Lumbar Disc Herniation Treatment Options
Treatment for lumbar disc herniation usually begins with conservative, non-surgical therapies which are often highly effective. Most patients will recover with 6 to 12 weeks of conservative management. If symptoms continue despite conservative management, surgical intervention can be considered. What are the treatment options for a lumbar disc herniation?
Non-surgical treatment of lumbar disc herniation
Non-operative treatments are usually the first line treatment for most patients with lumbar disc herniation. A number of supportive therapies are aimed at decreasing inflammation, controlling pain, and preventing re-injury including:
- Gentle heat
- Anti-inflammatory and pain medicines (NSAIDs, Tylenol, oral steroids, muscle relaxants)
- Physical therapy
- Epidural steroid injection (if pain is not controlled with oral medication)
Surgical treatment of lumbar disc herniation
Surgical management is the gold standard treatment for a lumbar disc herniation. Minimally invasive techniques decrease postoperative pain and provide faster recovery.
Minimally invasive lumbar microdiscectomy is a surgical procedure performed to treat herniated or ruptured discs in the lumbar (lower) region of the spine. It is a much less invasive alternative to traditional open surgery and aims to relieve pressure on the spinal nerves and alleviate associated pain.
During the procedure, Chicago spine surgeon, Dr. Singh makes a one – to two – cm incision (the size of a dime), in the back near the affected disc. The muscles surrounding the spine are gently separated, rather than cut or detached, which helps to minimize tissue damage and reduce postoperative pain.
Using specialized instruments and a surgical microscope, Dr. Singh visualizes the nerve root, and carefully removes the portion of the herniated or damaged disc that is compressing the spinal nerves without damaging the rest of the disc that functions as the shock absorber in the spine.
By removing the disc material, the pressure on the nerves is relieved and symptoms such as back pain, leg pain, and numbness are alleviated. The procedure takes less than 30 minutes and patients go home within two hours after surgery.
Minimally invasive lumbar microdiscectomy offers several potential benefits compared to open surgery, including smaller incisions, reduced muscle and tissue damage, less blood loss, shorter hospital stays, and faster recovery times.
An endoscopic laminectomy and discectomy is an ultra-minimally invasive surgery that uses a 10 millimeter or smaller skin incision (pen tip sized incision) and a camera to perform the procedure much like a knee arthroscopy.
Through these incisions, specialized surgical instruments and an endoscope (a thin, flexible tube with a camera) are inserted. Throughout the procedure, Dr. Singh uses the camera to capture and project real-time images of the operative site onto a monitor.
The lamina (the bony arch of the vertebra) may be partially or completely removed to access the spinal canal. This allows Dr. Singh to relieve pressure on the nerves by removing any disc material, bone spurs, or other structures causing compression. If a herniated disc is present, a discectomy may be performed to remove the protruding or damaged portion of the disc.
The images and videos of the disc bulge and nerve root are provided to the patient following surgery.
Lumbar endoscopic laminectomy/discectomy offers several potential benefits compared to even a minimally invasive discectomy. Advantages include smaller incisions, almost no muscle and tissue damage, no blood loss, and even faster recovery times. Additionally, the use of the endoscope provides improved visualization, allowing for precise surgical maneuvers and potentially better outcomes.
Minimally invasive lumbar spinal fusion is a surgical procedure performed to stabilize and fuse two or more vertebrae in the lumbar region of the spine. It is commonly used to treat recurrent lumbar disc herniations (those disc herniations that have happened again at the same level where the disc is completely worn out).
Instead of making a large incision, Dr. Singh makes several small incisions, usually less than an inch each (size of a quarter), in the back or side of the body. Through these small incisions, specialized surgical instruments and a tubular retractor system are inserted. In minimally invasive fusions, this special equipment allows for a much smaller incision without cutting muscles that permits Dr. Singh the ability to perform these procedures as an outpatient. Patients typically leave the surgery center 3-4 hours after the surgery.
Patients undergoing minimally invasive lumbar fusion are discharged home the same day and are able to walk following surgery in the surgery center. Most patients are able to return to work within 2-3 days after the surgery.
Schedule a consultation
If you or a loved has low back pain, contact Chicago spine surgeon Dr. Kern Singh who can assess your situation, provide an accurate diagnosis and guide you on the most suitable treatment options.
Dr. Kern Singh, MD is an internationally renowned spine surgeon specializing in outpatient minimally invasive and motion-preserving techniques and endoscopic spine surgery at Midwest Orthopaedics at Rush and Professor in the Department of Orthopaedic Surgery at Rush University Medical Center in Chicago, Illinois. Dr. Kern is one of the nation’s Top 100 spine surgeons and beloved by his patients for his compassionate care and excellent outcomes. He welcomes nationally and internationally-based patients.
- Alvi MA, Kerezoudis P, Wahood W, Goyal A, Bydon M. Operative Approaches for Lumbar Disc Herniation: A Systematic Review and Multiple Treatment Meta-Analysis of Conventional and Minimally Invasive Surgeries. World Neurosurg. 2018 Jun;114:391-407.e2. doi: 10.1016/j.wneu.2018.02.156. Epub 2018 Mar 14. PMID: 29548960.
At A Glance
Dr. Kern Singh
- Minimally invasive and endoscopic spine surgeon
- Inventor and surgeon innovator with multiple patents in spinal surgery and instrumentation
- Author of more than 10 textbooks in minimally invasive spinal surgery
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