Herniated nucleus pulposus (slipped disk)

A soft cervical collar may be prescribed for people with cervical radiculopathy. The collar helps reduce the pain and muscle spasms by limiting neck movements. A rigid neck collar may occasionally be necessary to eliminate weight bearing on the cervical spine in people with severe pain and muscle spasms.

SURGERY

For the few patients whose symptoms persist despite the above interventions, surgery may be a good option to control pain.

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Diskectomy is performed to remove a protruding disk under general anesthesia. The hospital stay is short, about 2-3 days. You will be encouraged to walk the first day after surgery to reduce the risk of blood clots.

Complete recovery takes several weeks. If more than one disk needs to be taken out or if there are other problems in the back besides a herniated disk, more extensive surgery may be needed. This may require a much longer recovery period.

Other surgical options include micro diskectomy, a procedure removing fragments of nucleated disk through a very small incision with X-ray guidance and chemo nucleosis.

Chemonucleolysis involves the injection of an enzyme (called chymopapain) into the herniated disk to dissolve the protruding gelatinous substance. This procedure may be an alternative to diskectomy in certain situations.

Expectations (prognosis):

Most people will improve with conservative treatment. A small percentage may continue to have chronic back pain even after treatment. People who injure themselves on the job tend not to do as well as those without such injuries.

It may take several months to a year or more to resume all activities without pain or strain to the back. Certain occupations that involve heavy lifting or back strain may need modification to avoid recurrent back injury.

Complications: