When is surgery considered for treating a bulging disc?
Spine surgery can address neck or back pain caused by a bulging disc, but surgery is generally not considered as a first-line treatment. That’s because bulging disc symptoms can potentially resolve on their own. Even so, it’s important to keep in mind that the recovery process is usually not quick. It can take a few weeks for the pain to stabilize, and several more weeks before a gradual improvement becomes noticeable. Nevertheless, the discomfort can often be effectively managed in the meantime with conservative therapies, such as medications and exercise. This treatment approach ultimately helps many people avoid unnecessary surgery. For this reason, surgery should be viewed as a last resort treatment for a bulging disc.
In some cases, however, bulging disc symptoms may persist or worsen despite six to eight weeks of nonsurgical treatment. This is the point at which surgery is most often considered for treating a bulging disc, especially if the associated pain is severe or debilitating. These symptoms usually result from spinal nerve compression caused by a bulging disc, rather than the damage to the disc itself. In addition to localized and radiating pain, spinal nerve compression can produce muscle weakness, numbness and tingling sensations in an arm or leg. Surgery can potentially be more effective than conservative treatment to address a bulging disc because, in addition to alleviating symptoms, a surgeon can directly address their underlying cause by relieving the pressure on a compressed spinal nerve.
How to decide if the time is right for bulging disc surgery
Any type of surgery is a big step, and the decision to move forward is best made with the guidance of at least one trusted surgeon (second opinions on spine surgery are routinely sought and encouraged). For general educational purposes, Laser Spine Institute offers the following examples of situations in which surgical bulging disc treatment may be an appropriate next step to consider:
- Several months of nonsurgical treatment, such as lifestyle changes, nonsteroidal anti-inflammatory drugs (NSAIDs), heat and ice applications and physical therapy have not produced meaningful symptom relief.
- Unmanageable pain or progressive leg muscle weakness is interfering with daily activities.
- Balance or coordination issues are causing walking difficulties and limiting mobility.
- A rare neurological complication known as cauda equina syndrome, which can cause bladder and bowel incontinence, has developed (emergency surgery may be necessary to prevent permanent nerve damage).
Types of bulging disc surgery
In general, the goal of surgical treatment for a bulging disc is to relieve painful pressure on a compressed spinal nerve. This can sometimes be accomplished by removing soft tissue, such as damaged disc material or scar adhesions, or bony tissue, such as a bone spur or a portion of a vertebra. Depending on a patient’s clinical diagnosis, overall health and other individual factors, the recommended surgical treatment plan may include:
- Discectomy. A surgeon can remove a portion of a damaged disc that is pressing on a spinal nerve.
- Laminotomy. A surgeon can remove a portion of the lamina (vertebral arch) to widen the spinal canal and create more space for a compressed nerve.
- Foraminotomy. A surgeon can remove tissue to widen a partially blocked foramina, which is a small opening between vertebrae through which nerve roots exit the spinal cord.
- Spinal fusion or stabilization. A surgeon can add support and stability to the spine.
Before making any final decisions with regard to elective spine surgery, it’s important to take some time to explore all available options and gain a thorough understanding of each procedure, including its potential risks and benefits, as well as what can be expected in the days, weeks and months that follow. In most situations, it is unnecessary to rush into spine surgery, and a well-informed patient is better positioned to make optimal treatment choices.
