Does lumbar disc herniation require surgery?

Patients with lumbar disc herniation often ask, "Do I need surgery?" and "Under what circumstances do I need surgery?" Statistics show that 80%-90% of patients with lumbar disc herniation do not need surgery, so how do we determine the 10%? The following are three indications for surgical treatment given in the guidelines.

Based on my personal experience and my experience as a "senior lumbar disc herniation patient", I have summarized two surgical indications: 1. Strict, regular conservative treatment is ineffective, symptoms recur or even worsen, seriously affecting the patient's work and life." The first indication for almost all surgical operations is "regular, conservative treatment is ineffective", so before asking "whether surgery is needed", ask yourself whether you have done "stand more and sit less, exercise your back muscles regularly, work while standing, try not to drive..." If you don't do these well, who will be responsible for surgery in the future? "Seriously affected work and life status", obviously this is related to each person's pain threshold, the nature of work and life, and the requirements for quality of life. It is also related to the attending doctor's treatment philosophy and the degree of mastery of surgical methods (open, minimally invasive). Therefore, the choice of lumbar disc herniation surgery should follow the principle of "individualization".

Here is a method that can roughly judge (not very accurate): ask the patient whether he needs surgery. Some patients are still struggling with "Should I have surgery or not?" At this time, the surgery can be put on hold because he (she) still has room for choice. For example, it is like us young people from small towns who go to first-tier cities. After a while, we find it difficult to live there. Sometimes we struggle with whether to go back to our hometown. The struggle means that we still have certain conditions or abilities to stay here. If we say "The ticket has been bought, and I will go back to my hometown tomorrow," it means that we really can't stay here. If the patient clearly says "I must have surgery, I am not struggling." Then the symptoms may have caused him a lot of trouble.

Of course, it must be emphasized here that even if the symptoms of some diseases are very mild, according to the doctor's judgment, conservative treatment is ineffective, the symptoms will continue to worsen, and late-stage surgery will not be effective. For example, cervical spondylosis shows signal changes in the spinal cord. Even if the symptoms are not very serious, surgical treatment is recommended.

The second principle is that surgery is also recommended if there are obvious symptoms of nerve compression: muscle weakness; abnormal bowel and urination function, etc. In fact, these symptoms are more common in cervical spine diseases, and the probability of them occurring in patients with lumbar disc herniation is very low.

To sum up, after being diagnosed with "lumbar disc herniation", the decision of whether to have surgery or not is in our own hands. As long as you maintain a "lumbar spine healthy" lifestyle and persevere, you will most likely not need surgery.