Are you facing surgery for a herniated disc and are fearful of general anesthesia? Can this procedure be done under regional or even local? 

This is a common question, and a good one at that, since many people are afraid that they “won’t wake up” after being put under a general anesthetic — which requires a mechanical breathing tube down the patient’s throat.

You’d think that surgery for a herniated or bulging disc can be done under regional anesthesia or even under a nerve block, being that the procedure is non-invasive and relatively simple — when compared to heart, abdominal or brain surgery, and of course, joint replacement surgery.

However, this is not the case, says Dr. P. Justin Tortolani, an orthopedic surgeon and spine specialist with University of Maryland St. Joseph Medical Center.

Why General Anesthesia Is Necessary for Surgical Repair of a Herniated Disc

“Since the lumbar spine is where herniated discs occur, one cannot reliably anesthetize the lumbar spine with a lumbar epidural or spinal anesthetic,” says Dr. Tortolani.

“Spinal blocks higher up in the thoracic spine would theoretically be feasible.

“However, in this region there is much higher risk for cord injury from the anesthetic, and therefore it is not done.

“In addition, we don’t want to take the risk that the patient feels anything that we do, and we certainly don’t want the patient moving during the procedure.”

So why, then, can hip or knee surgery, which are more invasive, complicated and lengthier than herniated disc surgery, be performed under regional anesthesia?

Dr. Tortolani explains, “The hip and knee are much further down the body and therefore can be ‘blocked’ effectively with an agent administered in the lumbar region.”

A patient may want general anesthesia for bulging disc repair but may not qualify for it due to another medical condition such as severe heart disease.

For an opposing view by another spinal surgeon, go here.

Dr. Tortolani’s vast experience includes treating all disorders of the spine including herniated discs, spinal stenosis, and adult and adolescent scoliosis.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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