Discectomy is a surgical procedure that removes a herniated or degenerative disk from the lower back (lumbar) that may be pressing on the spinal cord or on a nerve root. Discectomy is usually recommended if medication or physical therapy fail to relieve any back or leg pain or if the patient has signs of nerve damage such as loss of feeling or weakness in the legs.
A lumbar discectomy is a surgical procedure that specifically fixes a herniated disc in the lower back. The spinal column is made up of bones called the vertebrae. The spinal cord passes through the spinal column, and these bones help to protect the spinal cord from injury. Between each vertebra there are discs which provide cushioning and support. Nerve roots pass from the spinal cord through small holes in the bones known as foramen. The work of the nerve roots is to send and receive signals to and from the body. The signals are sent to and from the brain through the spinal cord.
The outer wall of these discs can sometimes dry out and weaken with injury or ageing causing the soft inner disc to bulge out. This is what is known as the herniated or bulging disc. This herniated disc can press on the spinal cord and cause symptoms such as tingling, pain or weakness in a nearby part of the body.
A discectomy may be recommended if medication or physical therapy fail to relieve the symptoms. There are two techniques that can be used to perform it: open and minimally invasive techniques.
A discectomy can be performed anywhere along the spine from the cervical (neck) to the lumbar (low back). It is done under general anaesthesia and can take between 1-2 hours depending on the technique used.
During the surgery, the surgeon reaches the herniated disc from the posterior or back of the spine. To access the disc, a portion of the lamina is removed. The lamina is the outer side of the spinal canal, which protects the spinal cord. Depending on the case, one disc (single level) or more (multi-level) may be removed to ease pressure on the spinal cord.
The open technique involves using a large skin incision and muscle retraction thus enabling the surgeon to view the area directly.
The minimally invasive technique, also known as microendoscopic discectomy, involves the use of a small skin incision on the back. The surgeon inserts a small tube through this incision, between the vertebrae and into the space with the damaged disc. He/she then inserts tiny instruments through the tube to remove part of the disc. A laser can also be used to remove part of the disc. A minimally invasive technique causes less disruption of the back muscles and decreases recovery time.
A fusion may also be done at the same time as discectomy to help in stabilizing the spine for patients who have spinal instability, perform heavy physical activities or are athletes. Fusion uses bone graft and screws or plates to connect two vertebrae together, fusing them into one piece of bone.
What to expect
Following the discectomy surgery, the patient may spend a night at the hospital for observation. Pain medication is prescribed to control any discomfort during the recovery. Exercise and other activities can be resumed slowly.
NOTE: Duration of the procedure, downtime, and recovery vary on a case by case basis
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