Discectomy

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What is it?

Discectomy literally means "cutting out the disc." A discectomy can be performed anywhere along the spine from the neck (cervical) to the low back (lumbar). The surgeon reaches the damaged disc from the back (posterior) of the spine—through the muscles and bone. The surgeon accesses the disc by removing a portion of the lamina. The lamina is the bone that forms the backside of the spinal canal and makes a roof over the spinal cord. Next, the spinal nerve is retracted to one side. Depending on your particular case, one disc (single-level) or more (multi-level) may be removed.

A variety of surgical tools and techniques can be used to perform a discectomy. Your surgeon will recommend the technique most appropriate for your specific case.

What is its goal? to remove a herniated or degenerative disc in the spine causing neck, back or extremity pain, or nerve compression.

What is the success rate?

Good results are achieved in 80 to 90% of patients treated with discectomy.

What are the risks? No surgery is without risks. General complications of any surgery include bleeding, infection, blood clots, and reactions to anesthesia. Specific complications related to a discectomy may include:

• Deep vein thrombosis (DVT) is a potentially serious condition caused when blood clots form inside the leg veins. If the clots break free and travel to the lungs, lung collapse or even death is a risk. However, there are several ways to treat or prevent DVT. Get up and out of bed as soon as possible so your blood is moving and less likely to clot. Support hose and pulsatile stockings can keep the blood from pooling in the veins. Drugs, such as aspirin, Heparin, or Coumadin, may also be used.
• Lung problems. Lungs need to be working their best after surgery to provide tissues with enough oxygen to heal. If the lungs have collapsed areas, mucus and bacteria build up can lead to pneumonia. Your nurse will encourage you to breath deeply and cough often.
• Nerve damage or persistent pain. Any operation on the spine comes with the risk of damaging the nerves or spinal cord. Damage can cause numbness or even paralysis. However, the most common cause of persistent pain is nerve damage from the disc herniation itself. Some disc herniations may permanently damage a nerve making it unresponsive to decompressive surgery (Fig. 6). In these cases, spinal cord stimulation or other treatments may provide relief. Be sure to go into surgery with realistic expectations about your pain. Discuss your expectations with your doctor.

How long will I stay in the hospital?

Most patients go home within 1 to 2 days. The recovery time varies from 1 to 4 weeks depending on the underlying disease treated and your general health. You may feel pain at the site of the incision. The original pain may not be completely relieved immediately after surgery. Aim to keep a positive attitude and diligently perform your physical therapy exercises if prescribed.

Most people can return to work in 2 to 4 weeks or less with jobs that are not physically challenging. Others may need to wait at least 8 to 12 weeks to return to work for jobs that require heavy lifting or operating heavy machinery

What center provides this treatment?

Neurosurgical Spine Center