Diagnosis and treatment of lumbar and cervical herniated discs by an FMH neurosurgeon, at Clinique La Colline (Hirslanden).
A herniated disc results from degeneration of part of an intervertebral disc: part of the disc nucleus escapes into the spinal canal and compresses a nerve. This compression causes "sciatica"-type pain (leg) or "cervicobrachialgia" (arm).
Pain running down the leg to the foot (lumbar hernia) or into the arm (cervical hernia), sometimes with tingling. If the nerve is severely compressed, numbness or muscle weakness may appear — prompt medical advice is then recommended.
The main investigation is an MRI of the spine — lumbar for lumbar disc herniations or cervical for cervical herniations. Sometimes it is useful to perform an electroneuromyogram (ENMG), which assesses the degree of impairment of nerve conduction.
When conservative treatment has failed, surgery frees the nerve by resecting the part of the disc that is compressing it. This surgery is performed under general anaesthesia using a microsurgical technique under the microscope, in order to be as minimally invasive as possible.
Herniated disc surgery is performed through a very small skin incision in the back. The operation is carried out under the microscope, which allows a perfect identification of the nerve structures and, above all, of the relationship between the herniated disc and the trapped nerve. Sometimes the disc fragments adhere to the nerve root and must be freed very delicately. Sometimes, too, when the hernia has been present for a long time, the fragments compressing the nerve can be very hard and partly calcified — hence the importance of a surgical resection to make sure that the nerve root has been fully visualised under the microscope and is completely free.
As a guide, for a simple lumbar herniated disc: 4-5 days in hospital at Clinique La Colline (Hirslanden), stitches removed on day 10 at the practice, 4 to 6 weeks off work, physiotherapy from 6 weeks. See the full course of your care.
Learn more about spine surgery at the practice.
Do you recognise these symptoms? Call the practice: +41 22 347 67 40
Often, yes: most herniated discs improve with conservative treatment. Surgery is only proposed when it has failed or in case of neurological deficit.
Like any surgery, it carries risks, discussed in detail during the consultation. The microsurgical technique under the microscope keeps it as minimally invasive as possible.
Consultations are conducted in French, English or German. Our secretariat is available Monday to Friday, 8 am to 6 pm.