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How Often Is Surgery Necessary for Herniated Discs?


It is often possible to treat or manage the symptoms associated with a herniated disc without surgery. While it is rarely a first recommendation, for some people, surgery may be required. According to research cited by Harvard Health, about 10 percent of patients with herniated disc issues require surgery after six weeks. Similar research suggests that 90 percent of the time, surgery is not necessary for a herniated disc. This article details what you need to know about herniated discs and surgery.

Can Nonsurgical Treatments Be Beneficial?

National Library of Medicine references research on patients with a history of herniated disc issues. Up to 90 percent of patients questioned reported "good to excellent" outcomes with nonsurgical management efforts. This further emphasizes the fact only a small percentage of patients typically require surgery for a herniated disc. Part of the reason for this is because of the many nonsurgical options available today. The more commonly recommended options include:

• Medication
• Hot and cold therapy to manage flare-ups
• Steroid injections in the affected area to improve results with physical therapy
• A personalized physical therapy routine
• Lifestyle adjustments (e.g., improving posture, eating nutrient-rich foods, getting regular exercise)

When Is Surgery Required?

There is a difference between "requiring" surgery for a herniated disc and "considering" it. Disc-related surgery, which often involves a
discectomy or microdiscectomy to remove part of the protruding disc material, is likely to be required if any of the following circumstances apply:

• Symptoms include a loss of bowel or bladder control due to how a nerve is compressed
• Discomfort is coupled with severe radiating nerve pain
• Mobility is severely affected
Lower back pain is severe and no other treatments are effectively managing it

When Is Surgery Worth Considering?

As long as the symptoms experienced are not severe or potentially dangerous, surgery may not be recommended right away. With situations like this, conservative treatments are typically recommended for several months. However, if symptoms are still difficult to manage after 5–6 months, surgery may be discussed. Even in this instance, whether or not surgery for a herniated disc is worth considering depends on patient-specific factors, such as:

• General level of activity
• What is considered "manageable" as far as symptoms are concerned
• Goals or expectations with surgery
• Whether or not there are other nonsurgical options that have not been explored

Why Is Proper Diagnosis Important?

More often than not, surgery for a herniated disc is not required or immediately necessary. While this is good news for many patients, it is still best to get an accurate diagnosis before any decisions are made. There are many potential sources of spine-related pain, so it is important to rule out other possibilities. It is also worth knowing surgery for a herniated disc is often performed with minimally invasive techniques, such as those used with microdiscectomy. If your surgeon recommends having a microdiscectomy, it means you will likely have a shorter recovery period than what was once common with disc-related surgery.

If you have a herniated disc that is not responding to conservative treatment, a discectomy may be discussed and potentially recommended. Although this is generally a very successful procedure, having a large hole in the outer ring of the disc more than doubles the risk of needing another operation. A new treatment, Barricaid, is a bone-anchored device that closes this hole, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment, ask your doctor or contact us at 844-288-7474.

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