When an injured worker with a herniated disc exhausts conservative treatment yet still has disabling pain and restricted mobility, the doctor may recommend surgery. If the symptoms are mild and there is no danger they will get worse, surgery is not usually recommended. However, if signs appear that pressure is building on the spinal nerves, surgery may be required to return the worker to his best pre-injury condition. The signs doctors watch for when reaching this decision include weakening in the leg muscles, pain that won’t ease up, and problems with the bowels or bladder.
There are several surgical treatments or operations for lumbar disc herniation including laminectomy, discectomy, microdiscectomy and posterior lumbar fusion.
Laminectomy and Discectomy
The lamina forms a roof-like structure over the back of the spinal canal. In this procedure, a thumbnail-sized piece of the lamina is removed (laminotomy) so the surgeon can more easily take out the problem disc (discectomy). This procedure is mainly used when the herniated disc is putting pressure on a nerve and causing pain to spread down one leg.
Microdiscectomy
Microdiscectomy is becoming the standard surgery for lumbar disc herniation. The procedure is used when a herniated disc is putting pressure on a nerve root. It involves carefully taking out part of the problem disc (discectomy). By performing the operation with a surgical microscope, the surgeon only needs to make a very small incision in the low back. Categorized as minimally invasive surgery, this surgery is thought to be less taxing on patients. Advocates also believe that this type of surgery is easier to perform, that it prevents scarring around the nerves and joints, and that it helps patients recover more quickly.
Posterior Lumbar Fusion
Lumbar disc herniation causes mechanical pain, the type of pain caused by wear and tear in the parts of the lumbar spine. Fusion surgery is mainly used to stop movement of the painful area by joining two or more vertebrae into one solid bone. This keeps the bones and joints from moving, easing mechanical pain. In posterior lumbar fusion, the surgeon lays small grafts of bone over the problem area on the back of the spinal column. Most surgeons will also apply metal plates and screws to prevent the problem vertebrae from moving. This protects the graft so it can heal better and faster. There are times when the surgery is performed from an anterior approach as well.
McCormick Law Office in Milwaukee, Wisconsin attorneys represent employees having surgery due to a lumbar herniated disc. It is absolutely free to speak with an experienced workers compensation attorney on the telephone and/or in person to find out if the disc herniation may be work-related.
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