Injured workers with degenerative disc disease tend to gradually improve over time. Most do not need surgery. Some studies indicate only one to three percent of patients with degenerative disc problems typically require surgery. Doctors prefer to try nonsurgical treatment for a minimum of three months before considering surgery. If, after this period, nonsurgical treatment hasn’t improved symptoms, the doctor may recommend surgery. The main types of surgery for degenerative disc problems include:
Lumbar Laminectomy
The lamina forms a roof-like structure over the back of the spinal column. When the nerves in the spinal canal are squeezed by a degenerated disc or by bone spurs pushing into the canal, a laminectomy removes most, or all of the lamina to release pressure on the spinal nerves.
Discectomy
Surgery to take out part or all of a problem disc in the low back is called discectomy. Discectomy is done when the degenerated disc has ruptured (herniated) into the spinal canal, putting pressure on the spinal nerves. Surgeons commonly perform this operation through an incision in the low back. Before the disc material can be removed, the surgeon must first remove part of the lamina. Generally, only a small piece of the lamina is chipped away to expose the problem disc. This is called laminotomy. It usually creates enough room for the surgeon to remove the disc. If more room is needed, the surgeon may need to take out a larger section of the lamina by doing a laminectomy (described above).
Many surgeons now do minimally invasive surgeries that require only small incisions in the low back. These procedures are used to remove damaged portions of the problem disc. Advocates believe that this type of surgery is easier to perform. They also believe it prevents scarring around the nerves and joints and helps patients recover more quickly. Minimally invasive surgeries include percutaneous lumbar discectomy, laser discectomy, and microdiscectomy.
After surgery, the worker is entitled to temporary total disability benefits in Wisconsin if the surgeon states the need for the surgery was work-related. Unfortunately, many times the workers compensation insurance company has their own independent medical examiner or IME issue a contrary opinion, and the claims adjuster denies the claim. In those cases we fight for workers compensation benefits such as temporary total disability or TTD and then permanent partial disability or PPD at the end of healing. If there are permanent work-related work restrictions we go for loss of earning capacity or LOEC benefits and/or vocational retraining benefits as well. Keep in mind, surgery is not necessary for permanent restrictions or LOEC or retraining benefits.
McCormick Law Office in Milwaukee, Wisconsin protecting workers rights in workers compensation cases for degenerative disc disease.
