|
|
 |
|
|
|
| Home > Spinal Disorders > Disc Herniations > Lumbar Disc Herniation - Disorder Treatment |
 Print Page |
LUMBAR DISC HERNIATION
Disorder Treatment
|
Non-surgical Treatment
The first line of treatment is almost always non-surgical. The exception is when there is bladder or bowel incontinence or progressive weakness. A vast majority of patients suffering from leg pain will naturally recover given time and non-operative treatment. Non-operative treatments include strengthening exercises, physical therapy, chiropractic, acupuncture, traction, epidural injections, pain medications, and anti-inflammatory medications including steroids.
For buttock or leg pain and mild weakness (radicular symptoms), generally at least 6 weeks of non-operative treatment is pursued to monitor for natural recovery. The waiting period is based on the knowledge that 80-90% of radicular symptoms are known to spontaneously recover. If recovery is progressing, more non-operative treatment may be prescribed.
For isolated low back pain, generally at least 6 months of non-operative treatment is pursued to monitor for natural recovery. The waiting period is based on the knowledge that most midline low back pain is known to spontaneously recover within 6 months.
Surgical Treatment
Surgical treatment may be suggested to treat pain that has not responded to non-operative treatment or if there is severe neurologic deficit such as bowel or bladder incontinence or progressive weakness in vital muscle groups. With the exception of the presence of severe neurologic deficits, the decision to proceed with surgery is a quality of life decision.
Surgical options for a lumbar disc herniation are listed below. These surgical options often include a combination of surgical treatments (i.e. decompression, fusion, instrumentation). For a detailed explanation of the individual treatments, please visit the Surgical Treatments section of the web site.
- Lumbar Laminotomy/Foraminotomy
This procedure is used to remove part of the lamina and overgrown facet joint to relieve unilateral leg symptoms and is usually performed with the aid of magnification (either surgical loupes or microscope). Lumbar laminotomy/foraminotomy is the most commonly performed procedure for a standard posterolateral disc herniation.
- Minimally Invasive Procedures
Posterior foraminotomy can be performed through tubes and with the use of endoscopes. Laser decompression and disc removal have also been performed with mixed results.
- Far Lateral Discectomy
If the disc herniation occurs far lateral (occurs in approximately 10% of all disc herniations), this procedure is often necessary to relieve the pressure on the exiting nerve root.
- Lumbar Laminectomy/Foraminotomy
With this procedure, the lamina and overgrown facet joints are removed to make room for the nerves. This is the most common treatment for lumbar stenosis where there is bilateral buttock/leg symptoms.
|
|
|
> Go to Case Study
|
|
|
