Surgery for a slipped disc
Like other tissues of the body, the intervertebral discs are subject to a constant wear process. This long-term damage can lead to a displacement of the gelatinous core of the intervertebral disc. If the outer fibrous ring of the intervertebral disc tears, this can result in a herniated disc.
If the fibrous ring is still intact, so that the entire disc protrudes into the spinal canal, we speak of a protrusion, an incomplete disc herniation. Both are often asymptomatic, but can also cause severe pain and nervous failure symptoms. According to recent studies, the number of disc operations doubled between 2005 and 2010.
Nevertheless, ultimately 90% of herniated disks can be treated conservatively, mainly by means of effective pain and physiotherapy. However, a surgical intervention becomes absolutely necessary when serious symptoms, so-called “red flags”, occur. It is worth knowing here that muscle weakness or paralysis only occurs as a result of severe nerve damage, while sensory disturbances occur even with slight nerve damage.
For this reason, the “red flags” of a herniated disc include above all increasing or sudden muscle paralysis, as well as paralysis of the bladder and rectum muscles, which can result in permanent faecal and urinary incontinence. The so-called cauda equina syndrome is also a warning sign that must be taken seriously. In this syndrome the nerve cords of the cauda equina, the spinal cord in the lowest part of the spinal canal, are compressed.
Damage to these nerve cords results primarily in sensory disturbances and muscle weakness in the legs. Even though serious complications and side effects of operations on the intervertebral disc are on the whole rather rare, it should be noted that the operations are always accompanied by certain risks. Since these can be potentially serious due to the close proximity of the intervertebral disc and nerves or spinal cord, the necessity of a surgical intervention should be carefully considered from the outset.
One of the most frequently occurring and unfortunately difficult to prevent complications is scarring in the surgical area, which can lead to entrapment of the nerve root or the outer skin of the spinal cord (dura mater) and cause corresponding discomfort. Furthermore, the operation can also result in direct injury to the dura mater. As a result, spinal fluid leaks through this spinal cord.
Although this fluid is completely replenished within a few hours, severe headaches and/or nausea can occur after the operation. This complication occurs in about 1 to 2 % of all disc operations. Apart from this, in very rare cases an infection can occur as a result of the operation.
However, slight pain directly after the operation is to be expected and should therefore not be overestimated. They can usually be treated well by taking common painkillers. Also worth mentioning is the recurrence rate in disc surgery, i.e. how many patients are affected by a herniated disc again despite surgery.
Currently, this rate is between 5 – 10%. A recurrence usually occurs within the first three months, but can also only become noticeable after several years. If a new herniated disc actually occurs, a new operation is recommended.
The duration of a disc surgery depends strongly on the surgical technique used. As with surgical interventions in other parts of the body, minimally invasive procedures take more time here than open surgical methods. Apart from this, the extent of the herniated disc and the anatomical conditions of the patient also play a role.
Nevertheless, in most cases the surgery should last between 30 and 60 minutes. Immediately after the operation, the patient remains under observation for a few hours until the effects of the anesthesia have completely worn off and acute complications have been ruled out. Typically, most patients are able to resume their daily activities two to three days after the operation.
However, it should be noted that in the first few days, it is not advisable to walk too long distances. The length of time for which the newly operated patient walks daily should be increased slowly and deliberately. For up to one month after the operation, the patient should neither drive nor do any sports.
Likewise, no weights over 15 kg should be lifted for up to three months after the operation. How long the actual sick leave will be after the operation is difficult to predict and strongly depends on the course of the disease after the operation. Depending on the patient’s occupation, he or she may have to be on sick leave for several months.
Patients who have to work physically hard need considerably more recovery time than office workers. Despite these prospects, the above-mentioned precautions should be taken seriously in any case. Their observance significantly reduces the probability of a new herniated disc and thus the need for another operation.
