumbar or cervical area and are accompanied by pain or changes in mobility and sensitivity.

Cervical disc herniation that must be operated on.
Herniated discs can appear in any area of the spine, although they’re prevalent in the lumbar and cervical areas.

Herniated disc treatments

Before operating on a herniated disc, different less aggressive treatments are usually tried. The normal thing is to start with a pharmacological one to alleviate pain and discomfort. First, if the pain is mild, pain relievers such as ibuprofen or naproxen are recommended.

If pain control can’t be controlled with these types of drugs, corticosteroids can be tried. They’re injected into the affected area, near the spinal nerves. In some cases, opioid medications are even prescribed.

The problem is that these drugs tend to create tolerance, dependence, and addiction. In addition, they have multiple side effects. Therefore, they must be used with caution. Any of the medical treatments is combined with physiotherapy and personalized exercises.

When is it necessary to operate on a herniated disc?

Operating on a herniated disc becomes one of the options when the rest of the treatments have failed. The truth is that most patients don’t require surgery. They tend to improve after days or weeks with the medical approach.

However, if the symptoms persist for months or there’s disability, operating on a herniated disc is almost a priority. Disability can be a consequence of damage caused by the disc to a nerve. Mobility or the ability to control sphincters may be affected.

In addition, at present, there are different techniques to operate on a herniated disc. In some cases, the intervention can be considered by a minimally invasive technique, with small incisions and a faster recovery. There are usually very good results.

Preparation to be able to operate on a herniated disc

To operate on a herniated disc the patient must be aware of the risks and precautions prior to surgery. It’s recommended that healthy habits are adopted.

For example, the ideal thing is for the patient to lose weight and get fit 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 avoid aggravating the damage.

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

What are the options to operate on a herniated disc?

As we have explained throughout the article, these days there are numerous options to operate on a herniated disc. In the following sections, we’ll explain what the main techniques are and what they consist of.

Operate a herniated disc by discectomy

Discectomy is the most widely used technique to operate on a herniated disc. It consists of eliminating the damaged part of the disk or the entire disk. When the problem is in the cervical spine, it is carried out through an anterior approach.

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 bone plug in most cases. An artificial disc 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 within the spinal canal, using a kind of hinge. The idea is to create more room for the herniated disc and thus relieve symptoms.

Laminectomy consists of trimming or removing a part of the vertebra that is affected. Thus, it’s possible to expand the space in the spinal canal and reduce the pressure on the spinal cord, in addition to making more space for the nerves.

Cervical corpectomy

Cervical corpectomy is similar to the previous technique. It’s a process by which a part of the vertebra is removed, but also a 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 frequently used technique to operate on a herniated disc. It consists of joining the two vertebrae that contain the herniated disc. Many types of instruments can be used for this, as is the case in corpectomy.

Recovery from surgery

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

For example, doing very strenuous exercise or lifting heavy objects. Driving or sitting for very long periods of time is also not recommended. Squatting is also not beneficial for recovery.

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

Exercises for operated herniated disc.
A guided rehabilitation with postoperative exercises can reduce convalescence time.

Risks and complications after operating on 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 usually notice a marked increase in their quality of life.

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

The patient may not feel satisfied after surgery. It usually occurs in people in whom the damage prior to the operation wasn’t well established. As there are no obvious signs that the symptoms were due to compression of a nerve, the symptoms are maintained and surgery is considered to have been a failure.

A herniated disc usually improves with medical treatment

Although operating on a herniated disc is a good option, the truth is that most patients don’t require surgery. With medical treatment and therapy, they usually improve markedly.

However, if this procedure is used, the patient must be aware of all the risks and possible complications. However, there are usually good results and the patient’s quality of life improves.

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