Unifying Concepts

Indications for Intervertebral Disk Surgery

The use of surgery for herniated intervertebral disc and spinal stenosis varies widely within and among countries. It has been postulated that the main reason for treatment failure is poor selection of candidates for the procedure.

Indications for Intervertebral Disk Surgery

There are four indications for intervertebral disk surgery:

  1. Progressive motor weakness from nerve root injury demonstrated on clinical examination or electromyography (EMG),
  2. Bowel or bladder disturbance or other signs of spinal cord compression,
  3. Incapacitating nerve root pain despite conservative treatment for at least 4 weeks, and
  4. Recurrent incapacitating pain despite conservative treatment.





  1. Larequi-Lauber T, Vader JP, Burnand B, Brook RH, Kosecoff J, Sloutskis D, Fankhauser H, Berney J, de Tribolet N, Paccaud F. Appropriateness of indications for surgery of lumbar disc hernia and spinal stenosis. Spine. 1997 Jan 15;22(2):203-9.[Medline]


Created: Jan 05, 2009

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