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 fan out from the spinal cord. It 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. 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 hipbones (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
Your doctor may perform other procedures in addition to a discectomy to treat certain conditions. These 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. This may be necessary to access your spinal disc.
- Spinal fusion is the permanent joining together of two vertebrae. This procedure permanently stops movement between the two vertebrae.
Why is a discectomy performed?
Your doctor may recommend a discectomy 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. Ask your doctor about all your treatment options and consider getting a second opinion before deciding on a discectomy.
Your doctor may recommend a discectomy for degenerated, herniated or ruptured discs if you have:
- Back or leg pain or weakness or numbness that does not get better with other treatments in six weeks or more. Other treatments include anti-inflammatory medications, rest, and physical therapy.
- Problems with walking and performing other daily tasks
- Inability to control your bowels or bladder
Who performs a discectomy?
The following specialists perform discectomy:
- Orthopedic surgeons specialize in the medical and surgical treatment of diseases and conditions of the muscles and bones, including the spine.
- Neurosurgeons specialize in the surgical treatment of diseases and conditions of the nervous system, including the spine.
How is a discectomy performed?
Your discectomy will be performed in a hospital or surgery center. Your surgeon will use one of the following approaches:
- Open surgery involves 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 see and access the surgical area directly. 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. Other treatments include laminectomy, foraminotomy, and 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 an option if you do not need other surgical treatments.
- Microdiscectomy generally has generally involves a faster recovery, less pain, a lower risk of some complications, such as infection, than open surgery. Surgical tools are threaded around body 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.