A herniated disc happens when the gel-like center of a disc ruptures via a weak region in your outer wall. If the disc material compresses or touches your spinal nerve, you could experience tingling, numbness, and leg or back pain. Conventional treatments like pain medications, physical therapy, spinal injections, and rest are the first steps to recovery. Your symptoms can improve in six weeks, allowing you to return to your daily routine. If your symptoms continue, your doctor can recommend herniated disc surgery to decompress your nerves or remove the slipped disc.
Dr. George Rappard is a board-certified and seasoned Los Angeles dentist who performs minimally invasive spinal procedures that involve less cutting and entering your body. His medical techniques can lead to smaller incisions, less pain following surgery, shorter hospital stays, and a quicker recovery.
A Brief Overview of Disc Herniation Surgery
Disk herniation surgery is performed to relieve the pressure caused by a herniated disk (commonly known as a ruptured or slipped disk) on a spinal nerve.
Between every bone in the spine is a disc that serves as a shock absorber and cushions the bones. A slipped disc extends beyond the capsule that houses it, pushing into the patient’s spinal cord. While a slipped disc can happen anywhere along the spine, the lower back is the most vulnerable.
Common causes of a herniated disc include the following:
- Lifting something wrongly or after suddenly twisting the spine.
- Degeneration caused by aging or disease.
The condition does not always result in discomfort or pain, but if the disc pushes against nerves in the lower back, the patient can experience sciatica (pain in their legs or back). If the herniated disc happens in the neck, the individual can experience pain in their arms, shoulders, and neck. Additionally, the health condition can cause tingling, weakness, and numbness.
Your physician can recommend herniated disk surgery if:
- Nerve weakness causes difficulty walking or standing.
- You experience pain that travels into your legs, chest, arms, or buttocks and becomes challenging to manage.
- You cannot control your bowels or bladder.
- Conservative treatment options like steroid injections, weight loss, painkillers, physical therapy, or rest failed to improve your symptoms after six weeks.
Various Disc Herniation Surgery Options
When diagnosing a slipped disc, your physician will perform a physical examination. The medical expert will look for the source of your discomfort and pain by checking your muscle strength, nerve function, and whether you feel pain when touching or moving the injured site.
Moreover, your surgeon will inquire more about your symptoms and medical history. It can involve asking when you first experienced symptoms and what activities worsened your pain.
When contemplating a surgical procedure, ensure you consult a trained surgeon. Before recommending any treatment option over another, the surgeon will order diagnostic image testing, which can include the following:
- Nerve conduction studies or electromyography — Measures electrical impulses along muscles and nerves.
- X-ray — Produces clear images of your joints and vertebrae.
- Magnetic resonance imaging (MRI) — Produces 3D images of your spinal cord, discs, and nerve roots.
- Computed tomography (CT scan) — Provided detailed images of your spinal cord and neighboring structures.
A surgeon can also use age, health, and herniated disc location to determine the best surgical procedure.
After conducting a diagnostic test and collecting the relevant information, your doctor can recommend either of the surgeries below.
- Open discectomy —Your doctor can perform an open surgical procedure to remove the ruptured portion of your disc.
- Surgery on the core of your spinal disc — Your physician uses tools to access your spinal disc core and later a vacuum to remove your core. It makes your spinal disc tinier, reducing pressure on your nerves. You only qualify for this surgical procedure if your disc’s outer layer is not destroyed.
- Endoscopic spine surgery — The doctor uses an endoscope or a long thin tube to remove the herniated disc section. The treatment is minimally invasive. The doctor makes a small incision. Only a tiny scar will form, leading to a quick recovery.
Other surgical procedures include the following:
Your physician will open a small lamina (vertebral arch) to relieve pressure on your nerve roots.
The procedure is conducted through a tiny incision down the center of the neck or back over your herniated disc. Sometimes, the surgeon can remove all or part of your lamina to repair your herniated disc. Laminectomy involves the removal of all lamina, while laminotomy entails removing part of your lamina.
After removing the lamina, your surgeon will perform a discectomy to remove your herniated disc.
Laminectomy and laminotomy can be either cervical or lumbar.
- A cervical procedure — Relieves pain in your upper limbs and neck that a herniated disc causes in the neck region.
- A lumbar procedure — Relieves sciatic or leg pain that your slipped disc causes in your lower back.
Microdiscectomy is a popular surgical procedure for herniated discs in the lumbar region. The treatment involves removing a part of your disc that causes pressure on the nerve root. Sometimes, the surgeon can remove your entire disc. Your physician will access your disc through a small incision in your neck or back. The doctors use special tools and smaller incisions, making the procedure less invasive.
Surgeons can perform the surgical procedure on an outpatient basis.
Spinal Fusion (SF)
The procedure involves permanently fusing at least two vertebrae. After a laminectomy or laminotomy, an SF can be essential to stabilizing your spine.
Your skilled surgeon will perform spinal fusion using bone grafts from a donor or another body part. It also involves using metal rods and screws to offer additional support.
The possibility of requiring a spinal fusion depends on your herniated disc’s location. A lumbar laminotomy requires a spinal fusion, while a cervical laminotomy needs this option if the doctor operates from the patient’s neck.
Typically, this surgical option requires a hospital stay for a couple of days.
