Discectomy is a surgery performed to remove all or part of a pad that helps protect the spine. These pads, called discs, separate the bones of the spine (vertebrae). A surgeon can perform the removal of the disc (discectomy) in different ways:
Microdiscectomy: This procedure is still the preferred treatment due to its simplicity, low- complication rate, and a high percentage of satisfactory results.
Lower back discectomy (lumbar spine): It may be part of a larger surgery that also includes a laminectomy, a foraminotomy, or a vertebral arthrodesis.
Cervical Discectomy (cervical spine): It is most often performed along with a laminectomy, foraminotomy, or vertebral arthrodesis.
The surgeon makes a small (1 to 1.5 inch) incision (cut) in the back and moves the muscles away from the back of the spine. The doctor uses a special microscope to see the damaged discs and nerves.
The surgeon finds the root of the nerve and moves it away. Then, removes the tissue and fragments of the injured disc. The surgeon places the back muscles back in place and closes the wound with sutures or staples. The surgery takes about 1 to 2 hours.
The surgeon makes a larger cut in the back above the spine and moves the muscles and tissues to expose the latter.
A small part of the lamellar bone (part of the vertebrae that surrounds the spine and nerves) is cut and separated. The opening can be as large as the ligament that runs along the spine. The surgeon makes a small hole in the disc that is causing the symptoms and removes material from inside. Other fragments of the disc can also be removed.
When do doctors recommend surgery?
When one of the discs has a hernia (it comes out of its place), the soft gel inside presses through the disc wall. The disc can then put pressure on the spinal cord and the nerves that are coming out of the spine.
Many of the symptoms caused by a herniated disc improve or disappear over time without surgery. Most people with lumbago or neck pain, numbness or even mild weakness are often treated first with anti-inflammatory medications, physical therapy and exercise. Only a few people with a herniated disc need surgery.
The doctor may recommend a discectomy if you have a herniated disc and:
- Pain or numbness in the leg that is very intense or is not disappearing, therefore making it difficult to perform daily tasks.
- Severe weakness in the muscles of the lower leg or buttocks.
- Pain that spreads to the buttocks or legs.
- If you are having bowel or bladder problems. Or when the pain is so severe that strong pain killers do not help, you will probably need surgery.
What is the prognosis?
Most people have pain relief and can move better after surgery. The numbness and tingling should improve or disappear.