At what point do I need surgery for the herniated disc | Slipped disc of the BWS

At what point do I need surgery for the herniated disc

Herniated discs are still operated on too frequently, although the benefits of surgery are very limited. As a rule, timely pain relief and professionally supervised physiotherapy can achieve the same success. A surgical procedure is only indicated in particularly acute cases with severe symptoms and evidence of nerve involvement.

These are for example neurological deficits such as paralysis or bladder/rectum disorders. If paraplegia is imminent, the operation should be performed as soon as possible. If there is severe pain and sometimes organ dysfunction due to the herniated disc of BWS, the affected nerves should be surgically relieved as soon as possible.

Otherwise, surgery should only be an alternative after a long period of unsuccessful conservative therapy and persisting complaints. The operation removes the advanced tissue completely from the central canal and further loose parts are removed without reducing the stability of the mobile segment. This procedure is called nucleotomy.

In the case of slightly pronounced disc herniations, access to the affected area is microsurgically performed from the back (dorsal). In more severe cases, such as threatening paralysis, the surgical area can be opened laterally through the ribs and the disc space removed. In this major surgical procedure, the resulting gap is then stiffened by a bone graft and the adjacent vertebrae are screwed together.

Duration

The duration varies greatly with the severity of the herniated disc. First, the danger to surrounding organs, pathways and especially the spinal cord must be excluded. Surgical and conservative procedures also require different lengths of time.

Depending on the severity of the disease, a few days after the operation, improvement can be achieved through conservative drug therapy. After a few weeks at the latest, the symptoms should disappear so that physiotherapy can begin. This should be carried out over a long period of time, especially to prevent further back problems, a strength and movement training if possible forever.

On average, the symptoms should disappear after about 1-2 months. However, these figures are very variable, as the healing of the herniated disc depends on an enormous number of factors. Even potential paralysis and failure symptoms should improve after a while. If there is no improvement within a few months, other therapy methods must be considered.

Forecast

75% of all operated patients are free of complaints after the operation and are not restricted in their working life. In about 15% of cases, significant pain relief is achieved, but the ability to work is limited. 10% of those affected continue to have residual pain afterwards and 5% suffer from another disc prolapse at the same location. Only 1-2% suffer from a herniated disc at a different height of the spine.