Deciding About Surgery for a Herniated Disc

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Deciding About Surgery for a Herniated Disc

What kinds of surgery are done for a herniated disc?

The most common surgeries are:

  • Discectomy. It takes out part of the disc that is pressing on a nerve root or on the spinal cord. It works best for people who still have bad pain (sciatica) after they have tried other treatments.
  • Percutaneous discectomy. It also takes out any part of the disc that is pressing on a nerve. But it is done with a special tool through a very small cut.
  • Laminotomy and laminectomy. They ease pressure caused by changes in the spine from aging.
    • Laminotomy takes out some of the lamina. This is the thin part of the vertebrae that protects the spinal cord.
    • Laminectomy takes out most of or all of the lamina. It also may take out tissue that is making the spinal canal too narrow.

What are key points about this decision?

  • Most people get better after a few months of treatment without surgery. This treatment includes rest, medicines, shots, and rehabilitation.
  • Surgery may be a good choice if you have severe pain, numbness, or weakness in your buttock and leg. This is called sciatica. It can keep you from being able to do your daily activities.
  • If you have medium to very bad pain, you will probably feel better sooner if you have surgery. But after 5 to 10 years, how well you can do your daily activities will probably be about the same whether you have surgery or not.
  • A doctor may advise you to have surgery. It's a good idea to get a second opinion. The more you know, the better your decision will be.
  • Surgery for a herniated disc does not often cause problems. But there is a slight risk of harming nerves or the spine during surgery. Or you could have problems from the anesthesia. There is also a chance that you could get an infection.

Why might you choose surgery?

  • Surgery works well for many people with medium to very bad pain.
  • Surgery offers faster pain relief than other treatment.
  • With surgery, most people can go back to work sooner.
  • You have tried exercises and medicines for a few months. You do not think they have helped you.
  • You feel okay about the idea of having back surgery.

Why might you choose not to have surgery?

  • Treatments without surgery work for most people.
  • Research shows that 10 years after treatment, people who did not have surgery are just about as likely to be able to do their daily activities as people who had surgery.
  • You do not like the thought of surgery.
  • Your pain is not bad enough that you need to have surgery right now.

Your decision

Thinking about the facts and your feelings can help you make a decision that is right for you. Be sure you understand the benefits and risks of your options, and think about what else you need to do before you make the decision.

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