What Percentage of Herniated Discs Require Surgery?

Herniated discs are a common spinal condition that can cause significant pain and discomfort. They occur when the inner gel-like core of a spinal disc bulges out through a tear in the outer layer, potentially compressing nearby nerves. This can lead to pain, numbness, tingling, or weakness in the affected areas. Given the discomfort and potential impact on quality of life, many people wonder if surgery is the only solution. This article will explore what percentage of herniated discs require surgery and discuss alternative treatment options.

Understanding Herniated Discs

The spine is made up of vertebrae separated by intervertebral discs that act as cushions, absorbing shock and allowing flexibility. When a disc herniates, the inner nucleus pulposus pushes through the outer annulus fibrosus. If the material compresses surrounding nerves, it can cause symptoms ranging from mild to severe, depending on the location and severity of the herniation.

Symptoms and Diagnosis

Common symptoms of a herniated disc include:

• Back pain that may radiate to the arms or legs
• Numbness or tingling
• Muscle weakness
• Loss of reflexes

Diagnosis typically involves a physical examination, medical history review, and imaging studies such as MRI or CT scans. These methods help doctors determine the exact location and severity of the herniation, guiding treatment decisions.

The Percentage of Herniated Discs Requiring Surgery

Despite the occasional dramatic symptoms, the majority of herniated discs do not require surgery. In fact, studies suggest approximately 10 percent of herniated disc cases eventually require surgical intervention. This means 90 percent of cases can be managed with nonsurgical approaches.

Nonsurgical Treatment Options

Given the high success rate of nonsurgical treatments, it is important to explore these options before considering surgery. Here are some common nonsurgical methods for managing herniated discs:

• Rest and activity modification – Sometimes allowing the body time to heal naturally with reduced physical activity can alleviate symptoms. However, complete bed rest is generally discouraged.
• Physical therapy – A structured physical therapy program can strengthen the muscles supporting the spine, increase flexibility, and reduce pain. Therapists may use exercises (such as lower back pain exercises), stretches, and other modalities to help patients manage symptoms.
• Medications – Over-the-counter pain relievers like ibuprofen and acetaminophen are often used to manage mild to moderate pain. In some cases, doctors may prescribe muscle relaxants or stronger pain medications.
• Epidural steroid injections – For more severe pain, epidural steroid injections can reduce inflammation and provide temporary relief, allowing the patient to participate in physical therapy or other conservative treatments.
• Chiropractic care and massage therapy – These alternative therapies can reduce pain and increase mobility. Chiropractic adjustments may relieve pressure on nerves, while massage therapy can alleviate muscle tension.

When Surgery Is Necessary

Surgery for herniated discs is typically considered only after nonsurgical treatments have failed to provide relief. In some cases, surgery may be recommended earlier if there is:

• Severe pain – Intense pain that does not respond to other treatments
• Neurological deficits – Significant muscle weakness or loss of function
• Bowel or bladder dysfunction – Symptoms that can indicate a more serious condition, such as cauda equina syndrome, requiring immediate surgical intervention

Common Surgical Procedures for Herniated Discs

If surgery is necessary, the following are common procedures used to treat herniated discs:

• Discectomy – This procedure involves removal of the herniated portion of the disc to relieve pressure on the nerve.
• Microdiscectomy – This minimally invasive procedure involves removing the portion of the disc that is pressing on a nerve. It is often performed on an outpatient basis and has a relatively quick recovery time.
• Laminectomy – In this procedure, the surgeon removes part of the vertebral bone (lamina) to relieve pressure on the spinal cord or nerves. It is typically used for more severe cases.
• Spinal fusion – In cases of spinal instability, spinal fusion may be required to stabilize the spine. This involves joining two or more vertebrae together, which can reduce pain but also limit mobility.

Prevention: Reducing the Risk

While not all herniated discs can be prevented, certain measures can reduce the risk, including:

• Regular exercise – Strengthening the core and back muscles
• Proper lifting techniques – Avoiding strain on the back by lifting with the legs
• Good posture – Maintaining spinal alignment to reduce pressure on the discs

Weighing Your Options

While surgery can be effective for some cases of herniated discs, the majority of cases can be managed with nonsurgical treatments. Understanding the range of options available and working closely with healthcare professionals is key to finding the best treatment plan. If you or someone you know has a herniated disc, remember surgery is not the only answer—explore nonsurgical options and seek professional advice to make informed decisions about your health and wellbeing.

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 directly.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.