Ruptured disc surgery
Ruptured disc surgery — open spine and minimally invasive options
Ruptured disc surgery is usually only necessary for patients whose neck or back pain is severe enough that it limits their ability to work, exercise or take care of themselves. Typically, the number of patients requiring ruptured disc surgery is small—less than 10 percent of all patients who are diagnosed with a ruptured disc ultimately need surgical intervention. This is because it’s possible — and even likely — for the body to reabsorb ruptured disc material on its own. As a result, a physician will typically recommend that the patient focus exclusively on conservative measures for the first few months of treatment. However, a physician may recommend ruptured disc surgery in cases of significant nerve damage, or if a patient has tried several conservative treatment options, such as physical therapy, but is still experiencing severe pain.
Before turning to ruptured disc surgery, patients may be advised to try nonsurgical treatments such as:
- Medications — Anti-inflammatory medications and painkillers are two of the most common recommendations for conservative ruptured disc treatment. Patients can work with their physicians to find a specific medication and dosing regimen that’s best for their specific needs; over the counter and prescription options are both available.
- Physical therapy and exercise — Many patients find relief from ruptured disc pain by stretching and strengthening the muscles in the neck and back, enabling those muscles to take pressure off the damaged disc. An experienced physical therapist can assemble and demonstrate a list of exercises that can help a patient become stronger and more flexible. (And, in the event that weight loss is recommended to help reduce the amount of stress a patient’s spine sustains on a daily basis, a regimen that incorporates both strengthening exercises and low-impact cardio can help a patient lose excess weight and improve their overall fitness.)
- Heat and ice therapy — Warm compresses and ice packs can provide short-term pain relief, and generally have no negative interactions with other types of treatment. Heat has a mild analgesic effect, which can help reduce a patient’s perception of pain; ice can help reduce swelling and inflammation. Sometimes, alternating the two can be effective as well.
- Epidural steroid injections — Comprised of a long-lasting steroid and a temporary numbing agent, epidural steroid injections may provide longer-term pain relief when other conservative methods aren’t providing the desired results. Sometimes, a single injection can provide several weeks — or even several months — of relief.
In addition to these traditional treatments, alternative therapies can also be a part of a patient’s nonsurgical ruptured disc treatment plan. For instance, chiropractic adjustments can bring the spine back into proper alignment, helping to alleviate neck or back pain. Therapeutic message can alleviate tension in sore muscles, as can yoga; these options may be beneficial for patients who are looking to avoid ruptured disc surgery.
In the event that conservative and alternative treatments don’t work and surgical intervention is required, there are several types of surgery that might be used to treat a ruptured disc. For instance, a laminectomy can be performed to remove all of a lamina, or the upper covering of a vertebra. This procedure can help create more space for the nerves and in turn relieve pressure on the nerve root that’s causing pain. However, like all open back surgeries, a traditional open laminectomy can take quite some time to recover from, and patients face a relatively high risk of complications such as muscle damage and infection. This leads many patients to consider minimally invasive procedures instead.
At Laser Spine Institute, we offer several minimally invasive procedures that can be an alternative to an open neck or back operation. These state-of-the art surgeries are performed on an outpatient basis, so patients can return home shortly after their operation to continue their recovery in a more comfortable and familiar setting. Additionally, the average recovery times for our procedures are shorter than the average recovery times for more invasive open spine operations, and the complication rates are lower as well.
After evaluating a patient’s individual needs, our team may recommend one of the following minimally invasive decompression surgeries as a form of surgery for a ruptured disc or similar spinal condition:
- A laminotomy, during which a surgeon removes part of the lamina, or the bony arch that surrounds the spinal cord
- A foraminotomy, during which a surgeon removes bone and tissue that is compressing one of the spinal nerves that branches out of the spinal cord
- A discectomy, during which a surgeon removes a portion of a bulging or herniated disc that is compressing the spinal cord or a nerve root
- A facet thermal ablation, during which a surgeon uses a laser to deaden the facet joint nerve that is sending pain signals to the brain
Sometimes, a minimally invasive stabilization (MIS) procedure may be more appropriate, in which case our team might recommend:
- A decompression with Interlaminar Stabilization™ device, during which a surgeon decompresses a compressed nerve root (or part of the spinal cord), then inserts a specialized coflex® device to stabilize the spine
- An anterior cervical discectomy fusion (ACDF), during which a surgeon removes a disc and stabilizes the spine through a small incision in the front of the neck
- A cervical disc replacement, during which a surgeon replaces a deteriorated vertebral disc with an artificial disc
- A transforaminal lumbar interbody fusion (TLIF), during which a surgeon removes a damaged disc and inserts a bone graft and a spacer into the disc space through a small incision
- A lateral lumbar interbody fusion (LLIF), during which a surgeon removes most of an intervertebral disc and restores the proper disc height with a spacer, while accessing the surgical site through small incisions on the side of the body
- An SI joint fusion, during which a surgeon stabilizes the part of the spine where the sacrum meets the pelvis
- A posterior cervical fusion, during which a surgeon fuses together two or more of the vertebrae in the upper (cervical) part of the spine, accessing the area through a small incision in the back of the neck
If your symptoms aren’t responding to conservative ruptured disc treatments, you may need more progressive treatments, like ruptured disc surgery. For a review of your MRI, and to learn more about our surgical options, contact us today.