My Spine Explained
If conservative management is unsuccessful , surgery is usually indicated . In situations where there is muscle loss or sensation loss due to a compressed nerve , surgery is considered much earlier . Compression that continues for too long can cause permanent nerve damage ; the longer the duration of the symptoms , the less the chance of success when operating to decompress the nerves .
Invasive ( surgery ) – The indications for surgery are :
1 . Failed conservative management . This would include the use of analgesic medication , anti-inflammatory medication , physiotherapy and chiropractic treatment for a period of at least six weeks before surgery is contemplated . 2 . Pain that does not respond to any other treatment modality and is sufficiently severe to limit your daily activities and quality of life . This includes local lower back pain , referred pain and radicular pain . 3 . Muscle weakness due to nerve compression ( radicular weakness ). 4 . Spasticity of the legs . 5 . Cauda Equina syndrome or Conus Medullaris syndrome . These are serious conditions that are characterised by weakness , sensory loss and bowel and bladder dysfunction . These are emergencies that require immediate surgery .
There is a whole spectrum of operations that might be suitable for treating a herniated ( prolapsed ) disc . Please see the relevant chapter regarding the procedure that your specialist is suggesting .
Does this treatment have any complications ?
There are no real complications regarding conservative management of a slipped ( herniated or prolapsed ) disc beyond the fact that the clinical effects may increase , leading to surgery .
The surgical management carries rare , but potentially serious complications . The most common complications of surgery are infection and wound haematoma ( bleeding under the skin ). The most feared complication is nerve damage , but this is extremely rare , although not unknown . The outer layer of the nerves ( the dura ) can also be torn and this will lead to a leakage of spinal fluid ( cerebrospinal fluid ). This needs to be repaired .
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