What are my alternative options to disc surgery?
Treatment options for neck or low back pain
When a patient presents with a herniated cervical or lumbar disc with clinical evidence of nerve root irritation (cervical or lumbar radiculopathy), he or she has several choices: no surgery, traditional open surgery, microscopic surgery or micro-endoscopic surgery. If he or she chooses no surgery, evidence shows that the herniated disc may decrease in size or disappear within a few weeks or months. Epidural injections may also prevent the need for neck or back surgery.
Types of surgical treatment: open discectomy vs. micro-discectomy
Surgery is generally reserved for patients who fail to respond to conservative treatment or have significant or progressive weakness or loss of sensation due to irritation of a nerve root by a herniated disc.
Traditional Open Discectomy
A traditional open discectomy causes considerably more disruption of spinal tissues than a microsurgical procedure usually resulting in a longer recovery time.
A microsurgical discectomy is minimally invasive and is less disruptive of spinal tissues usually resulting in a shorter recovery time.
The goal of surgery is the removal of any material (usually disc material) pressing on the spinal nerve. At the least, the portion of the disc which protrudes into the spinal canal is removed. More aggressive surgery involves exploring the ruptured disc for any loose fragments. The aim of the more aggressive approach is the prevention of recurrent disc herniation.
An even less invasive form of cervical or lumbar disc surgery involves the use of endoscopes. An endoscope is a long thin tube which contains a light and a video camera allowing the surgeon to visualize the spinal structures on a monitor. The surgery is performed using very fine instruments through the same tube (also called a cannula).
How to avoid the need for disc surgery
Dr. Grimm often will prevent the need for disc surgery by performing epidural injections and/or prescribing physical therapy.