Herniated Disc. Neck pain. Arm pain. Back pain. Sciatica. One cause — many solutions.

Often yes — particularly for lumbar disc herniations. Studies consistently show that approximately 80% of lumbar herniations improve significantly within 6–12 weeks with conservative care. The body’s immune system treats the herniated nucleus material as a foreign body and gradually resorbs it over weeks to months. Interestingly, larger extruded herniations (where the nucleus has fully escaped through the annulus) often resorb faster than smaller contained bulges. Cervical herniations also frequently improve, though cord compression may warrant more expedited intervention. The key is a structured conservative plan with appropriate monitoring — not passive waiting.

These terms are often used interchangeably but have distinct meanings. A bulging disc means the disc has lost height and the annulus protrudes beyond the vertebral endplates — but the annulus has not torn. A herniated disc means the nucleus has pushed through a tear in the annulus. An extruded disc means the nucleus has completely escaped through the annulus. A sequestered disc means a fragment of nucleus has broken off and is free in the spinal canal. “Slipped disc” is a colloquial term with no precise medical meaning. For practical purposes, herniated and extruded discs tend to cause more significant nerve compression and more acute symptoms than bulges.

The standard recommendation is 6 weeks of structured conservative treatment — physical therapy, medications, and activity modification — before surgical evaluation is discussed. If injections are added and provide temporary but not lasting relief, that trial is typically extended to 8–12 weeks. However, these are guidelines, not rules. If you have significant motor weakness (foot drop, hand weakness), progressive neurological deficit, or cord compression (cervical myelopathy), waiting 6 weeks is not appropriate — earlier evaluation and potentially expedited surgery is warranted. The consultation with Dr. Katsevman will establish the right timeline for your specific situation.

Yes — and the treatment differs significantly. Sciatica caused by a lumbar disc herniation (the most common cause in patients under 50) is best treated with rest, physical therapy, injections, and if needed, minimally invasive discectomy. Sciatica caused by spinal stenosis (more common over 60) requires a different surgical approach — laminectomy or TOPS rather than discectomy. Sciatica caused by spondylolisthesis, piriformis syndrome, or SI joint dysfunction has its own treatment pathway. Dr. Katsevman identifies the specific source of your sciatica from your MRI and clinical presentation before recommending any treatment.

Disc reherniation after discectomy occurs in approximately 5–15% of cases — most commonly within the first year. It is more likely when the annular defect left after discectomy is large (larger than approximately 6mm). Dr. Katsevman’s 3R Discectomy addresses this risk directly with the optional Barricaid® annular closure device, which has been shown to reduce reoperations for reherniation by 81% compared to discectomy alone. If you have already reherniatedafter a prior discectomy, revision surgery is still possible — the approach depends on the anatomy, the level, and what was done previously. Dr. Katsevman will review your prior operative report and current MRI to determine the best path forward.

Absolutely. Dr. Katsevman offers in-person and telemedicine second-opinion consultations for patients across Florida and nationally. If you’ve been told you need surgery and want to understand your options more fully — or if you’ve been told surgery is not possible and want to know if that’s true — bring your MRI images and prior records. A second opinion from a fellowship-trained minimally invasive specialist frequently changes the picture: either confirming the recommendation with added confidence, or identifying a less invasive option that wasn’t offered.