When do you operate for prolapsed disc?
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
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
Neuromuscular disorders