What About Disc Surgery?
What About Disc Surgery?
By Dr. Jeffrey Carlson
Have you ever heard a horror story about a back or neck surgery that somehow went terribly wrong, making things worse? Alternatively, do you know someone who has done extremely well after spine surgery, achieving relief of symptoms and a return to enjoyable activities? Disc surgery of the lower back or neck has long been the gold-standard for improving function and pain in those patients with disc herniations. There are, however, good and poor outcomes that may result from any surgery. With this in mind, what can be expected after disc surgery?
As background, the discs in the neck or lower back are the cartilage filled joints that allow our spines to move. As with any other mechanical part, these joints can wear out or rupture, causing pressure on the nerves that are nearby. These "pinched nerves" can generate pain in the arm or leg that can be quite severe. Generally, pinched nerves can be treated with oral or injectable anti-inflammatory medications, physical therapy, traction and rest.
When the nerve pain is not mitigated using these conservative methods, surgery is considered to provide pain relief. The basic concept of the surgery is to remove the offending piece of disc from pinching the nerve. Only that portion of the disc that is pushing on the nerve is removed and not the whole of the disc. Even with large disc herniations, most surgery only removes 10-20% of the disc. This leaves enough of the disc for the vertebrae to move and prevents them from rubbing on each other.
Over the past 10 years, many improvements have been made to the technology used and the approaches for Spinal Disc Surgery. Surgical incisions are now usually about 1 inch long versus the 3 inch incision of the past. Incisions sites are now injected with a numbing agent after surgery to greatly reduce post-operative pain. The surgery itself takes about 30-45 minutes to perform (previously - 90 minutes) and most patients will wake-up after the surgery without leg or arm pain. The only restriction after surgery is a limitation on lifting for the first 6 weeks of recovery. In our more athletic patients, we allow them to get back to conditioning during the 6 week recovery period. After 6 weeks, there are no restrictions, and patients can return to their normal daily activities as well as their normal athletic activities.
Several studies have evaluated the effects of disc surgery on a patient's ability to return to normal activities. The most recent study involved disc surgery done on NFL professional football lineman in the American Journal of Sports Medicine. As lineman are the largest football players, as well as incurring the most strain on their backs during play, these athletes can be completely incapable of a high level of performance, even with mild back pain. This recent study found, of the 52 players treated with surgery, 81 percent returned to play professional football. Of the 36 starting lineman that had surgery, 33 returned to their starting position on their professional football team. So for those of us who don't stress our backs like professional football players, we should be back to our normal activities very quickly and with high levels of satisfaction about our recovery. There were no complications in any of these patients. The complication rate in disc surgery nationally is less than 1%. Unfortunately, when complications happen, these patients may take 3-6 months to recover.
More than 90% of patients will improve after a disc herniation with medications, injections and physical therapy. However, with progress in surgery and improved recovery, there is no need to live with the pain of a disc herniation. It is important that you consult a highly-qualified, fellowship-trained spine specialist for diagnosis and effective treatment. Leveraging today's technology and the expertise of a skilled Orthopaedist, herniated disc patients are able to return to their life faster than ever before AND with increased function and complete pain relief.
Dr. Jeffrey R. Carlson is an orthopaedic doctor with the Orthopaedic & Spine Center in Newport News, VA, offering services such as Virginia Beach spine surgery and other Virginia Beach orthopedics procedures. The Orthopaedic and Spine Center can be found online at: OSC-Ortho.com.