Artificial Disc Surgery
The surgery is ideal if you have lower back issues. During the procedure, your surgeon will administer general anesthesia and enter your abdomen via an incision. The doctor will replace your damaged discs with artificial discs. You will be admitted to a healthcare facility for a couple of days.
Please note that artificial disc surgery is not ideal for osteoporosis and arthritis patients.
According to the North American Spine Society, patients who undergo herniated disc surgery earlier rather than later can experience a faster recovery and improved health.
Most patients can return home a day or two after the operation. Some can even return home on the same day.
Your physical therapist should help you loosen stiff joints, strengthen your core muscles, and create a home exercise program to protect your spine. Patients should gradually return to their daily routines, particularly during manual labor. While some exercise can benefit you, you should consult your physician before engaging in strenuous activities. You should also avoid bending over and lifting heavy weights, sitting for extended durations, and driving for about four weeks.
Since sitting in a chair and leaning forward can pressure the spine, individuals with sedentary jobs should be cautious of their posture. The patient should take short walks or do gentle exercises every hour.
If you plan to resume driving following surgery, wait until you have finished all drugs that cause drowsiness. You should also be able to shift your foot between pedals and turn in your seat without feeling pain. You can test your comfort level by driving in a parking lot in the company of a skilled motorist.
Risks and Complications
Generally, herniated disc surgery is safe. However, you can experience any of the following risks:
- Damage to your blood vessels and nerves.
- A tear in your spinal cord’s protective lining.
- Issues with your new disk.
- Leaks of spinal cord fluids.
It is less likely that the surgery will not improve your signs and symptoms or your pain will improve for a while and return in the future. In approximately five percent of patients, the slipped disc can rupture again, resulting in the recurrence of signs and symptoms.
While surgery provides faster relief compared to other conventional treatments, it is not always the most effective option. Speak with your surgeon about the benefits and risks of the surgical procedure before deciding on your treatment.
Preparing for Your Herniated Disc Surgical Procedure
Adequate preparation for the surgical procedure can assist you in being comfortable with the surgery and increase the possibility of successful outcomes. Here are some preparation tips:
Choosing the Location
Typically, doctors conduct surgery in a surgical center or hospital. You could be required to go to the hospital if you have a severe health condition that needs monitoring. Additionally, if your procedure is performed on several spine discs and carries more significant risks, your doctor can perform the operation at the hospital. In this case, you will be admitted to the hospital for at least a day.
On the other hand, uncomplicated disc challenges happen at an outpatient healthcare facility. You can return home hours following the operation.
Your herniated disc surgery cost varies depending on the operation’s location. Remember to consult with your insurance provider and surgeon to understand the cost.
What to Put On
On your surgery date, ensure you wear comfortable clothes. The surgeon will ask you to change into a loose-fitting hospital gown.
If you will stay in the healthcare facility for a few days, remember to carry a robe, a pair of slippers, and extra undergarments.
Beverages and Foods
Your healthcare provider will advise you not to drink beverages or eat food on your surgery day. Beverages and foods in the stomach can be regurgitated if the doctor administers anesthesia, causing severe challenges like aspiration, vomiting, and nausea.
The surgeon will advise you when to stop drinking and eating before the surgical procedure. If you are on medication, you can drink a small quantity of water to aid in swallowing your drugs.
Here are recommendations on when you should stop drinking and eating specific beverages and foods before your surgery:
- Stop eating meat and fatty or fried foods eight hours before the surgery because they can delay gastric emptying.
- Eat snacks and a light meal that does not include protein or fat at least six hours before the surgical procedure.
- You should drink clear liquids two hours before your surgery. It includes fruit juice with pulps, clear tea, black coffee, water, and carbonated beverages.
You could have been on prescription medication before your operation. Notify your doctor if you are taking any drugs. They will advise you when to stop taking specific drugs and resume them after treatment.
What to Carry to the Surgical Room
When preparing for surgery, list issues to bring to the healthcare facility. These can include the following:
- Your identification.
- Your insurance card.
- A loved one.
- Copayment for medical services, if necessary.
While the nursing staff can properly store your property, avoid carrying valuables, electronic devices, and jewelry to the healthcare facility.
Disc Herniation Surgery Cost
For patients without health insurance, the cost of a herniated disc surgical procedure can range from $20,000 to $50,000. An outpatient procedure falls on the lower end, while an operation with a hospital stay is on the higher end.
Typically, health insurance covers the surgical treatment, provided a doctor recommends it. For patients carrying insurance, assuming they have met the deductible, the out-of-pocket cost would consist of coinsurance of up to 40% of the treatment.
If you have the procedure without insurance, speak with your surgeon to determine if you can negotiate a lower rate. You can also arrange reasonable payments to make the costs more manageable.
Contact a Qualified Spine Surgeon Near Me
Does it seem like nothing relieves the symptoms of your slipped disc?
Physical exercise, anti-inflammatories, oral steroids, and medications sometimes prove ineffective remedies for a herniated disc. If this is your case, Dr. George Rappard can recommend disc herniation surgery as a last resort. Before recommending surgery to relieve pressure on your disc, our experienced Los Angeles surgeons can evaluate your medical history and perform diagnostic imaging tests to determine the severity and location of your slipped disc. Our medical team can also answer your questions and give you recommendations to follow before, during, and after the surgical procedure.
Please contact us at 424-777-7463 to schedule an appointment and learn whether you are an ideal candidate for a herniated disc surgical procedure.