Herniated Disc Surgery: Cost and What to Expect
For people who have suffered a herniated disc that has not healed within six months—and is causing debilitating pain that interferes with day-to-day activities—surgery, known as a microdiscectomy, may be the only option.
The goal of this kind of surgery is to remove the herniated disc material that is pressing on a nerve root or spinal cord.
Since all surgeries carry a certain level of risk, more conservative treatment options should be attempted first. In addition, the cost of surgery can be very expensive, especially for patients not covered by health insurance.
Herniated Disc Treatment Options
There are basically three ways to treat a herniated disc:
- Give it time to heal on its own, possibly combined with physical therapy
- Epidural injections to reduce inflammation
Herniated disc material pressing on the sciatic nerve not only can cause pain in the lower back and leg, but can even cause weakness and numbness in the back, leg, and foot.
Within the last year my son herniated a disc in his back (L4/L5), and he definitely experienced pain, weakness, and numbness down to his foot. This very much affected his ability to walk.
Give It Time to Heal on Its Own
WebMD's treatment overview estimates that 50% of patients heal within the first month of herniating a disc as the inflammation decreases. Within six months, all but 10% of patients heal, and it is these 10% of patients (like my son) that opt for surgery for their herniated disc.
Not only does time allow for inflammation reduction, but it also allows for the possibility of resorption to occur. Resorption is when the body absorbs the jelly-like herniated disc material that breaks down over time.
Epidural Injections May Ease Pain
While giving the body a chance to heal on its own, patients may be in a tremendous amount of pain. Often, painkillers and inflammation-reducing medications are prescribed, though they are not necessarily effective long term. Addiction to painkillers may result.
As patients attempt to heal and avoid surgery, some decide to have epidural injections of cortisone through a procedure done with an x-ray guided needle. The idea is to reduce inflammation and ease pain. The downfall of the cortisone injections is that oftentimes pain relief is only temporary.
My son did not have this procedure done since more than six months had passed since he herniated his disc, and because his orthopedic doctor explained that the cortisone may only be a temporary solution, perhaps as little as even one week.
After waiting at least six months and perhaps attempting cortisone injections, if there is still a lot of pain, weakness and numbness, surgery is really the only option left.
A microdiscectomy is often hospital day surgery and it only takes about an hour to perform. The surgeon will make an incision several inches long, remove a small piece of bone (laminectomy) to expose the nerve root, remove the herniated disc material, and finally close up the incision.
The patient will spend some time in a recovery room and within a few hours will most likely be released to complete recovery at home.
Once the decision has been made to have surgery, patients and their families begin to wonder about the actual financial cost of having a microdiscectomy.
Cost for medical procedures and surgeries can vary wildly from surgeon-to-surgeon, hospital-to-hospital, city-to-city, and country-to-country. Cost Helper tracks consumer prices and estimates that the cost of herniated disc surgery, including surgeon's fees, for an uninsured patient ranges from $20,000 to $50,000 (USD).
Keep in mind that the total cost of a microdiscectomy includes fees for the anesthesiologist, surgeon, and hospital, as well as radiology and medications. The chart below is a breakdown of the summary of charges for my son's microdiscectomy surgery performed in a Chicago-area hospital during 2012.
Cost of My Son's Microdiscectomy
Health Insurance Coverage
While the total charges for my son's surgery were just about $20,000, luckily our health insurance covered the vast majority of it. Typically most health insurance plans, as well as Medicare, will cover this type of back surgery. The insured may still be responsible for deductibles and co-insurance.
Please note that the example of charges above is for a microdiscectomy, not a discectomy. A discectomy involves removal of part of the disc and is usually an inpatient procedure requiring a hospital stay since it is more invasive.
What to Expect Before and After the Procedure
In a non-scientific poll taken on the article about my son's surgery, 79% of respondents who have undergone a microdiscectomy stated that if they had to do it again they would choose to have the surgery again.
Even though microsurgery is often day surgery, it is still major surgery and all pre-operative and post-operative procedures should be followed. Once surgery is scheduled, expect pre-operative instructions from your physician's office.
Following the microdiscectomy, you and the person with you at the hospital to bring you home will be given post-operative instructions, including information on dealing with surgical pain, wound care, and when to call the doctor or hospital. Most of these instructions will be printed to refer to if necessary.
Likewise, it is important to follow-up with the physician/surgeon as recommended. The doctor will check the site of the incision and perhaps recommend exercises to aid in proper healing and reducing scar tissue.
While the herniated disc surgery cost may be high for uninsured patients, the financial costs of surgery have to be weighed against the cost of living with the debilitating chronic pain, weakness and numbness that a herniated disc may bring.