When do you need surgery for a herniated disc?
introduction
Purely conservative treatment is sufficient for up to ninety percent of all patients with a herniated disc. In some patients, the symptoms go away completely after a few weeks.
There are different constellations of findings under which an operation is possible. If conservative treatment fails, surgery is an option. In the presence of paralysis and pain that cannot be treated with medication, a surgeon must be called in. In addition, there are constellations of findings in which a disc operation can be performed but is not absolutely necessary.
In the case of a herniated disc, the choice of treatment depends largely on the severity of the symptoms, warning signs of nerve damage and the patient's wishes.
When do you always have to operate on a herniated disc?
In principle, a herniated disc must always be operated on if the patient is threatened with serious nerve damage. When the disc presses on a nerve root due to the prolapse, the pain typically radiates
A herniated disc in the cervical spine (Cervical spine) characteristically radiates pain in the arm and shoulder. Numbness and tingling in the hands and arms are also possible. A weakness of the arm muscles can occur.
A herniated disc in the lumbar spine (lumbar spine) area can be accompanied by a radiation of pain in the legs and / or buttocks, tingling and / or paralysis of the leg muscles. Symptoms of paralysis are important warning signs of nerve damage. This includes muscle weakness and symptoms of paralysis with impaired fine and gross motor skills, which can appear as dropping objects or as an unsteady gait.
In addition, it is essential to have an operation if those affected suffer from involuntary urination and / or stool. That speaks for paralysis of the urinary bladder and rectum.
A herniated disc in the lumbar spine can trigger sudden impotence. The warning signs of nerve damage, especially paralysis, are an absolute indication for emergency surgery. A large herniated disc can press against the spinal cord and cause a (complete) paraplegic syndrome. A paraplegic syndrome manifests itself through symptoms of paralysis and sensitivity disorders.
If the intervertebral disc presses against the nerve fiber bundle in the area of the lower lumbar spine, the so-called cauda equina, paralysis of the thigh muscles, rectum and urinary bladder as well as loss of sensitivity in the anal, genital and thigh area ("breeches area") develop. Kauda syndrome is also an absolute surgical emergency. Without an operation, root death with permanent damage occurs.
Another indication for an operation is pain in the person affected, which cannot be effectively treated and is perceived by the patient as intolerable.
Read more about the topic here: Operation of a herniated disc.
When can you operate on a herniated disc?
A "one can, but one does not have to operate" situation is usually present in patients with a herniated disc when there are no neurological deficits. This means patients who have no paralysis of body parts or organs such as the bladder or rectum.
If those affected suffer from numbness in certain parts of the body, severe pain, or muscle weakness without paralysis of the body parts, an operation can be considered. The same applies if a patient perceives his symptoms as extremely high levels of suffering.
Nevertheless, an operation in the case of a herniated disc does not always lead to the desired success. An operation often helps to alleviate the symptoms, but does not guarantee freedom from symptoms. In such “one can, but one does not have to operate” situations, a period of several months is sometimes set in which the person concerned is initially treated conservatively. If there is no improvement by the end of the period, an operation can be considered again.
Find out more about the topic here: Treatment of a herniated disc.
Appointment with a specialist for a herniated disc?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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A herniated disc is difficult to treat. On the one hand it is exposed to high mechanical loads, on the other hand it has great mobility.
Therefore, treating a herniated disc requires a lot of experience.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
When do you not need to operate if you have a herniated disc?
A herniated disc can cause symptoms of varying degrees of severity. If those affected suffer from tingling or pins and needles on the arms or legs with symptom-free areas, there is usually no need to operate. The same applies if the herniated disc only causes pain or a slight muscle weakness, without serious symptoms of paralysis. In the cases mentioned, conservative treatment is indicated.
In up to ninety percent of all patients with a herniated disc, conservative therapy leads to an alleviation of the symptoms. Pain-relieving medication, physiotherapy, warmth and targeted, gentle positioning measures are the pillars of conservative disc prolapse treatment.
Another possible case constellation, in which one should not operate, is when a conservative attempt at therapy has led to an improvement in the patient's symptoms. Then it makes sense to continue the previous conservative treatment over a longer period of time.
More information on the subject Medication for a herniated disc you'll find here.
