Herniated Disc Treatment Options

Treatment options for a herniated disc depend on the location and severity of symptoms.

Herniated cervical disc treatment options

Conservative management is often the first option to treat a herniated cervical disc. It includes rest, pain management with over-the-counter pain medication, physical therapy which may include cervical traction, a cervical collar or neck brace, and exercises to improve neck strength and flexibility. Corticosteroid injections or nerve blocks may be used to reduce inflammation and relieve pain.

Procedures for a herniated cervical disc

In severe cases, surgery may be recommended to remove part or all of the damaged disc or to fuse two or more vertebrae together. Common surgical procedures for a herniated cervical disc include a cervical microdiscectomy or removal of the herniated disc, anterior cervical decompression and fusion, or cervical endoscopic foraminotomy with or without discectomy.

• Cervical microdiscectomy: A cervical microdiscectomy is a surgical procedure performed to treat a herniated cervical (neck) disc. The procedure is performed with an endoscope (a thin, tube-like instrument with a camera and light) to visualize the spinal anatomy and remove the damaged tissue inserted through a small incision in the neck and involves removing a portion of the damaged disc that is pressing on a nerve root or spinal cord. The goal of the surgery is to relieve pressure on the nerve, reduce pain, and improve function. During the procedure, Dr. Girardi will make a small incision in the neck and use a microscope or magnifying lens to visualize the damaged disc. The herniated portion of the disc is then carefully removed, relieving pressure on the nerve or spinal cord. In some cases, a small piece of bone may be placed to stabilize the vertebral segment after the disc has been removed.
• Anterior cervical decompression and fusion (ACDF): This is a surgical procedure performed to treat a herniated cervical disc, spinal stenosis (narrowing of the spinal canal), or other conditions that cause nerve compression in the neck. The procedure involves removing the damaged disc and fusing two or more vertebrae together to stabilize the neck and relieve pressure on the nerve. During the procedure, Dr. Girardi makes an incision in the front of the neck to access the damaged disc. The disc is then removed, and a spinal implant or bone graft is placed between the two vertebrae to promote fusion. The implant may be a metal plate, screws, or a cage filled with bone or bone substitute material. After the procedure, patients may need to wear a neck brace for several weeks and may need physical therapy to help regain strength and mobility. It’s important to discuss the potential risks and benefits of the procedure with your doctor, as well as the expected recovery time and outcomes.
• Cervical endoscopic foraminotomy: This procedure may be performed with or without discectomy. It is a minimally invasive surgical procedure performed to treat a herniated cervical disc or spinal stenosis (narrowing of the spinal canal). The procedure is performed through small incisions in the neck and uses a specialized endoscope (a thin, tube-like instrument with a camera and light) to visualize the spinal anatomy and remove the damaged tissue. During the procedure, Dr. Girardi will make one or more small incisions in the neck and insert the endoscope to visualize the damaged disc or stenosis. If a herniated disc is present, the damaged portion of the disc may be removed (discectomy). If spinal stenosis is present, the narrow area may be enlarged (foraminotomy) to relieve pressure on the nerve. Cervical endoscopic foraminotomy is a minimally invasive procedure that can provide relief from neck pain and improve function. It is typically performed as an outpatient procedure, with patients able to go home the same day.

Herniated lumbar disc treatment options

Conservative treatments for herniated lumbar discs include anti-inflammatory and pain medications as needed. Applications of hot or ice compresses, sometimes in alternation, are frequently recommended. Muscle relaxants may be prescribed to diminish muscle spasms in the back. A course of physical therapy, and exercises to improve back and abdominal muscle strength can provide some relief. Epidural injections of a corticosteroid may also be administered to reduce nerve irritation and facilitate healing. For some patients, chiropractic care or some type of alternative medicine may also provide relief. Surgery is reserved for patients with symptoms that do not respond to conservative measures or those who have muscle weakness, difficulty walking or loss of bowel or bladder function.

Procedures for a herniated lumbar disc

When the condition does not respond to conservative measures, and the patient continues to experience pain, surgery may be necessary. This is true in approximately 10 percent of all patients with herniated discs. The type of procedure performed will depend upon where the herniated disc is located and on the severity of the damage. There are several surgical options. All of these operations all are performed in the hospital under general anesthesia:

• Lumbar Laminotomy: A lumbar laminotomy is a surgical procedure performed to relieve pressure on the spinal cord or spinal nerves caused by a herniated disc. The procedure involves removal of a portion of the lamina, the bony plate that covers the spinal canal, to create more space for the compressed nerve roots. It may also involve removal of the herniated disc. The procedure may be performed as an open surgery or minimally invasive surgery, depending on the patient’s condition and surgeon’s preference. The goal of a laminotomy is to alleviate pain, numbness, and tingling, or muscle weakness in the legs caused by the herniated disc. A laminotomy is a less invasive alternative to a laminectomy, which involves removal of the entire lamina.
• Lumbar microTop of Formdiscectomy: A microdiscectomy is a surgical procedure used to treat a herniated disc in the lumbar (lower) back. The objective of this procedure is to remove the portion of the disc that is putting pressure on the nerve roots and causing pain, numbness or weakness in the legs. The procedure is performed through a small incision in the back using a microscope to magnify the area being operated on, allowing for a smaller incision and a more precise removal of the herniated portion of the disc. Microdiscectomy is typically performed on an outpatient basis and patients can often return to normal activities within a few weeks after the and typically involves removing only the portion of the disc that is causing symptoms. Post operative physical therapy can help restore strength and flexibility.
• Spinal fusion: After a lumbar discectomy where the entire disc is removed, the spine will be unstable and cause painful movement. Lumbar spinal fusion is stabilization surgery to eliminate painful motion after a discectomy. This procedure involves fusing two or more vertebral bones in the lumbar (lower) region of the spine to prevent movement and reduce pain. The fusion process can be accomplished in a number of ways, including the use of bone grafts, metal screws and rods, or artificial spinal discs. The goal of the procedure is to create a solid bridge between the affected vertebral bones, which will prevent the motion and instability that was causing the pain.

Endoscopic spine surgery is the culmination of over 50 years of surgical innovation. It is minimally invasive spine surgery that offers significant benefits including minimal disruption of the soft tissues, smaller incisions, reduced postoperative pain, early mobilization, shorter hospital stays and faster recovery. Internationally renowned New York spine surgeon Dr. Federico Girardi is an expert in minimally invasive spine surgery which requires a superior set of technical skills.