Surgical treatments for herniated discs may be considered for patients who suffer from back pain. Spine specialists often recommend herniated disc surgery when pain in the lower back is evident along with the following symptoms:
- leg pain that doesn’t improve after 4 weeks of non-surgical treatment
- pain that is severe enough to interfere with normal activities and require strong pain medications
- weakness, abnormal sensitivity, and loss of motion
Herniated disc surgery can be particularly tricky as it brings many potential health complications. Surgical treatments for herniated discs – such as discectomy, percutaneous discectomy, laminotomy, and laminectomy – can cause the following complications in patients:
- Pre-surgery
Complications can develop from herniated discs even before the surgery begins. One of the most serious complications of herniated discs is cauda equina syndrome. This condition develops when a large chunk of disc material ruptures into the spinal canal, particularly in the area where the nerves for bowel and bladder control travel before they leave the spine. Excess pressure on these nerves may cause serious damage to them; as a result, you permanently lose the ability to control your bowels and bladder.
The good news is that cauda equina syndrome is relatively rare. If your doctor suspects that you’re developing this syndrome, he or she may recommend immediate surgery to relieve pressure on these nerves.
- During surgery
Many complications may occur while the surgical procedure is performed. For instance, the anesthesia used during any type of herniated disc surgery may cause some complications in the patient. During the removal of a herniated disc, nerve injury or a dural tear may also ensue.
During any surgery on the spine, there is always a risk of nerve injury or nerve damage. Nerves may be damaged due to bruising or accidental scalpel cuts. The damage may also be caused by inflammation of the tissues around them. Surgical nerve damage can manifest post-surgery, as numbness, tingling, or weakness in the region of the damaged nerve or in other areas of the body. Difficulties in walking or changes in regular walking patterns may also be evident.
Dural tears, on the other hand, occurs when a tear develops in the watertight covering of the spinal cord and spinal nerves. This watertight sac of tissue is referred to medically as dura mater. Dural tears are not uncommon during spinal surgery; if they occur, the tear is simply repaired and the tear often heals without complications.
If a dural tear goes unnoticed, though, it continues to leak spinal fluid and cause problems down the road. Spinal headaches (caused by leaking spinal fluid) may occur and an increased risk of spinal meningitis (infection of the spinal fluid) occurs. A second surgery may also be carried out to repair the dura, if the dural leak doesn’t seal itself off on its own.
- Post-surgery
In many cases, complications don’t arise until after the surgical procedure is completed. Some of these complications are immediately evident, while others may take weeks or even months to develop.
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- Infection. Infection may develop along the skin incision, inside the disc, or even in the spinal canal around the nerves. If the area around the skin incision is infected, the patient is usually prescribed antibiotics. If the infection is in the spinal canal or the disc itself, a second surgery may be needed to drain the infection, along with antibiotics after the surgery.
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- Re-herniation. Even with a successful herniated disc surgery, there’s always a chance (10% to 15%) of the same disc herniating again. A re-herniation usually occurs in the first six weeks after a surgery, but it can occur at any time. This may require a second surgery for treatment.
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- Degenerative disc disease. When a disc herniates, the spinal segment it’s in becomes more prone to degeneration. Herniated disc surgery may add to the injury, as the surgery removes a portion of the herniated disc. Many specialists say that patients have an increased risk of developing complications in the area where a disc has been removed. A second surgery may also be required if the degenerative process causes severe, immobilizing pain in the patient. It may take years for patients to develop degenerative disc disease.
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- Persistent pain. In some cases, back pain can’t be relieved even by surgery. There are many reasons pain may still be present after herniated disc surgery. Nerves may have suffered permanent damage from the pressure from disc herniation and lost the ability to recover. Scar tissue may also develop around the nerves in the weeks after the surgery and cause further back pain.