Herniated disc surgery can sometimes cause numbness or weakness in one or both legs. Paralysis is one of the rarest of all potential complications (1 in 10,000) of herniated disc surgery.
While extremely rare, paralysis or nerve injuries can occur due to damage to the spinal column during the operation.
What is a herniated disc?
Spine vertebrae are padded by discs between each bone, which function as shock absorbers. When a disc is herniated (also called slipped or ruptured disc), part of the disc nucleus is pushed out of the annulus into the spinal canal. Since there is limited space in the spinal canal, the disc bulge pushes against spinal nerves, thereby causing pain.
Herniated discs can occur anywhere in the spine but are most common in the lower back (lumbar spine) and the neck (cervical spine). The region where the pain is felt depends on which portion of the spine is affected.
How is herniated disc surgery performed?
Most herniated discs don't require surgery, as symptoms may resolve on their own. In some cases, the herniated disc may not cause symptoms at all.
If the pain does not get better with conservative treatment measures, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and physiotherapy, your doctor may suggest surgery depending on the degree of pain and disability. The goal of herniated disc surgery is to reduce pressure on the nerve, thereby easing pain and other symptoms.
Common techniques used to alleviate pressure on the nerves include:
- Open discectomy: The surgeon accesses the disc directly through an incision to remove the herniated part of the disc.
- Endoscopic spine surgery: The surgeon uses an endoscope to remove the herniated segment of the disc. This procedure is minimally invasive, requiring only a small incision. This results in only a small scar that can heal easily.
- Core spinal disc surgery: The surgeon accesses the core of the spinal disc and uses a vacuum to remove it. This makes the spinal disc smaller, which reduces pressure on the spinal nerve.
- Laminotomy or laminectomy: Vertebrae have a part that covers and secures the spinal canal called lamina. A laminotomy removes part of the lamina, whereas a laminectomy removes the entire lamina. Both procedures involve making a tiny incision down the center of the back or neck over the region of the herniated disc. Post-surgery, the surgeon performs a discectomy to remove the herniated disc. There are two types of laminotomies and laminectomies:
- Lumbar surgery: Eases leg or sciatic pain caused by a herniated disc in the lower back region.
- Cervical surgery: Eases pain in the neck and upper limbs caused by a herniated disc in the neck area.
- Spinal fusion: Following a laminotomy or laminectomy, a spinal fusion (SF) may be necessary to stabilize the spine. An SF includes joining two bones with screws.
- Artificial disc surgery: In artificial disc surgery, the surgeon replaces the damaged disc with an artificial one.
QUESTION
Nearly everyone has low back pain at some time during their life. See AnswerAmerican Academy of Orthopaedic Surgeons. Herniated Disk in the Lower Back. https://orthoinfo.aaos.org/en/diseases--conditions/herniated-disk-in-the-lower-back/
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Surgery for a slipped disc. https://www.ncbi.nlm.nih.gov/books/NBK279471/
NYU Langone Hospitals. Surgery for Herniated Disc. https://nyulangone.org/conditions/herniated-disc-in-adults/treatments/surgery-for-herniated-disc
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