Surgery for herniated discs is sometimes a medical necessity. Sometimes the doctor and the patient make this decision together. The first question is that patients who go to the doctor with complaints of low back and leg pain and who have a herniated disc in their MRIs are wondering whether surgery is necessary or when surgery is needed.

 

Is Surgery Necessary For Herniated Disc?

In cases that start suddenly or last for a long time, make low back movements difficult, even lock the waist, and can hardly walk, patients seek a remedy for treatment. They want to return to their pain-free life as soon as possible. At this stage, sometimes the patient is stuck with the hernia phenomenon instead of functionality. With the removal of the hernia, he wants to return to normal anatomically and physiologically. Most of the time, the diagnosis of herniated discs defines the patient’s problems in a simple framework. Surgery can be appealing as it offers a straightforward solution to this well-defined problem. However, low back pain is a more complex problem. Doctors attach importance to surgery for every herniated disc. The success rate of back surgery is closely related to the proper selection of patients who are likely to benefit. If every patient with a hernia in the lumbar MRI had been operated on, the success rate of the operations would have been shallow. For this reason, “when is the hernia operated on?” The answer to the question is significant.

Another question is, “What percentage of herniated discs need surgery?”. It is challenging to answer this question clearly, but the cases that do not require surgery are more in percentage.

Should A Hernia Patient Have An Operation Immediately?

Although the herniated disc is a critical problem that causes low back and leg pain, in most cases, the complaints resolve over time (1-1.5 months) with treatment or spontaneously. Most people recover with methods such as changing activities of daily living (for example, not lifting heavy weights), exercises to strengthen the back, physical therapy, and pain medications. Surgery can be considered in patients whose complaints do not resolve with these and similar non-surgical treatment options. In most cases, a herniated disc is not operated on immediately. Giving a waiting period gives the patient a chance to recover without surgery. For this period, some experts advocate waiting six weeks, some experts three months, and others six months. However, there are some cases where doctors should perform lumbar hernia surgery without wasting time.

What Is A Severe Disc Herniation?

This type of hernia usually requires surgery. The spinal bones (vertebrae) are separated by discs that act as cushions between the bones and provide movement. A herniated disc is when the disc protrudes from the pressure of the spine, causing pain by pressing on the surrounding nerves. The discs may be pushed from one place to another by the effect of the force, or the impact of the tension may just tear them off. This can pressure neighboring nerves, causing pain, numbness, or weakness. Sometimes it may not cause any complaints.

A hernia can be seen in every part of the spine (from the neck to the coccyx). However, it is most commonly seen in the waist, then in the neck, and rarely in the back.

Situations In Which It Is Not Recommended To Wait For Herniated Disc Surgery

Surgery should be performed without delay if a lumbar hernia compresses certain nerve roots and neurological symptoms such as weakness and loss of sensation in the muscles stimulated by these nerve roots. Cauda equina syndrome, in which bladder and bowel functions are impaired, is also a problem that requires urgent surgery.

Lumbar hernias can be operated on with different techniques such as laminectomy, discectomy, micro-discectomy, artificial disc surgery, and spinal fusion. My preferred method is micro-discectomy, with the microsurgery method with the highest success rate.

Is The Patient’s Opinion Important In The Decision Of Herniated Disc Surgery?

Most of the time, the patient and the doctor decide on surgery for a herniated disc. In this case, the patient should think about the following questions:

• Am I comfortable with the idea of ​​back surgery? Or is surgery something I want to avoid altogether?
• I’ve tried exercise, medication, and physical therapy for several months. Did these work or not?
• Is my pain so severe that I can no longer bear it, Or can I manage for a while?
• Do I need to reduce my pain immediately and return to work quickly, Or do I have time to recover slowly?

However, if your doctor has informed you that the condition mentioned above requires mandatory surgery, you should not waste time.

Lumbar Hernia Surgery Risks

Microdiscectomy and endoscopic microdiscectomy surgeries are low-risk procedures. However, as with all surgeries, hernia surgery also has risks. The literature has reported that approximately 5-10 percent of patients who underwent surgery recur the lumbar hernia. The risk of recurrence in the first three months after surgery is higher than in other periods. For this reason, you should be especially careful during the first three months of recovery and act as your doctor recommends during this period.

What Is The Success Rate Of Herniated Disc Surgery?

The surgical success rate in the herniated disc is 95 percent with correct diagnosis and corrective surgery. There is a 5% risk of surgical complications. Less than a 1% probability; Damage to the nerves, infection, blood collection, and anesthesia-related complications may occur. Complications due to fatal internal organs or main vessels injuries or excessive blood loss occur at one in ten thousand.