What Is a Discectomy?
A discectomy is a surgical procedure to excise all or part of an intervertebral disc. A disc is a shock absorber of the spine, each one sitting between two vertebrae to enable flexibility while minimizing friction between the bones. When a disc is damaged, not only do you lose its benefits, but its soft contents can spill into areas occupied by sensitive nerves, which then cause pain. There are three types of discectomies:
- An anterior surgical approach, which is from the front
- A lateral discectomy, which is from the side
- A posterolateral approach, which is from behind and to the side
What Are the Reasons for a Discectomy?
One of the main causes of chronic back pain is a herniated spinal disc. You can get a herniated disc in your neck, your middle back or your lower back. A disc herniation is a painful condition that requires treatment.
When an intervertebral disc is damaged, the gel-like substance in its center leaks out. That substance has to go somewhere, and it often presses on your spinal nerves, resulting in debilitating pain and other symptoms. Spinal doctors recommend a discectomy to remove the damaged portion of a herniated disc. There are three different results from a herniated disc:
- When the substance invades your spinal column, it creates a condition called cervical stenosis if it’s in your neck or lumbar stenosis if it’s in your lower back.
- When the substance compresses a root nerve exiting your spinal canal, it’s a radiculopathy or compressed nerve, which can occur in your neck (Cervical Radiculopathy), your mid-back or your lower back (Lumbar Radiculopathy).
- It’s possible you have a herniated disc that doesn’t cause any symptoms at all. These are usually discovered during routine imaging tests or while diagnosing another condition.
When Is a Discectomy Necessary?
A herniated spinal disc, including a bulging or slipped disc in your neck, requires surgery if it’s causing symptoms. When the leaked disc material pushes against a nerve root or your spinal cord, it leads to an array of spinal problems, including chronic pain. The condition usually occurs due to disc degeneration, spinal injury or infection.
Some situations that require the removal of damaged disc material include:
- The diagnosis of a herniated disc or pinched nerve
- Persistent pain, weakness or numbness in your leg or foot
- Leg pain due to sciatica
- Non-surgical treatments, such as physical therapy or medication, don’t work
- Loss of mobility in your legs
- Loss of bowel or bladder control
- Numbness or tingling in your buttocks, genitals or legs
Are All Discectomies the Same?
During your discectomy surgery, your spine surgeon has choices to make, such as which steps to take. All discectomies are not the same. Within the procedure, your surgeon may decide to do:
- Open discectomy. In this procedure, the spinal surgeon uses an incision in your back or neck to access the damaged disc. It’s called an open discectomy because your surgeon makes an incision wide enough to see what he’s doing. This procedure requires a longer recovery.
- Microdiscectomy. For this procedure, your surgeon can use smaller incisions, from two to 12 millimeters. He passes a tube with a camera, like an endoscope, through the incision. Surgical instruments are delivered to the damaged disc through the tube. Your surgeon relies on a computer monitor during the process. Because you have smaller incisions, you need less time to recuperate.
- Laminotomy. Sometimes, to get to the damaged disc, your surgeon has to remove the back of a vertebral bone, called the lamina, to allow more access. This procedure also relieves pressure on the spinal cord and allows your doctor to remove any bone spurs that are causing pain and compression.
Furthermore, a herniated disc can occur in any section of your spine. Your exact procedure depends on what part of your spine has been hurt by a herniated disc:
- Cervical discectomy. This is the removal of a herniated or degenerative disc in your neck.
- Lumbar discectomy. This surgery removes a herniated or degenerative disc in the lower spine.
- Anterior cervical discectomy. This is a surgical procedure to remove a herniated or degenerative disc in the neck from an incision in your throat.
- Anterior cervical discectomy fusion (ACDF). After an anterior cervical discectomy, your spine surgeon inserts a graft to fuse together the bones above and below the damaged disc.
- Thoracic discectomy. This procedure removes a herniated or degenerative disc in the mid-back area.
How Long Is My Recovery from a Discectomy?
A minimally invasive discectomy is effective and offers faster treatment compared to non-surgical treatment. With this outpatient procedure, you can go home the same day you have surgery. If you have an open discectomy, a short hospital stay of one or two days is necessary. Depending on the nature of your occupation, you can return to work in two to six weeks. Guidelines for recovery include:
- Taking medication for any discomfort
- Understanding the risks, such as nerve damage and infection
- Avoiding physical activities that include bending, lifting, twisting, strenuous activity and driving for two weeks
- Taking precautions when bathing
- Calling your doctor if the incision shows signs of infection or if your temperature exceeds 101.5 degrees Fahrenheit
- Scheduling a follow-up appointment
- Avoiding smoking for two weeks
- Using an ergonomic work area