Microdiscectomy in Turkey

Most disc herniations settle on their own. The usual course of sciatica from a herniated disc is that it improves over weeks to months with time, movement, pain control and physiotherapy, which is why spine surgeons work through a period of conservative treatment before operating. Surgery brings the relief forward rather than creating relief that would never have come.

So the honest reasons to operate are narrow: severe leg pain that is not settling despite proper conservative treatment, weakness in the leg that is getting worse, or cauda equina syndrome. A scan showing a bulging disc is not by itself a reason. Disc bulges are common on scans of people with no pain at all, and what matters is whether the level shown on the image matches the nerve that your own symptoms follow.

• Leg pain that has not settled

  Radiating pain down one leg in the pattern of a single nerve, persisting despite proper conservative treatment, with a scan that matches the examination. This is the case the operation was designed for.

• Weakness that is getting worse

  A dropping foot, or a leg giving way. Progressive weakness moves the decision forward, and the longer a nerve has been compressed the less predictable its recovery becomes.

• Mainly back pain

  Aching across the low back without leg symptoms is a different problem with different answers. A microdiscectomy is not usually one of them.

• Recent, and improving

  Sciatica that started recently and is easing week by week is on the path most people take without surgery. Time is a legitimate treatment here, not a fobbing off.

Narrowing of the spinal canal rather than a disc fragment is a different operation: see laminectomy. For a disc in the neck rather than the lower back, see cervical disc disease. For curvature, see scoliosis treatment.

• It does not repair the disc. The worn disc stays worn. What is removed is the fragment pressing on the nerve.
• It does not reliably treat back pain. If back pain is your main symptom, this is the wrong operation to be discussing, and a surgeon should say so.
• It does not prevent a future herniation. At the same level or another one. Nothing offered afterwards changes that, whatever a package says.
• It does not always restore lost strength. A weak foot may recover, partly recover, or not. Time under compression matters, which is why progressive weakness is assessed quickly.
• It does not remove the need for rehabilitation. The exercise programme afterwards is part of the treatment, and it happens at home rather than in the clinic that operated.

• How many levels are treated. One level is the standard case. More than one changes the operation and the recovery, and it should be named in the quote.
• Whether fusion or instrumentation is proposed. A far larger operation with a different recovery. If metalwork appears in a quote for sciatica, ask exactly why.
• Hospital nights and the level of care. A spine operation is not a day case package like cosmetic surgery, and the quote should say how many nights and in what kind of unit.
• Imaging and pre-operative assessment. Whether new imaging, blood tests and the anaesthetic review are included.
• Physiotherapy and follow-up. What is included before you fly, and what is expected of you at home.

The clinic list on this page shows each clinic's current price with a note on what it includes. For instalments, see payment plans. For canal narrowing, see laminectomy; for the neck, see cervical disc disease.

• Ask who operates and what they are trained in. Spine surgery is done by neurosurgeons and by orthopaedic spine surgeons. Ask which, and how much of their practice is lumbar disc work.
• Ask what proportion of patients they turn down. A surgeon who operates on everyone who asks is telling you something about how the decision is made.
• Ask about recurrence at the same level. How often it happens in their hands, how it is assessed, and what a second operation would involve.
• Ask about the hospital, not just the surgeon. Which hospital, what happens overnight, and who sees you if something changes at two in the morning.
• Ask how they handle a complication after you fly. Named contact, expected response time, and what they will send to a doctor at home.