Discectomy

What is a discectomy?

Discectomy is the surgical removal of part or all of a spinal disc. A discectomy treats degenerated, herniated (prolapsed, bulging or slipped), or ruptured spinal discs. Spinal discs are located between each vertebra of your spine and act as cushions to protect your spine. A herniated disc can press against the spinal cord or the nerves that frame the spinal cord. A discectomy can relieve nerve compression and pain caused by a herniated disc.

Discectomy is a common but major surgery with significant risks and potential complications. You may have less invasive treatment options and should consider getting a second opinion about all your treatment choices before having a discectomy.

Types of discectomy

The types of discectomy procedures include:

• Cervical discectomy is the removal of a disc in the neck area (cervical spine).
• Lumbar discectomy is the removal of a disc in the lower back (lumbar spine).
• Sacral discectomy is the removal of a disc in the back between your pelvic, or hip bones (sacral spine).
• Thoracic discectomy is the removal of a disc in the middle part of the back (thoracic spine).

Other surgical procedures that may be performed

In addition to discectomy, your doctor may recommend one or more additional procedures to treat certain conditions. These can include:

• Foraminotomy is the widening of the opening where the nerve roots leave the spinal canal. Your doctor may use this procedure when the opening (foramina) is narrowed causing pressure on the spinal nerves.
• Laminectomy is the removal of a bony area called the lamina. The lamina is the back part of each vertebra of the spine. A laminectomy can relieve pressure in your spinal canal or on your spinal nerves.
• Spinal fusion is the permanent joining together of two vertebrae. This procedure permanently stops movement between the two vertebrae.

Why is a discectomy performed?

Discectomy is a major surgical procedure that your doctor may recommend to treat certain diseases and conditions of the spine. Your doctor may only consider a discectomy for you if other treatment options that involve less risk of complications have been ineffective. Talk with your doctor about all your treatment options and consider getting a second opinion.

Your doctor may recommend a discectomy for degenerated, herniated or ruptured discs under the following conditions:

• Back or leg pain, weakness or numbness that does not get better with other treatments after six weeks or longer. Other treatments include anti-inflammatory medications, rest, and physical therapy.
• Severe back or leg pain, weakness or numbness that makes walking and other daily tasks difficult or impossible
• Inability to control your bowels or bladder

How is a discectomy performed?                

A neurosurgeon or orthopedic surgeon will lead a surgical team to perform your discectomy. A neurosurgeon is a doctor who specializes in the surgical treatment of diseases and conditions of the nervous system, including the nerves of the spine. An orthopedic surgeon is a doctor who specializes in treating diseases and conditions of the muscles and bones, including the spine.

Surgical approaches to discectomy

Your doctor will perform a discectomy using one of the following general approaches:

• Open surgery is performed by making a two-to-four inch incision down the middle of the affected part of your spine. An open surgery incision allows your doctor to directly view and access the surgical area. This is the most common type of surgery for ruptured or herniated discs of the lumbar spine. Your surgeon may perform an open surgery if you need other surgical treatment on your spine in addition to a discectomy. These may include laminectomy, foraminotomy, or spinal fusion.
• Microdiscectomy is a minimally invasive surgery. It involves inserting special instruments through a small incision, usually less than one inch, along the side of the affected area of your spine. Microdiscectomy may be a treatment option if you do not need other surgical treatments. Microdiscectomy, as compared to an open procedure, generally entails a faster recovery time, less pain, and a lower risk of some complications, such as infection. This is because your surgeon can thread surgical tools around many structures instead of cutting through them as in open surgery.
• Anterior discectomy is the removal of a spinal disc through an incision in the front part of your body. For cervical discectomy, the approach is through the neck. For lumbar and sacral discectomy, the approach is through the abdomen or belly. For thoracic discectomy, the incision is in the chest.