What is a slipped disc and how does it happen?

A slipped disc is where the spongy centre of a disc bulges out and puts pressure on a nerve where it leaves your spine.

Each disc is made up of a tough fibrous outer coat with a soft spongy centre.

Eventually the spongy centre can bulge out and press on a nerve, or some of the spongy centre can squeeze out of the fibrous coat and press directly on a nerve. This is called a slipped disc and it can cause pain, as well as weakness and numbness in the area that the compressed nerve supplies.

What are the benefits?

The aim of surgery is to relieve the pressure on the nerve so it can recover. This should improve leg pain (called sciatica) and help you to get back to your normal activities.

Are there any alternatives?

For many people, symptoms get better without surgery. Treatment involves painkillers and rest, followed by an exercise programme. If you have a lot of pain, you can also have a steroid injection near the affected nerve into the epidural space (an area near your spine).

What will happen if I decide not to have the procedure or the procedure is delayed?

If you develop any of the following symptoms, contact your healthcare team.

• Change in control of your bladder and bowel and difficulty getting an erection.
• Pain in both legs.
• New weakness your doctor does not know about.
• Numbness or loss of sensation in your genitals or back passage.

What does the procedure involve?

The procedure is usually performed under a general anaesthetic but various anaesthetic techniques are possible.

The procedure usually takes between 1 and 2 hours. Your surgeon will make a cut on the centre of your back between the vertebrae. They will use an operating microscope or another magnification tool to make a hole in the ligament between the vertebrae to show the nerve and the disc. Your surgeon will hold the nerve out of the way and remove the disc.

How can I prepare myself for the procedure?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. Nicotine is known to prevent wounds from healing properly following back surgery, and increases the risk of unsightly scarring and chronic pain.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Being overweight puts unnecessary strain on your back.

Regular exercise should help you prepare for the procedure, help you recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you may need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

Possible complications of this procedure are shown below. Some may be serious and can even be life threatening.

General complications of any procedure

• bleeding
• infection of the surgical wound
• allergic reaction to the equipment, materials or medication
• venous thromboembolism (VTE)
• difficulty passing urine
• chest infection
• heart attack or stroke

Specific complications of this procedure

• worse pain or numbness down your leg
• numbness between your legs, loss of normal bowel and bladder control and, for men, problems having an erection
• neuropathic pain. This is a burning pain that may happen once the pressure on the nerves has been released
• tear of the thin membrane that covers the nerves in your spine
• recurrence of a slipped disc

Consequences of this procedure

• pain
• scarring of your skin

What happens after the procedure?

You should be able to go home on the same day.

Keep your wound dry for 10 days.

Do not lift anything heavy or twist your body. Make sure you keep a good posture when sitting and walking, and regularly change your posture to avoid strain on your back. Your physiotherapist will give you advice about when and how to increase your activity levels.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Summary

A slipped disc is where the spongy centre of a disc bulges out and puts pressure on a nerve where it leaves your spine. The aim of surgery is to relieve the pressure on the nerve so it can recover.

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