What are the most advanced methods of slipped disc surgery?Normally, the slipped disc will be removed using a minimally invasive dorsal approach or endoscopic access, called microdisectomy.
The goal of this method is to remove the herniated disc material in order to decompress neurologic structures, such as nerve roots, the spinal canal and myelin membrane.
The disadvantage of this procedure is that destroyed and degenerated disc material will be left behind in the intervertebral space. Recent clinical evidence shows slipped disc reoccur approximately 50% of the time after microdiscectomy.
Therefore, when the patient is suffering from a painful and disabling slipped disc, I recommend a total discectomy by a ventral approach (through the abdomen) and the implantation of a viscoelastic total disc replacement.
What are the best treatments for a slipped disc? Do you always recommend surgery? Or are there non-invasive methods as well?Conservative treatment could be suitable for a slipped disc if the patient has acute or chronic lumbar back or neck pain without severe neurologic symptoms, such as paresis or paralysis of the bladder or limbs.
Conservative therapy consists of 3 to 6 months of physiotherapy and pain medication. However, if this therapy is unsuccessful and the patient is disabled in his daily activities, sport and work, I would recommend decompression surgery and a disc replacement.
What are the risks of spinal disc surgery?In the clinical literature, severe complications such as permanent paraplegia are very rare. The overall complication rate ranges from 6% to 8%.
This includes all possible adverse events, like infection, hematoma, fistula, inflammation, neurological deficits, thrombosis, embolism, or disturbances to the patient’s sexual function.
How many spinal surgeries have you performed in your career?I started in spinal surgery in 1986. In 27 years, I have performed more than 2500 surgeries on the cervical, thoracic and lumbar spine.
This case load includes complex circumferential reconstruction of destroyed vertebrae caused by trauma or tumour and decompression surgeries for degenerated slipped discs or in traumatic disorders.
Since 2001, I have implanted more than 1500 artificial discs in the cervical and lumbar spine.