Lumbar Disc Herniation Surgeries

The type and timing of surgery are determined according to the patient’s symptoms, neurological findings, and imaging results. The information below is general.

Question: What types of surgery exist for lumbar disc herniation?

Answer: Surgical options are generally evaluated along a spectrum from minimally invasive methods to open surgery options:

  1. Minimally invasive methods
  • Endoscopic discectomy
  • Nucleoplasty / annuloplasty / hydrodiskectomy
  • May be performed under local anesthesia or sedation in selected patients
  • There are series reporting complication rates of approximately 1–5% with proper patient selection
  1. Open surgical methods
  • Microdiscectomy (microsurgery): Performed under general anesthesia with a small incision
  • Instrumented fusion: Considered when instability is present. Long-term adjacent segment problems are reported at approximately 10–30%
  1. Motion-preserving surgery (prosthesis)
  • Performed with implants that partially allow spinal motion
  • Aims to reduce adjacent segment loading in selected patients

“Choosing the right surgery for the right patient is a stepwise and individualized solution in the treatment of lumbar disc herniation.”

How is the type of surgery selected?

  1. Clinical findings (leg pain, strength loss)
  2. MRI and, if necessary, dynamic X-rays
  3. Presence of instability
  4. Response to previously attempted conservative treatments