Surgery for a slipped disc

Photo of a doctor and patient in hospital

Under certain circumstances, slipped discs in the region can be treated with surgery. Possible reasons include paralysis or the ineffectiveness of other treatments to relieve symptoms over the long term.

Most people with a slipped disc don’t need surgery because the symptoms usually go away on their own within six weeks. Until then there are several non-surgical treatment options that aim to help relieve the pain and improve mobility.

Surgery is sometimes an option in an emergency situation or if the symptoms don’t go away after trying non-surgical treatments for a longer time. The aim of surgery is to remove spinal disc tissue that is pushing on the nerve. The idea is to give the nerve more space to reduce irritation and relieve symptoms such as pain.

Surgery is not an option if a slipped disc is discovered by chance, such as during an examination for other reasons, and is not causing any symptoms.

When is surgery an option?

Surgery is always performed if a slipped disc becomes an emergency. This is the case if it's causing paralysis or if herniated spinal disc tissue is restricting the nerves so severely that the bladder or bowel no longer work properly. But this only happens rarely.

Far more commonly, surgery is performed because long-term symptoms such as severe pain cannot be relieved effectively. The question of whether to go through with surgery is often difficult to answer, though. Surgery may be considered if

  • the symptoms are so severe that they have a major impact on everyday life,
  • imaging scans such as (MRI) and the type of symptoms clearly suggest that a slipped disc is the cause,
  • the symptoms don’t go away or get worse despite conservative therapies,
  • the pain shoots into the leg, and
  • the symptoms have lasted for at least 6 to 12 weeks.

Before deciding to go ahead with the procedure, it’s important to carefully weigh the pros and cons together with your doctor. Your personal situation also plays an important role here, including things like your age and overall health, your professional and private life, and your own hopes and expectations for the surgery. Our decision aid can help you to weigh the pros and cons of this kind of procedure.

Good to know:

In Germany, doctors who recommend the removal of spinal disc tissue must inform you of your right to get a second medical opinion free of charge.

What surgical techniques are used?

Various surgical techniques can be used when operating on a slipped disc:

  • Open surgery (usually microdiscectomy): Open microdiscectomy is the most commonly performed type of surgery for a slipped disc. It involves removing the damaged part of the spinal disc. The surgeon views the area being operated on through a microscope. Without the use of a microscope, the cut (incision) needed for the procedure has to be made bigger. People who have this open procedure are given a general anesthetic and usually have to stay in the hospital for a few days. Whether you have to stay in the hospital or not (outpatient procedure) depends on things like your age and how long the surgery takes. The risks associated with this surgery include bleeding, nerve damage and infections. A general anesthetic may lead to complications like breathing or circulation problems.
  • Endoscopic surgery (also known as minimally invasive or keyhole surgery): This procedure is also common. Especially small instruments are used so that only a small incision in the skin is needed. An is inserted into the incision in the skin and pushed through to the spinal disc, and then the instruments are fed through to the spinal disc using x-ray monitoring. This procedure can be carried out either with a general or local anesthetic. This endoscopic technique is used to speed up recovery and prevent the formation of scars that may cause problems. But the procedure is associated with risks, too, including bleeding, nerve damage and .

Experts recommend the removal of spinal disc tissue especially if nerve irritation causes problems in the legs.

Can surgery relieve the symptoms?

Open surgery and endoscopic surgery have been investigated in a number of studies involving participants for whom either surgery or conservative therapy were an option. Most of these studies involved surgery on people who had pain for weeks despite receiving conservative therapy. The studies show the following:

  • Surgery can relieve pain and other symptoms such as restricted mobility better than conservative therapy.
  • The pain goes away more quickly after surgery.
  • After three months, mobility is better following surgery than with conservative therapy.

But after one year, there was no longer any difference in pain between people who had surgery and those who had conservative therapy.

There are no detailed studies on the long-term advantages and complications of surgery. One possible complication is the formation of scars at the site of the operation, which can themselves cause problems such as nerve irritation.

The amount of time needed for paralysis to go away after surgery also depends on how severe it was beforehand. But it can take a while. There is no guarantee that it won’t come back after surgery, either.

Open or endoscopic surgery: Which is better?

Endoscopic surgery is probably as effective at relieving pain and improving mobility as open surgery.