Most people would understandably prefer to avoid a highly invasive open spine procedure, as well as the numerous risks and difficult recovery that often go along with it. But, this may not be the only surgical avenue to relief. For instance, the surgeons at Laser Spine Institute –– the leader in minimally invasive spine surgery –– perform minimally invasive outpatient procedures that are often the clinically appropriate first choice and provide many advantages versus open neck or back surgery.^
Laser Spine Institute’s approach to bulging disc surgery
At Laser Spine Institute, we offer both minimally invasive decompression surgery and minimally invasive stabilization surgery, having helped more than 75,000 patients find relief from painful symptoms caused by bulging discs and other degenerative spine conditions. Compared to traditional open spine surgery, our minimally invasive outpatient approach to bulging disc surgery offers a number of potential advantages, including:
- Smaller incisions (our board-certified+ surgeons can decompress the nerve through a less-than-1-inch incision)
- A muscle-sparing approach
- A lower risk of infection and other surgical complications^
- A faster recovery (our patients are encouraged to walk on the same day as their surgery^)
- A 98 percent patient satisfaction^ score
- A 98 out of 100 percent patient recommendation^ score
Recovering from minimally invasive bulging disc surgery
As with any type of surgery, many factors can influence a patient’s recovery time following minimally invasive bulging disc surgery. Every patient is a unique individual whose body heals at a different rate, which can be difficult to accurately predict. For general planning purposes, the experts at Laser Spine Institute suggest preparing for a minimum of 12 weeks of rehabilitation following minimally invasive spine surgery.
With that said, some patients may recover more quickly or more slowly. It can take up to six months (and sometimes longer) for the body to completely heal from surgery. During that time, it is essential to follow the surgeon’s postoperative instructions, maintain reasonable expectations and, most importantly, take it slow. Although it can be tempting to jump back into regular activities as soon as comfort permits, this approach is not recommended. Additionally, any activities and movements that cause or worsen discomfort should be avoided and discussed with a physician.
Resuming activities after minimally invasive spine surgery
To help our patients better prepare for minimally invasive bulging disc surgery, the spine specialists at Laser Spine Institute offer the following general guidelines on when certain activities can be safely and comfortably resumed after surgery:
- Walking. Physical activity can enhance blood circulation and promote healing. Additionally, exercise is especially important after surgery to help prevent blood clots, pneumonia, muscle weakness, constipation, gas pain and bed sores. Walking is an excellent form of low-impact exercise that can be performed soon after surgery, virtually anywhere and without any special equipment. For these reasons, we encourage our patients to walk two to three times for five to ten minutes at a time on the same day as their surgery^ and every day thereafter, gradually increasing in time and intensity as their comfort permits.
- Driving. We instruct our patients not to drive for 24 to 48 hours after their surgery, which means they need to arrange to have a family member or friend drive them home. For safety reasons, we also advise our patients not to drive while they are taking narcotic pain medications or muscle relaxants, both of which can impair reflex time. When driving is resumed, we believe it’s best to begin with short drives, getting out of the car at least once every 30-45 minutes to briefly stretch, walk around and reposition the body.
- Lifting. To help protect the spine and avoid further injuries, heavy lifting should be completely avoided after spine surgery. As healing takes place, this restriction can gradually be eased. For instance, within one to four weeks after surgery, 10 to 15 pounds may be safely lifted as tolerated. After that, the weight load may be increased by up to 10 pounds as tolerated. When lifting, it is important to maintain good posture and keep the spine in a neutral position.
- Sitting. Because sitting places a significant amount of stress on spine, it can be painful after surgery and should be resumed only as comfort allows. Slouching can add to the stress, so it is vital to support the lower back and maintain good posture by keeping the ears, shoulders and hips aligned and the knees level with the hips (a stool or foot rest can be used to raise the feet and knees, if necessary). It is also important to take a break from sitting to stand and stretch at least once every 30 to 45 minutes.
- Working. The timeframe for returning to work after spine surgery can vary based on the nature of the job. For instance, a patient who performs light office duties may be able to go back to work approximately two weeks after surgery. On the other hand, a patient who performs physical labor may need to take three to 12 weeks off (an earlier return may be possible if certain activities are restricted).
There are many treatment options for a bulging disc –– both conservative and surgical –– and the associated pain does not have to become a way of life. If you’re ready to take your next step toward finding symptom relief, contact Laser Spine Institute. Our caring team can tell you more about our minimally invasive outpatient surgery, answer your questions, evaluate your diagnosis and provide a free MRI review* to help you determine if you are a candidate .