Discectomy: Definition, Reasons, Risks, Preparation, and Procedure
What is a discectomy?
A discectomy is a surgical operation done on your spine to relieve the symptoms of a herniated or bulging disc. When a spinal disc herniates, the protruding portion of it can pinch or compress the nerves around it. This can cause weakness, numbness or pain in your back, and the pain can also follow the path of the nerve, radiating down your legs or arms. A discectomy removes the portion of the disc that is damaged or bulging.
Discectomy works best for the pain that radiates away from the back, down into either the arms or the legs. It is not as helpful for relieving pain centered in the back or neck. The majority of patients who have pain in the neck or back find more relief with non-surgical treatments such as physical therapy and medications for pain.
If non-surgical treatments haven't been successful in relieving your pain, or if your symptoms continue to get worse, your doctor may recommend discectomy. There are several different methods used to perform the discectomy. One technique that is minimally invasive involves small incisions and a minuscule camera.
Reasons for Discectomy
A disc herniates when a crack or tear develops in the tough outer rim and some of the gel-like centers of the disc escapes through the crack or tear. This gel-like material takes up space in the spinal canal, placing pressure on the nearby spinal nerve or the spinal cord itself. A discectomy is a surgical procedure that is done to take the pressure off the nerves or spinal cord by removing part or all of the herniated disc. Herniated discs are sometimes called slipped discs, ruptured or bulging discs, or prolapsed discs.
Your physician might advise discectomy if:
- Nerve weakness has progressed to the point you have difficulty walking or standing
- After six weeks of non-surgical treatment, such as physical therapy, your symptoms are not improving
- A fragment of a disc becomes lodged in the spinal cord and is compressing a nerve
- The pain radiating into your arms, chest, legs or buttocks is no longer manageable
Risks of Discectomy
Discectomy is considered to be a safe operation. Just like any surgery, there is a risk of complications occurring during a discectomy. Possible complications include the following:
- Spinal fluid leaking
- Damage to nerves or blood vessels around and in the spine
- Damage to the protective layer of tissues that surround the spine
Preparation for Discectomy
You may not be able to eat or drink for several hours before your operation. Your doctor will provide you with instructions concerning this. If you have any questions, be sure to ask your physician.
A discectomy is typically completed under general anesthesia, so you will be asleep during the operation. You will be given medication to make you sleepy to breathe in through a mask or through an intravenous (IV) line.
After the incision is made, small portions of ligaments and spinal bone may have to be taken out so the surgeon can see and operate on the disc that is damaged. The goal is to remove only the portion of the disc that is compressing the nerve while leaving the rest of the disc intact. Sometimes the entire disc needs to be removed. When this happens, the surgeon will need to fill the gap left by the disc with another piece of bone or an artificial bone. The vertebrae lying just above and just below where the damaged disc was removed, will be joined together using surgical medical hardware.
Following a discectomy, you will wake up in the recovery room. You will stay here for a short time to make sure your condition is stable. Some people return home the same day they have a discectomy, but if there were any other medical problems, you might have to stay a few days to help prevent complications.
Depending on the type of job you do, you might be able to return to work within two to six weeks. If your job requires operating heavy machines or equipment, or heavy lifting, your physician may not allow you to go back to work for six to eight weeks. For at least four weeks after surgery limit, the amount of stooping, bending and lifting you do, and you might also need to decrease the amount of time you spend sitting.
A skilled physical therapist will be able to instruct you in an exercise plan that will improve the flexibility and strength of your back muscles.
Results of Discectomy
Discectomy helps to relieve the symptoms of a herniated disc in most people who have clear indications of nerve compression, such as pain that radiates from the back into the arms or legs.
A discectomy may not provide permanent relief, however, because it does not solve the underlying problem that initially caused the disc to herniate. Your doctor may make some recommendations that will help you avoid injuring your spine again, such as a routine program of low-impact exercise or weight reduction. It may also be recommended that you avoid activities that require repetitive or extensive lifting, twisting or bending.