The majority of people diagnosed with a herniated disc will not have to be subjected to surgery.  Those that pass the qualifications for a surgery will be given surgical options.  The more traditional open back surgery is not as common today because of the risks involved, as well as the longer recovery time and hospitalization requirement.

The non-traumatic surgeries available for people require a less invasive incision.  Because of this, the recovery time is almost immediate and requires no hospital time.  In fact, most people will go home the same day and will only require a band-aid over the incision.

Herniated Disc – Percutaneous Endoscopic Discectomy

In this procedure, a local anesthetic is given to the patient.  A small incision will be made for a round Depuy Tube.  As the tube is inserted, the muscles will be pushed out of the way.  In a traditional surgery, these muscles would have been cut or torn.  This tube will help to prevent damage to the surrounding muscles.

A laser, camera, suction, irrigation, and other surgical instruments will be inserted through this tube.  The laser will vaporize the disc material, which will reduce pressure on the spinal cord or nerve.  Relief will generally be felt as the pressure is taken off of the nerve.   The tube will be removed, and the muscles will move back into their original place.

This herniated disc procedure will take from 30 to 45 minutes.   Recovery time is usually less than two hours. The patient will be able to leave as long as there is someone to drive him/her home.

Herniated Disc – Endoscopic Cervical and Lumbar Discectomy (Laser Spine Surgery)

Endoscopic laser spine surgery is a minimally invasive procedure that only requires a local anesthetic.   A small metal tube is inserted into the area where the herniated disc has ruptured.  With the help of an X-ray and a camera, a large piece of disc material will be vaporized with a laser.  This will kill the pain nerves inside the disc and harden the disc to prevent more leakage of the disc material.  These two types of laser spine surgery are similar, yet they do have some minor differences.   One of these differences is the size of tube that is used.  A cervical discectomy will require a 4mm in diameter tube, while a lumbar will require a 3mm in diameter tube.  Both surgeries have a high success rate and are highly recommended as opposed to the traditional open back surgery.

Herniated Disc Laser Spine Surgery Postoperative Care

The majority of the patients will feel relief from pain immediately following the procedure.  Patients are allowed to get up and walk the same day.  They can be released from the hospital within one to two hours.

Muscle relaxants may be prescribed for those who experience lower back muscle spasms.  These muscle spasms can last for a few days after the procedure.  A patient may also use heat and a light massage for these muscle spasms, if needed.

The lumbar section of the back is where the majority of herniated discs will occur.  The lumbar segments of the back are located in the lower back.  A lumbar herniated disc occurs when the inner gel-like material leaks out of the outer core.  A herniated disc in the lumbar section of the spine can put pressure on the spinal nerve root.  This will cause sciatica, which is pain that can shoot down the leg.

Nearly 90% of herniated disc in the lumbar area will occur at the bottom of the spine.  The spine is described in segments.  Most herniated discs occur in lumbar segments 4 and 5 (L4-L5), which will cause pain in the L5 nerve, or lumbar segment 5 and sacral segment 1 (L5-S1), which will cause pain in the S1 nerve.   Symptoms will depend on where the herniated disc is located within the Lumbar segments.

Symptoms for L5 Nerve Impingement

A herniated disc at this location can cause weakness when extending the big toe.  This weakness can run up into the ankle.  The top of the foot can experience numbness and pain.  Radiating pain can shoot up into the buttocks.

Symptoms for S1 Nerve Impingement

A herniated disc at this location can cause loss of ankle reflex.  It can also cause weakness in an ankle push off.  The patient is not able to do toe rises.  Pain and numbness can radiate down the leg to the sole of the foot or outside of the foot (Sciatica).

Sciatica and the Herniated Disc

It is important to understand that sciatica is a symptom, not a diagnosis.  Sciatica is a symptom of a herniated disc that has put pressure on the radiuclar nerve in the lower back.  The clinical diagnosis for a herniated disc protrusion that causes the sciatic symptom is called “radiculopathy”.   When pressure is put on this nerve from a herniated disc, leg pain can occur along with tingling, numbness, or weakness that will begin in the lower back and travel through the buttocks and down the large sciatic nerve in the back of the leg.

The symptom sciatica can be very painful and even debilitating.  However, while it can be extremely painful, it is not commonly known to cause permanent sciatic nerve damage.  Because the spinal cord is not located in the lower spine, a herniated disc in this area will not generally pose a paralysis threat.

Cauda Equina Syndrome

The conus medullaris is formed just below the spinal cord and near the first lumbar vertebra.  Just below the conus medullaris is a bundle of nerve roots called the cauda equina.   Cauda Equina Syndrome is a rare condition that can be caused by compression or inflammation of the nerve roots.

There are two sciatica symptoms to watch for in order to determine if the Cauda Equina Syndrome is present.   It is important to seek emergency medical care in the event that the weakness in the leg becomes progressive and if bladder or bowel incontinence or dysfunction occurs.

Symptoms of the lumbar herniated disc can possibly be relieved within 4 to 6 weeks with nonsurgical treatments.  If after this time there is still pain, surgical options may be discussed.