Purpose of Herniated Disc Surgery

Herniated disc surgery, also known as a spinal discectomy, is a procedure that is performed to decrease pain, limited mobility, and weakness that is caused by nerve compression from a spinal disc herniation. When a disc herniates it may cause pressure on a spinal nerve that travels down your leg or arm.

The purpose of surgery for a herniated disc is to remove pressure from the nerve, thus relieving pain, improving strength and flexibility, and restoring normal motion. Herniated disc surgery is typically performed by an orthopedic or neurological surgeon.

Diagnosis Related to Herniated Disc Surgery

Herniated disc surgery is performed on people with a diagnosed disc herniation. Your spinal discs are small shock absorbers that are situated between your vertebrae, or spinal bones. There is an outer covering of the disc that surrounds a jelly-like material.

Sometimes poor posture, trauma, heaving lifting, or wear and tear causes pressure against the discs. When this happens, the jelly inside the disc pushes out of place and compresses a spinal nerve. This compression may cause a host of conditions, including:

• Back pain
• Sciatica
• Cervical radiculopathy
• Foraminal stenosis

Any of these conditions may cause symptoms that may lead you to consider herniated disc surgery. Symptoms of a herniated disc may include:

• Back or neck pain
• Pain in your arm or leg
• Weakness in your arm, hand, or leg
• Numbness and tingling in your arm or leg
• Changes in your bowel or bladder function

If you have any of these symptoms, visit with your physician right away. They will be able to assess you for a herniated disc and get you started on treatment.

Most people with a herniated disc do not require surgery to correct the problem. There is a continuum of care that usually occurs prior to considering herniated disc surgery. This may include:

• Exercise
• Physical therapy or chiropractic care
• Pain medication
• Spinal injections

The goal of these treatments is to decrease your pain and inflammation caused by the herniated disc, improve your mobility, and improve function related to sitting, standing, and walking.

Occasionally, conservative measures fail to adequately relieve your pain and restore your functional mobility. In this case, herniated disc surgery may be considered.

Surgery for a herniated disc is often an elective procedure. It is performed non-emergently to reduce pressure on a spinal nerve.

In rare cases, the surgery may be done as an emergency procedure. For instance, if you have a herniated disc that is causing severe weakness or paralysis in your arm, hand, or leg muscles, then your surgeon may recommend surgery right away in an attempt to quickly reduce nerve compression in hopes of restoring normal nerve conduction and strength to your weakened or paralyzed extremity.

Cauda equina syndrome is another condition that may require rapid surgical intervention. This condition is caused by a herniated disc that is compressing the nerves that serve your anus and bladder. Symptoms of cauda equina syndrome include:

• Difficulty initiating urination
• Difficulty prevent bowel movements
• Numbness and tingling in the area around your genitals and rectum, also known as saddle anesthesia

This condition requires rapid decompression of the nerves that are being pinched from the herniated disc to recover normal bowel and bladder function.

Criteria

Not every person is a candidate for spinal disc surgery. There are established criteria that you must meet prior to having surgery. This may include:

• Proper diagnosis of a herniated disc
• Significant pain
• Difficulty with normal functional mobility
• Attempts at conservative management prior to considering surgery

If you are having pain and limited mobility due to a confirmed spinal disc herniation, and if you have attempted reasonable conservative treatments but have failed to gain adequate mobility or pain control, then your surgeon may consider you to be a candidate for herniated disc surgery.

Tests and Labs

Prior to considering surgery for cervical or lumbar radiculopathy due to a herniated disc, you must have certain tests and measures. These may include:

• X-ray: This test assesses your spinal bones and alignment and rules in or out a spinal fracture.
• Magnetic resonance imaging (MRI): This test allows your surgeon to visualize the soft tissue around your spine. An MRI will likely be used to diagnose your herniated disc and give your surgeon an idea of the severity of the nerve compression caused by the herniation.
• Computed tomography (CT) scan: This diagnostic test provides your physician with a three-dimensional picture of your spinal bones and may be used to rule out a fracture or bony problems that may be causing your spinal pain.
• Electromyographical (EMG) test: An EMG is used to examine which nerve or nerves are impaired as a result of your herniated disc.

Once you have had these diagnostic tests, your surgeon will have a nearly complete picture of the herniated disc and nerve compression that is likely causing your pain.

If surgery recommended, you will likely have to have a few other tests done to ensure that surgery is safe for you. These may include:

• Cardiac function tests
• Chest X-ray
• Pulmonary function tests
• Blood tests

These tests are used to ensure that it is safe for you to have herniated disc surgery and that you can tolerate the anesthesia that is used during the procedure.

A Word From Verywell

If you have having leg or arm pain that is caused by a herniated disc, you may benefit from a discectomy. The purpose of this herniated disc surgery is to cut away the disc and relieve pressure from your spinal nerve. Decompression of your spinal nerve can help you feel better, move without pain, and regain normal mobility related to sitting, standing, and walking.