Discectomy is a surgical procedure involving the removal of degenerative or herniated discs that stress the spinal cord or radiating nerve. A herniated disc occurs when the annulus fibrosus is torn, increasing pressure and irritation on the nerves. For spinal cord conditions involving the discs, your doctor may recommend that you undergo other treatment before settling for a discectomy. If you are a good candidate for discectomy, your surgeon will remove the affected disc and reduce the pressure from the spinal cord. This helps relieve numbness, pain, and tingling sensations associated with herniated discs and other conditions.
Discectomy surgery could be open or minimally invasive. Your doctor may recommend an open discectomy when the disc has ruptured and the damage goes beyond the disc walls. Although discectomy is a safe procedure, some complications could arise. Therefore, seeking the services of an experienced neurosurgeon is crucial. If you are in the Los Angeles area, we invite you to visit or contact Dr. George Rappard’s Clinic to evaluate if you are an ideal candidate for a discectomy and/or offer you alternative treatment options.
Overview of Discectomy
The spine and vertebral column are composed of many bones known as vertebrae that rest on each other. Between the vertebrae are discs that provide cushioning and support, allowing you to bend your back. When the discs are damaged or diseased, they become bulged or herniated. A herniated disc compresses the spinal cord's nerves, causing pain that radiates from the back to the extremities. When you visit a doctor with symptoms of a herniated disc, the doctor could recommend its removal is a procedure known as a discectomy.
Discectomy is generally a surgical procedure that is performed where one or more discs form your vertebrae. The main aim of discectomy surgery is to relieve the pressure and pain associated with a damaged disc. Therefore, individuals who are diagnosed with herniated discs are candidates for discectomy.
A herniated disc is a condition where one of the rubbery discs sitting between the vertebrae becomes problematic. One or more discs could rupture due to pressure from the nucleus. While a herniated disc can occur at any part of your spinal cord, the condition is common in the lower back. When you visit your doctor with any of the following symptoms, you could be diagnosed with herniated disc:
- Leg or arm pain. When you have a herniated disc on the lower back, you can experience pain in the buttocks, thighs, and calf. On the other hand, you can experience pain in the arms when the herniated disc is in the neck.
- Tingling sensation and numbness. Most people who have a herniated disc will experience tingling sensations on parts of the body served by the nerves.
- General weakness When the damaged disc weakens muscles, you may feel weak and find it challenging t stand or lift your arms.
If the doctor finds that your symptoms are associated with a herniated disc, they could use x-rays and other forms of imaging to confirm the condition. Before the surgeon settles on discectomy, they might recommend other treatment options like pain medications and therapy.
Types of Discectomy
There are several types of discectomy that your surgeon can explore to remove a problematic disc, including:
- Microdiscectomy — Microdiscectomy is a minimally invasive discectomy procedure where your doctor uses a microscope to magnify the surgical field. This type of discectomy allows the surgeon to make tiny incisions on your skin. Some of the benefits of microdiscectomy are that it has a lower risk of complications and less scarring. Your doctor will recommend this type of discectomy when the discs have minimal damage.
- Percutaneous Discectomy — In this type of discectomy, the doctor inserts a percutaneous needle through your skin and into the disc, then pulls it out to remove the disc. Percutaneous discectomy relieves pain for patients suffering from leg pain or sciatica.
- Endoscopic discectomy —An endoscopic discectomy involves small incisions through which the doctor inserts an endoscope to visualize the condition of the discs and guide them to remove the damaged ones.
- Laser discectomy —This procedure uses laser beams to penetrate the body and remove the damaged disc.
Difference Between Discectomy and Microdiscectomy
Traditionally, a discectomy was major surgery that required large incisions to your back under general anesthesia. Often these procedures left behind open wounds that took longer to recover and left scarring. Microdiscectomy is a more advanced procedure for the removal of a damaged disc. The procedure is minimally invasive; your surgeon will access the damaged discs using image-guided instruments. While anesthesia is still used for the procedure, microdiscectomy can be done outpatient and takes a shorter time to recover.
Although discectomy and microdiscectomy are used to treat the same condition, your doctor’s choice of the right procedure is based on the nature of your condition. When the damage to your vertebral disc has moved beyond the walls of the disc, the doctor may need to use an open discectomy to remove the disc.
Reasons for Performing Discectomy
Some of the main reasons why your doctor could recommend discectomy include:
- Improve mobility. When one of the discs in your vertebrae is damaged, you may experience severe pain, muscle spasms, and discomfort affecting your mobility.
