**The cost of lumbar disc surgery** caused by long-term and complex treatments, do not hesitate and be sure to see a doctor. performed intensively, have up to 85% better results than patients who wait months or years for surgery. A long delay in decision-making can cause permanent nerve damage and make full recovery difficult, even after surgery." Urinary or fecal incontinence (horse tail syndrome) Cauda equina syndrome is one of the most serious lumbar disc emergencies that requires immediate medical intervention. This condition occurs when a large herniated disc puts pressure on a set of nerves that control the function of the bladder, bowel, and lower limbs. The main symptoms include loss of urinary or stool control, numbness or tingling in the genital area and the inside of the legs (similar to the feeling of a horse's saddle). If this condition is not treated quickly, permanent damage to the nerves may occur and the patient may experience chronic excretory or sexual disorders. In case of diagnosis of cauda equina syndrome, it is necessary to determine the time of lumbar disc surgery to reduce the pressure on the nerves. This surgery helps preserve nerve function and prevent more serious problems. Timely treatment of this condition is the key to prevent permanent complications and improve the patient's quality of life. ### Severe and unbearable pain Severe and persistent lumbar disc pain that does not respond to any non-surgical treatment such as medication or physical therapy may indicate the time for lumbar disc surgery and immediate intervention. This type of pain usually occurs due to compression of the sciatic nerve or severe irritation of the disc and can be so unbearable that the patient experiences discomfort even while resting, sitting or sleeping. In such cases, doctors may suggest surgery as a final solution after carefully evaluating the patient's condition and performing imaging such as MRI. Surgery in these cases is performed with the aim of reducing pressure on the nerve, relieving pain and restoring normal function. Acting quickly to treat these conditions not only helps reduce pain, but also prevents long-term complications such as permanent nerve damage. ### Decreased muscle strength and movement Significant reduction in muscle strength and movement is another lumbar disc emergency that requires immediate treatment. This condition occurs when the damaged disc puts pressure on the motor nerves, causing muscle weakness or reducing the patient's ability to perform daily activities. In more advanced cases, the lack of treatment can lead to muscle wasting and completely impair the patient's movement. After a thorough examination and imaging review, your doctor may recommend surgery to relieve pressure on the nerves and restore muscle strength. Surgery at this stage can play a key role in preventing permanent damage and restoring the patient's normal function. ### Failure to respond to non-surgical treatments One of the conditions when the time for lumbar disc surgery comes is when there is no response to non-surgical treatments such as physiotherapy, massage therapy, corticosteroid injection or drug therapy; In this case, the patient may still experience severe pain, weakness, or numbness that does not improve and interferes with their daily life. This condition usually occurs when the disc damage or nerve compression is too severe and conservative methods are not able to solve the problem. In these cases, surgery is performed with the aim of removing the source of pressure on the nerve and restoring balance to the spine. The specialist doctor evaluates the need for surgery by using advanced imaging such as MRI and the severity of the injury. This intervention helps patients who have been facing pain and limitation for a long time to restore their quality of life. ### Instability of the spine One of the answers to the question, when does the lumbar disc need surgery? When the spine is unstable. Spinal instability is another condition that can require emergency lumbar disc surgery. This condition usually occurs when the vertebrae are unable to maintain balance and strength due to a herniated disc or destruction of the supporting structures of the spine. The result of this instability can include severe pain, difficulty moving, and an increased risk of nerve damage. Surgery in these conditions is performed with the aim of stabilizing the spine. Procedures such as spinal taping or fusion can restabilize the spine and relieve pressure on the nerves. Early diagnosis and timely action for lumbar disc surgery can prevent serious complications such as permanent nerve damage and return the patient to daily activities. ### Advanced movement problems or partial paralysis One of the important issues that patients should consider when facing serious lumbar disc problems is the importance of accurate timing for surgery. Especially in an emergency, quick action can mean the difference between a full recovery or permanent damage. Under what conditions does lumbar disc surgery become an emergency procedure? - Severe disc pressure on the spinal cord or motor nerves. - Advanced movement problems or signs of partial paralysis. Signs of severe nerve damage that can quickly lead to permanent problems. - The need for urgent surgery to remove pressure from the spinal cord and motor nerves. - The importance of time in preventing permanent paralysis or loss of organ function. - Evaluation of injury severity by doctors through clinical signs and accurate imaging. - Quick decision for surgery in order to increase the chance of full recovery of the patient. Symptoms of lumbar disc surgery Many patients suffer from chronic pain, limited mobility or neurological problems that interfere with their daily life. Timely identification of these symptoms helps the doctor to carefully decide on surgery or continuing non-surgical treatments. The following table lists the most important warning signs: Emergency cases for lumbar disc surgery Some conditions require immediate surgical intervention to prevent permanent nerve damage. When a patient experiences severe pain, loss of urinary or stool control, sudden muscle weakness, or widespread numbness, they should see a doctor immediately. These situations are clear examples of when the lumbar disc needs to be operated and any delay can have irreparable consequences. Surgery in these emergency situations often reduces pain, restores function and prevents long-term damage. > According to Dr. Anthony M. Awadala, spine surgeon, "immediate disc surgery is recommended in cases of severe lower limb weakness, perineal numbness, or bladder or bowel dysfunction." Tips before lumbar disc surgery Patient preparation before surgery plays an important role in the success of the operation and reducing complications. Following some simple tips can make the recovery process shorter and safer. The most important items are listed below: - Complete medical history review - Performing pre-operative tests - Informing about the drugs used - Quit smoking and alcohol - Set up a healthy eating plan - Planning for rest after surgery - Provision of auxiliary aids such as canes or medical belts - Preparing the living area to reduce the pressure on the back - Teaching the correct techniques of moving and lifting objects All these tips will help you to perform lumbar disc surgery with the least risk and the most success. When is the right time for lumbar disc surgery? According to the results of a 2024 study published in the journal *Spine*, patients who underwent lumbar disc surgery within the first 6 weeks after the onset of severe lumbar disc symptoms experienced 40% faster improvement in motor function and pain reduction than patients who delayed surgery. Also, the data shows that if lumbar disc surgery for the elderly and other patients is performed between 3 and 6 months after the onset of symptoms, the chance of success is reduced by about 20%. These statistics highlight the importance of early detection of conditions such as lumbar disc herniation, pressure on the sciatic nerve, and numbness or weakness in limbs. Research also suggests that in cases where nerve damage or signs of partial paralysis are present, each month delaying laminectomy or microdiscectomy reduces the chance of full nerve function return by 15%. For this reason, experts recommend that if there is no response to non-surgical treatments within 6 to 8 weeks, the patient should be evaluated for surgery in time to avoid irreversible complications. The right time for lumbar disc surgery becomes necessary when symptoms of the disease, such as severe pain, muscle weakness or numbness, have not responded to non-surgical treatments and have disrupted the patient's daily life; Also, in acute cases such as urinary or fecal incontinence (horsetail syndrome) and a severe decrease in muscle strength, surgery should be performed without delay. The decision for surgery should be made by a specialist doctor after a complete assessment of the patient's condition. In this regard, referring to an experienced and expert doctor like **Dr. Mahmoud Yazdan Panahi** can have a significant effect on the success of the treatment. Dr. Yazdan Panahi, with extensive expertise and experience in treating lumbar disc problems, chooses the best method based on the patient's condition.