When do you operate for prolapsed disc?
Indications for Surgery Absolute indications Relative indications 1. Bladder and bowel involvement 2. Increasing neurological deficit 1. Failure of conservative treatment--Up to 6 weeks of trial is usually given 2. Recurrent sciatica: 1st attack 90% recover 2nd attack 90% recover; 50% recurrent consider surgery 3rd attack 90% recover but all recurrent propose surgery 3. Significant neurological deficit with SLR reduction 4. Disc rupture in stenotic canal 5. Recurrent neurological deficit
Busy executive needs quick surgery
Only with weakness no pain
Severe pain interfering with activity and not relieved by rest and treatment of 8 weeks
Patient of PID with difficulty in ambulation
Neuromuscular disorders