Minimally Invasive Surgery for Herniated Discs: What You Need to Know

Q: Minimally Invasive Surgery for Herniated Discs: What You Need to Know

Hello： If the symptoms are indeed severe, the most immediate and effective approach so far is surgery. <br>Your concern about paralysis is likely minimal. <br>The intervertebral disc material removed during surgery is due to a herniation that has caused abnormal structures affect

Lumbar disc herniation - minimally invasive surgery for disc removal?

Two months ago, after moving, I gradually started having difficulty walking.
Pain began in my right hip and extended down to my calf.
I then went to see another doctor for treatment and received two sessions of physical therapy, but my condition worsened, and now the pain has extended to the soles of my feet.
I went to a large hospital for an examination and had an MRI, which revealed a herniation at the fourth and fifth lumbar vertebrae.
The doctor recommended rehabilitation and surgery, but as a student, I cannot commit to long-term rehabilitation.
I was hesitant about surgery, so I sought acupuncture treatment, which provided some relief.
The acupuncturist mentioned that my nerves were inflamed, but due to the long travel distance, I feel the effects are gradually diminishing, and the pain persists.
Eventually, I couldn't tolerate it anymore and went to another large hospital.
The doctor told me that the primary issue is severe compression at the coccyx area, and he suggested minimally invasive surgery to remove the cartilage.
However, I have heard from others that if the surgery fails, it could lead to paralysis.

Q1.
Is it really that serious?
Q2.
If the cartilage is removed, what kind of long-term effects can I expect?
Q3.
Will anything be implanted after the cartilage is removed, or will it just be removed without any replacement?
Q4.
How long will I need to rest before I can return to classes?
Q5.
Is there a chance of recurrence after the surgery?

BD, 20~29 year old female. Ask Date: 2016/06/17

Dr. Wang Shouji reply Orthopedics

Hello: If the symptoms are indeed severe, the most immediate and effective approach so far is surgery.
Your concern about paralysis is likely minimal.
The intervertebral disc material removed during surgery is due to a herniation that has caused abnormal structures affecting the spinal nerve roots.
Given your age, typically only the area compressing the nerve will be removed.
After surgery, you can return to class in a few days, but physical education classes may need to be postponed for about two to three months.
The recurrence rate at the surgical site is approximately 5%.
Thank you!

Reply Date: 2016/06/17

More Info

Minimally invasive surgery (MIS) for herniated discs is a topic that raises many questions, especially for those who are experiencing significant pain and discomfort, as you are. Your situation, involving a herniated disc at the L4-L5 level, is not uncommon, and it’s understandable that you have concerns about the surgery, recovery, and potential complications. Let’s address your questions one by one.

Q1: Is it really that serious?
Yes, herniated discs can lead to serious complications if left untreated, especially if they are causing significant nerve compression. This can result in chronic pain, weakness, or even loss of function in the affected leg. While the risk of paralysis from a herniated disc surgery is very low, it is not zero. The key is to weigh the benefits of surgery against the risks, especially if conservative treatments like physical therapy or injections have not provided relief.

Q2: What are the potential side effects of removing the disc material?
Removing the herniated portion of the disc can lead to several outcomes. Most patients experience relief from pain and improved mobility. However, there can be risks of complications such as infection, bleeding, or nerve damage. Additionally, some patients may experience residual pain or discomfort post-surgery. Long-term, there is a risk of developing degenerative disc disease in the adjacent discs due to altered biomechanics in the spine.

Q3: Will anything be put back in after the disc material is removed?
In minimally invasive surgery for herniated discs, typically, the herniated portion of the disc is removed, and no additional material is placed in its place. The goal is to relieve pressure on the nerve roots. In some cases, if the disc is severely degenerated, a surgeon might recommend a fusion or artificial disc replacement, but this is not standard for every case.

Q4: How long will recovery take before I can return to school?
Recovery time can vary significantly based on individual circumstances, the extent of the surgery, and your overall health. Generally, patients can return to light activities within a few days to a week after minimally invasive surgery. However, returning to full activities, including school, may take several weeks. It’s crucial to follow your surgeon’s advice regarding activity levels and rehabilitation.

Q5: Is there a chance of recurrence after surgery?
While surgery can relieve symptoms and improve function, there is always a possibility of recurrence, especially if the underlying causes of the herniation are not addressed. Factors such as poor posture, lack of core strength, or improper lifting techniques can contribute to future herniations. Engaging in a proper rehabilitation program post-surgery can help mitigate these risks.

In conclusion, minimally invasive surgery for herniated discs can be an effective option for those suffering from significant pain and mobility issues. It’s essential to have a thorough discussion with your healthcare provider about the risks and benefits specific to your situation. They can help you make an informed decision based on your symptoms, lifestyle, and treatment goals. Remember, taking care of your spine health is crucial, especially as a student who may be engaged in activities that put strain on your back.

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