Herniated Disc Treatment
When part of a disc that cushions the bones (vertebrae) of your spine ruptures, it can put pressure on your cervical (neck), lumbar (lower back), or thoracic (upper and middle back) nerves, and cause pain, numbness and weakness.
Finding the precise origin of nerve pain and discomfort can be challenging.
Dr. C.J. Berg works closely with patients to identify the source of their pain and discomfort and seek solutions for resolving chronic neck and back issues. A board-certified neurosurgeon, with more than 8 years of experience in military leadership positions (including neurosurgical consultant to the U.S. Air Force Surgeon General), and a Healthcare MBA, he approaches each situation with a broad knowledge base and a commitment to beginning with the least aggressive, and most effective, treatments possible.
Diagnosing Herniated Discs
In order to find the right fix for the right patient, diagnosis is key. Because neurological complaints often do not present as physical exam findings, it’s important to get a thorough patient history to ensure that the description of pain and other symptoms coincides with imaging and other diagnostic tests.
Dr. Berg will ask a series of detailed questions:
- How long has the pain been there?
- Did the pain start in the neck and move into the arm after a few months?
- Has the pain always been in the arm?
- Is it a burning pain? Is it electric? Is it a deep ache?
He will then correlate the patient’s history with their description of current complaints, and review imaging findings to pinpoint the source of pain and discomfort.
Contact Dr. Berg’s office today to learn more about herniated disc treatment and schedule a consultation.
Treating Pinched Nerve Symptoms
Dr. Berg will always start with the least aggressive options. A trial of conservative treatment may start with:
- Physical therapy
- Anti-inflammatory medications
The next level of treatment may include:
- Spinal injections
- Chiropractic manipulation
- Other non-surgical options
The Right Herniated Disc Surgery for the Right Patient
If conservative treatments don’t alleviate pain and discomfort, Dr. Berg will discuss surgical options based on a patient’s situation, the location of the herniated disc, and the extent of disease progression.
Lumbar (lower back):
- Decompression – A decompression, or discectomy, is a 45-minute, outpatient procedure that removes the damaged portion of a herniated disc to alleviate the pressure on the nerves that is causing radiating pain and discomfort.
- Decompression with fusion – When the damage is more extensive, or there is evidence of instability, a surgeon will utilize components such as titanium cages, plates, screws and rods, to bridge bone segments and fuse them together.
- Decompression options –
- If a ruptured disc is pinching nerves in the front of the neck, an anterior discectomy may be done from the front
- A discectomy from the back of the neck will take the pressure off the spinal cord.
- Decompression with fusion –If there is instability after removing the damaged portion of a herniated disc, decompression may be followed by a fusion or an artificial disc implant.
- Cervical disc replacement – One- or two-level artificial disc replacements are designed to maintain neck motion for those who qualify. Patients must be under 50-years-old, with no evidence of arthritis in the neck.
Thoracic (upper and mid back):
- Decompression – A surgeon may approach from behind or through the chest to remove a herniated disc and relieve pressure on the spinal cord.
- Decompression with fusion – While thoracic disc herniation is rare, treatment is similar to the lumbar and cervical spine. If there is instability following a discectomy, a fusion may be required.
It’s important to get the surgery you need to resolve a chronic issue that’s disrupting your life. While people are often hesitant to have a spinal fusion, it has been the gold standard for many years and can eliminate the problem permanently, without having to worry about repeat herniations in that location.
Herniated Disc Surgery and Recovery: What to Expect
Most surgeries for herniated discs are outpatient or require just an overnight stay in the hospital. Outpatient surgeries may be done at a hospital or an outpatient surgery center.
- When patients wake up after a discectomy, the pain is gone, and they can go home.
- After a two-level cervical disc replacement, most patients can return to work in a couple of days.
- After spinal fusion, patients wear a brace for a few weeks.
- Most patients will have weightlifting restrictions, and some light activity restrictions for several weeks to reduce stress and avoid a repeat herniation.
- Most patients are ready to resume all activities without restrictions after two-three months. Cervical disc replacement patients have no restrictions after one month.
- Dr. Berg will monitor progress as patients gradually increase physical activity.
- Most patients are off pain medications within two weeks.
- Dr. Berg will follow up at one-month, three-month, and 12-month intervals.
Repeat Surgeries: A Rare Occurrence
A discectomy removes the damaged portion of a herniated disc, where the softer material inside has pushed through a crack in the tougher exterior and is irritating, or compressing, nearby nerves.
In rare cases (7-18 percent for lumbar patients), a patient who re-herniates the same disc may require a follow-up surgery. This is most likely to happen in the first eight weeks after a discectomy.
Dr. Berg will do another minimally invasive discectomy once. If it happens again, there may be a larger underlying issue which requires removing the entire disc and doing a fusion.
Herniated Disc Treatment in Columbus, Ohio
Dr. C.J. Berg is a board-certified neurosurgeon with a mission to revolutionize the way spine health is viewed, managed, and treated. He is committed to getting to the root cause of chronic neck and back pain so that he can diagnose accurately and treat effectively, utilizing the least invasive surgical (and nonsurgical) techniques and the most advanced recovery methods to allow patients to get back to living their lives as soon as possible. To schedule a consultation, please call (614) 468-5333 or book an appointment online.
- Eugene J Carragee et al, “A Prospective Controlled Study of Limited Versus Subtotal Posterior Discectomy: Short-Term Outcomes in Patients With Herniated Lumbar Intervertebral Discs and Large Posterior Annular Defect,” Spine 31, no. 6 (2006): 653-657, doi: 10.1097/01.brs.0000203714.76250.68; Gianna L. Ambrossi et al, “Recurrent Lumbar Disc Herniation After Single-Level Lumbar Discectomy: Incidence and Health Care Cost Analysis,” Neurosurgery 65, no. 3 (2009): 574-578, doi:
What Can Cause a Herniated Disc?
- Heavy lifting
- Sudden twisting
Herniated Disc Symptoms
- Discomfort, shooting pain, or burning sensation in arms or legs
- Arm or leg weakness or numbness
- Ankle or foot discomfort
- Leg pain that worsens when sitting
- Loss of balance