But it is not yet clear whether one type of surgery takes significantly less time than the other, or whether bleeding is less common during endoscopic surgery.

Are other surgical procedures available?

In rare cases, other, more extensive surgery is performed – especially if the vertebrae are also damaged by wear and tear and the spine is no longer stable.

In a procedure called spinal fusion, the surgeon joins the vertebrae above and below the slipped disc together with screws so that they remain firmly in place. Those vertebrae can then no longer be moved. The spinal disc is removed, and the resulting gap between the vertebrae is filled with bone or a titanium implant.

Another option is to put in an artificial spinal disc (implant) that can be used without having to fuse the vertebrae together. The aim of this procedure is to relieve the pain and also avoid the kind of restricted movement that people experience after spinal fusion surgery.

There is hardly any research on the use of these procedures to treat slipped disc. That is why it’s not clear whether they can relieve the symptoms better than conservative therapy. But surgery can lead to complications.

How can rehabilitation help following surgery?

A large number of rehabilitation programs are available for people who have had surgery. Research has shown that rehabilitation immediately after slipped disc surgery (follow-up rehabilitation) can shorten the recovery time and improve mobility.

Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale Versorgungsleitlinie Nicht-spezifischer Kreuzschmerz (in Überarbeitung). AWMF-Registernr.: nvl-007. 2021.

Chen BL, Guo JB, Zhang HW et al. Surgical versus non-operative treatment for lumbar disc herniation: a systematic review and meta-analysis. Clin Rehabil 2018; 32(2): 146-160.

Chen X, Chamoli U, Vargas Castillo J et al. Complication rates of different discectomy techniques for symptomatic lumbar disc herniation: a systematic review and meta-analysis. Eur Spine J 2020; 29(7): 1752-1770.

Cong L, Zhu Y, Tu G. A meta-analysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation. Eur Spine J 2016; 25(1): 134-143.

Czabanka M, Thome C, Ringel F et al. [Operative treatment of degenerative diseases of the lumbar spine]. Nervenarzt 2018; 89(6): 639-647.

Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Neurochirurgie (DGNC) et al. Konservative, operative und rehabilitative Versorgung bei Bandscheibenvorfällen mit radikulärer Symptomatik (S2k-Leitlinie). AWMF-Registernr. (neu): 187-057. 2020.

Evaniew N, Khan M, Drew B et al. Minimally invasive versus open surgery for cervical and lumbar discectomy: a systematic review and meta-analysis. CMAJ Open 2014; 2(4): E295-305.

Gadjradj PS, Harhangi BS, Amelink J et al. Percutaneous Transforaminal Endoscopic Discectomy Versus Open Microdiscectomy for Lumbar Disc Herniation: A Systematic Review and Meta-analysis. Spine 2021; 46(8): 538-549.

Jacobs WC, Arts MP, van Tulder MW et al. Surgical techniques for sciatica due to herniated disc, a systematic review. Eur Spine J 2012; 21(11): 2232-2251.

Jordan J, Konstantinou K, O'Dowd J. Herniated lumbar disc. BMJ Clin Evid 2011: pii: 1118.

Klein C. Orthopädie für Patienten: Medizin verstehen. Remagen: Michels-Klein; 2014.

Lewis R, Williams N, Matar HE et al. The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model. Health Technol Assess 2011; 15(39): 1-578.

Nie H, Chen G, Wang X et al. Comparison of Total Disc Replacement with lumbar fusion: a meta-analysis of randomized controlled trials. J Coll Physicians Surg Pak 2015; 25(1): 60-67.

Oosterhuis T, Costa LO, Maher CG et al. Rehabilitation after lumbar disc surgery. Cochrane Database Syst Rev 2014; (3): CD003007.

Rickers KW, Pedersen PH, Tvedebrink T et al. Comparison of interventions for lumbar disc herniation: a systematic review with network meta-analysis. Spine J 2021; 21(10): 1750-1762.

Wei FL, Li T, Gao QY et al. Eight Surgical Interventions for Lumbar Disc Herniation: A Network Meta-Analysis on Complications. Front Surg 2021; 8: 679142.

Wei FL, Zhou CP, Zhu KL et al. Comparison of Different Operative Approaches for Lumbar Disc Herniation: A Network Meta-Analysis and Systematic Review. Pain Physician 2021; 24(4): E381-E392.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on July 19, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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