Treatment Options Patient Information

Treatment Options

There are a number of treatment options for a ruptured lumbar disc, each accompanied by its own set of risks and benefits. The four basic approaches are:

Endoscopic surgery in progress

• Taking Time: For some patients, all that is required in order to heal and recover is time.
• Taking Medication: For others, medication may reduce the inflammation or ease the pain in the affected area and thereby provide relief from their symptoms.
• Using Physical Therapy: For some, physical measures such as physical therapy (or gentle exercise) may provide relief and aid in the recovery from a ruptured disc.
• Having Surgery: For those patients whose ruptured disc is causing a "pinched" nerve, a Micro Endoscopic procedure often is the recommended treatment.

When a Endoscopic Spinal Procedure is NOT an Option

The severity of your symptoms (pain, weakness, lack of mobility) and your general health and physical condition will play an important part in determining when surgery is not an option for you. In general, surgery is not an option when:

• your back and leg pain is not caused by a ruptured disc; or
• you do not have leg symptoms;
• there is a medical reason which prevents you from having surgery;
• medication which reduces swelling or relieves pain would provide you with adequate relief;
• physical measures would improve your condition.

When is a Spinal Endoscopic Procedure an Option?

A lumbar microdiscectomy can be an option for treating low back pain and numbness and tingling in the legs. This type of surgery is performed by orthopedic surgeons and neurosurgeons who are experts in diagnosing the causes of back and neck pain and recognizing when a patient is likely to get better with surgery. However, surgery is not always the first option, and it is usually recommended only when specific conditions are met. Surgery is usually recommended when a ruptured disc is causing back pain and pinching a spinal nerve root(s) and only after the pain has failed to improve with time, physical therapy, and medications. The specific indications for performing a discectomy include:

• Leg pain which limits your normal daily activities
• Weakness in you leg(s) or feet
• Numbness in your extremities
• Impaired bowel and/or bladder function

If you, or someone in your family is experiencing these types of symptoms, then you should see an orthopedic surgeon or a neurosurgeon who specializes in spine surgery. Your surgeon will be able to discuss what type of procedures might be right for you and whether or not you would be a candidate for a microsurgical discectomy.

The Risks of Having Surgery

Some of the more common risks of having any surgery include excessive bleeding, infection, or a negative reaction to anesthesia. Clinical experience and scientific calculation indicate that these risks are low, but surgery is still a human effort. You should feel free to ask any questions you have about your specific risk factors.

Since the procedure involves surgery in and around the spine, further nerve damage is a possibility. In some cases, the nerve is already so damaged that the surgical procedure required to simply reach the nerve could be the "straw that breaks the camel's back." The end result could be numbness, paralysis or a loss of bowel and bladder control. (However, deciding not to have surgery may have exactly the same consequences. Your decision should be based on a weighing of the risks of having surgery versus the risks of not having surgery.)

The Benefits of Having Surgery

You can think of surgery as the first step in the healing and recovery process. It can help relieve pressure on your spinal nerve(s) and, thereby, help relieve your pain. It also may help you begin the process of regaining some of the lost mobility in your extremities.

The Endoscopic Spine Surgery Procedure and its Specific Benefits

The endoscopic spine surgery is an operation on the lumbar spine performed using a surgical endoscope and microsurgical techniques.

The Endoscopic Disc procedure requires only a very small incision and will remove only that portion of your ruptured disc which is "pinching" one or more spinal nerve roots. The recovery time for this particular surgery is usually much less than is required for traditional lumbar surgery.

Your Chances for Success Your level of healing will be determined by your age, your general health and the severity of the damage to your spinal nerve, as well as your attitude and your willingness to work at recovery.

Arthroscopic ACL repair

Endoscopic view of disc removal

Scar After Operation

Making Your Decision

When you consider your options, keep in mind the impact your condition has on your way of life and carefully weigh the risks and benefits of having surgery against the risks and benefits of not having surgery. The decision is yours.

If You Decide to Have Surgery...

Approach your surgery with a positive mental attitude and with full confidence that you have made the right decision. While the surgeon concentrates on finding and removing the cause of your pinched nerve, you must concentrate on the recovery process. Cooperate fully with your surgeon and focus on the improvements you will make in the future not on the problems of the past.

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