Herniated Disc Surgical Procedures

Several surgical procedures exist to address severe back pain that does not go away after four to six weeks of conservative treatment such as rest, modified activity and pain medication. The surgical options, generally only undertaken or needed by 1 out of every 10 people suffering from such back pain due to a herniated disc (disk), include the minimally invasive (chemonucleolysis) as well as the open decompression options (diskectomy and microdiskectomy).

Herniated Disc (Disk) Defined

• The human spine contains vertebrae discs (bone pads, if you will). These discs are made up of an outer hardened shell known as an annulus, which contains a soft (jelly-type) material on the inside known as the nucleus tissue. They become herniated when the outer shell weakens---usually near the spinal cord and due to pressure of some sort---allowing the nucleus tissue to protrude out of the damaged annulus and come into contact with nerves in the spine.

Herniated Disc Cause

• More often than not, the pressure that causes the disc to become herniated is due to an individual's normal wear and tear associated with aging (also known as degenerated disc). But attempting to lift items that are too heavy, or twisting while lifting a heavy item can cause the tear to the annulus (disc) too, according to the Mayo Clinic. And, although more rare, a herniated disc can also be caused by a serious trauma or fall.

Chemonucleolysis: Minimally Invasive

• Chemonucleolysis, a procedure in which the affected disc is injected with enzyme from tropical papaya trees (sometimes providing immediate pain relief), is not performed in the United States very often because of potential complications including allergic reaction and neurological concerns.

  But sensitivity testing, proper surgical technique usage and a complete medical history evaluation prior to surgery can make it a viable option, due to its 70 to 80 percent success rate (potentially preventing more serious surgery), according to the Mayo Clinic.

Microdiskectomy

• The most common surgical procedure for a herniated disc is a microdiskectomy. If a reduced hospital stay is desired, and your doctor does not have any concerns about possible side disc damage or decreased space--and is comfortable using a microscope and smaller incision--than the microdiskectomy has an 80 to 90 percent success rate and can be performed as outpatient surgery. If the surgery is done in the hospital, generally only a one- to three-day stay is required.

Diskectomy

• Sometimes it becomes necessary to remove a large part of the disk during surgery, especially if the disc is causing pain in the leg rather than the back. Diskectomy surgery allows for such removal, while also providing the patient with the option of outpatient surgery.

  Pain is not always immediately relieved, though, and the patient may also have incision pain with this surgery type, since incisions are larger. Regular sedentary work can be resumed in as few as two to four weeks after surgery, with regular physical activity generally okay six to eight weeks after surgery.