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equina syndrome (emergency)","Intractable radicular pain with concordant MRI findings"],"main_risks":["Recurrent disc herniation","Wound infection or discitis","Dural tear with cerebrospinal fluid leak","Nerve root injury, persistent numbness or weakness","Bleeding or hematoma","Persistent or recurrent back or leg pain","Anesthesia-related risks and venous thrombosis"],"pain":"Moderate incision-site and back pain for the first days to 2 weeks, controlled with oral analgesics; leg pain usually improves quickly after surgery.","preparation":["Recent MRI or CT confirming herniation level and side","Pre-operative medical assessment and blood tests","Fasting before general anesthesia as instructed","Review of medications with the surgical team","Stop smoking where possible","Arrange transport and help at home for the first days"],"recovery_timeline":[{"phase":"Day 0-3","description":"Mobilization the same or next day, wound care, pain control.","restrictions":["No heavy lifting","Avoid prolonged sitting and bending"]},{"phase":"Weeks 1-2","description":"Walking progressively increased; wound heals and sutures or skin closure are checked.","restrictions":["No lifting over a few kilograms","No driving while on strong analgesics"]},{"phase":"Weeks 2-6","description":"Return to light or desk work and gradual activity; start of core stabilization exercises.","restrictions":["Avoid heavy lifting and twisting"]},{"phase":"Weeks 6-12","description":"Progressive return to exercise and physical work.","restrictions":["Avoid high-impact and contact sports until cleared"]}],"rehabilitation_days":{"min":7,"max":21,"unit":"days","qualifier":"Light daily activities resume within 1–3 weeks; return to work, heavy lifting and sport come later."},"result_longevity":"Many patients have lasting relief of leg pain; recurrence at the same or adjacent level can occur in a minority, and long-term outcome depends on spine health and lifestyle.","revision_rate_pct":{"min":5,"max":10,"unit":"percent","qualifier":"Repeat surgery for recurrent herniation or persistent symptoms at the same level within 2-5 years."},"scars":"Small midline or paramedian incision, typically 2-4 cm for microdiscectomy, usually fading to a thin line.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation."},"stages":[{"code":"surgery","label":"Discectomy removing the herniated fragment","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of procedure."}}],"qualifier":"Standard single-level primary microdiscectomy in one session."},"success":{"metric":"Patients reporting good or excellent outcome for leg pain and function","value":80,"unit":"percent","horizon":"1–2 years","population":"Adults after primary lumbar discectomy for radiculopathy failing conservative care","evidence_status":"limited"},"techniques":[{"name":"Microdiscectomy","suits_whom":"Typical lumbar disc herniation with nerve root compression.","recovery":"Short stay or same day; return to light work in about 2-4 weeks."},{"name":"Endoscopic discectomy","suits_whom":"Selected lumbar herniations suitable for a minimally invasive approach.","recovery":"Often same day; slightly quicker early recovery."},{"name":"Anterior cervical discectomy and fusion","suits_whom":"Cervical herniation with radiculopathy or myelopathy.","recovery":"Usually 0-1 night; desk work in about 2-4 weeks."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Single-level primary lumbar microdiscectomy, operating time."},"initial_assessment_documents":["Spine MRI report and images","Neurological examination or specialist report","Record of prior conservative treatment","List of blood thinners","Recent spine X-rays (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-session surgery; stay 5-10 days including 0-2 hospital nights; follow-up visits usually done at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the surgeon explains how long nonsurgical treatment should be tried before surgery is considered","scope":"procedure","source":{"url":"https://www.orthoinfo.org/en/diseases--conditions/herniated-disk-in-the-lower-back/","host":"orthoinfo.org","quote":"Your doctor will talk to you about how long you should try nonsurgical treatments before considering surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check the qualifications of the clinician who will be doing the procedure","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"Check the qualifications of the clinician who will be doing the procedure","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Make sure you understand the possible complications and side effects before agreeing to treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check that you are satisfied with the facilities and standards where you will be treated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check that you are clear how your aftercare will be coordinated before you go","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A hard sell before booking is a warning sign","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, no mention of aftercare.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"No discussion of possible complications during the consultation is a warning sign","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, no mention of aftercare.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"No mention of aftercare in the offer or consultation is a warning sign","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, no mention of aftercare.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Sudden numbness or muscle weakness","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/procedures/discectomy","host":"my.clevelandclinic.org","quote":"Sudden numbness or muscle weakness.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Difficulty peeing or pooping","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/procedures/discectomy","host":"my.clevelandclinic.org","quote":"Difficulty peeing or pooping.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Severe pain or worsening pain","urgency":"contact_clinic","general":true,"source":{"url":"https://my.clevelandclinic.org/health/procedures/discectomy","host":"my.clevelandclinic.org","quote":"Severe pain or worsening pain.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Gives the home doctor the surgery and prescribed-medicine details","document":"discharge letter","source":{"url":"https://www.guysandstthomas.nhs.uk/health-information/recovering-lumbar-spine-decompression-or-discectomy/advice-help-your-recovery","host":"guysandstthomas.nhs.uk","quote":"Your GP gets a discharge letter from the hospital about your surgery and the medicines that we prescribed for you.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"T2","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Lets the home doctor compare new spine scans and avoid repeat tests","document":"spine mri or ct copies","source":{"url":"https://radiologyinfo.org/en/info/article-your-medical-images","host":"radiologyinfo.org","quote":"You may want copies of your medical images to bring with you to a doctor's appointment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You want pain relief from a herniated disc without surgery","name":"Epidural steroid injection","source":{"url":"https://my.clevelandclinic.org/health/treatments/22091-lumbar-epidural-steroid-injection","host":"my.clevelandclinic.org","quote":"Lumbar ESIs are most effective in providing pain relief from a herniated disk and spinal stenosis.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"microdiscectomy","name":"Microdiscectomy","how_it_works":{"text":"Surgeon removes damaged disc tissue to relieve nerve pressure","source":{"url":"https://www.healthline.com/health/microdiscectomy","host":"healthline.com","quote":"With a 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