Standardized Treatment Protocols
Once diagnosed, if a patient is going to see improvement in their symptoms, it will occur within 6 - 12weeks. Non-surgical treatments are preferred in the meantime to see if symptoms will abate on their own.
Conservative Approach
- Rehabilitation - physical therapy
- Osteopathic manipulation
- Thermotherapy & cryotherapy
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Oral steroids
- Cortisone injections
Surgical Approach
Due to the maximally invasive nature of these interventions, a conservative approach to rehabilitation is preferred initially for a disc herniation, dependent on the severity of the patient's case (pain, neurological symptoms, etc,.). This can also depend on the surgeon or physician. Typically, surgery is utilized if non-surgical approach does not show improvements within 4-6 weeks.
Types of Surgical Interventions for Disc Herniations
Lumbar Microdiscectomy (most effective)
Types of Surgical Interventions for Disc Herniations
Lumbar Microdiscectomy (most effective)
- Small incision in the midline of lower back
- Erector Spinae are lifted off the lamina
- Ligamentum Flavum removed from over the nerve root
- Small portion of the inside facet joint is removed to facilitate access to the nerve root
- Relieves pressure from over the root
- Nerve root gently moved the side and disc material is removed from underneath
- Healthy portion left in tact
- The pressure off of the inflamed region allows for instant relief
- Takes months for healing, but symptom relief typically immediate
Laminotomy/Laminectomy
- All or part of the lamina removed from spine
- Relieves pressure on nerve root
- Typical performed for spinal stenosis but may be utilized to relieve cause of herniation
- Allows for more room, decreasing pain
**Surgical approaches not limited to the ones discussed here