My Spine - Lumbar
2. Pain that does not respond to any other treatment modality and is suffi-
ciently 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
prolapsed (herniated) disc. Please see the relevant chapter regarding the pro-
cedure that your specialist is suggesting.
Does this treatment have any 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. Speak to your special-
ist about a more comprehensive list of possible complications (see the chap-
ter Your Back Operation).
What are the long-term expectations?
Lumbar degeneration and lumbar disc disease are progressive entities. In
cases where the disease is conservatively managed, it is possible that the her-
niated portion may retract and no longer cause symptoms or require surgery.
When only a portion of the slipped (herniated) disc is surgically removed,
there is a possibility that another piece of the remaining disc may herniate and
compress a nerve root, requiring further surgery. When the disc is complete-
ly removed and a fusion is formed, this may accelerate the degeneration
process in the adjacent discs. It is obvious that disc degeneration is a progres-
sive entity that may well require further treatment in the future, no matter
what treatment is instituted.
34