- Failure of other treatment methods. For any medical condition, surgery is often the last treatment option. Before recommending a discectomy for herniated discs, the doctor may recommend other treatments like pain medications, anti-inflammatory drugs, and physical therapy. If these treatments are ineffective, you may need a removal of the damaged disc.
- Evidence that surgery will solve the problem. When you visit your doctor with herniated disc symptoms, your doctor performs different tests to determine the most suitable treatment method.
- A severe case of a herniated disc. Some symptoms of herniated discs can be treated using medication and physical therapy. However, removal may be the best action if the disc is completely damaged.
When your doctor determines that you are a good candidate for discectomy, you will have enough time to prepare for the surgery. Your surgeon will perform a physical assessment to determine if you have any underlying medical conditions that can affect the surgery outcome. You may need to stop smoking several weeks before the surgery if you are a smoker. If you are set for an open discectomy, you may need to be admitted to the health facility a day before the surgery for proper preparation. During the discectomy surgery, the surgeon follows the following procedure:
- Administration of anesthesia. Before the surgery, the doctor will inject anesthesia into your lower back. Whether you receive local or, general anesthesia will depend on the type of discectomy.
- The doctor sterilizes your back to avoid contamination and reduce the likelihood of infection.
- The surgeon makes an incision on the region above the herniated disc. This exposes the affected part of the spine.
- If you undergo an open discectomy, a small bone from your spine is removed to allow for visualization of the nerves.
- Once the problematic disc is identified, the doctor removes it and sutures the layers of tissues back.
Post-operation Care for Discectomy
Discectomy has a high success rate. However, the doctor will give you some post-operative guidelines that you must follow to enhance your recovery. Post-operation care for discectomy includes:
You will most likely be released from the hospital within one to two days. The time you need to recover from the procedure completely may vary between one to four weeks, depending on the diseases for which you underwent discectomy. Additionally, your general health and the presence of underlying medical conditions could affect the outcome of your surgery.
Although you receive anesthesia before discectomy, you may experience a little discomfort. However, when the anesthesia wears off, you can feel numbness at the point of the incision. Additionally, you could experience some pain and muscle spasms. Before leaving the hospital, your doctor will prescribe anti-inflammatory medications and muscle relaxants.
With advancements in technology, discectomy procedure has become less invasive. While there is no open wound, you will have tape strips across the incision areas. The small dressings will fall off after several days. Your surgeon may recommend avoiding using heated tubs or prolonged water contact with the incision area. You must also go for follow-up appointments.
After a discectomy procedure, you should be careful with how fast you begin exercising. Walking is encouraged during the recovery period, but you should not do it for a long period. Walking helps you to regain mobility and reduce scarring.
Returning to work
Full recovery from a discectomy procedure aims to return to work and other normal activities. If you engage in sedentary work or office settings, you can return to work within four weeks post-recovery. However, the doctor recommends returning to work between six to eight weeks post-operation for patients who engage in manual or more physically demanding work.
Your doctor will recommend a well-balanced diet rich in proteins to promote recovery from the discectomy procedure. Additionally, a high protein diet contains zinc which helps prevent infections. Drinking plenty of water after discectomy surgery helps keep you hydrated and avoid muscle tightness.
Complications Associated with Discectomy
Many patients have reported positive results after discectomy. However, all types of surgical procedures present some level of risk. General complications that could be reported after a discectomy procedure include:
- Deep vein thrombosis. DVT is a serious condition when blood clots form inside your leg veins. If the clot breaks free and moves to the lungs, your lungs could collapse. One way to avoid this complication is by doing mild exercises like walking after the surgery. The doctor can also prescribe aspirin and heparin to prevent clotting.
- Nerve damage. Any surgery on the spine has the potential to cause nerve damage. Damage to nerves may be characterized by numbness and paralysis.
- Reduced mobility. In rare cases, you could experience severe pain accompanied by loss of sensation on the legs, which can cause immobility and slower performance in daily activities.
- Excessive bleeding. Depending on the underlying problem and area of the incision, you may experience some bleeding from the area of the Although excessive bleeding is unlikely, patients with blood clotting problems may experience complications. If you are on blood thinners, your surgeon could recommend stopping the medication several weeks before the procedure.
- Poor outcome. Not all patients who undergo discectomy find relief for their medical condition. There is a possibility that the surgery will not improve your condition. Some factors contributing to poor discectomy surgery outcomes include wrong-level surgery and improper preoperative or postoperative The worst-case scenario is the recurrence of the condition that prompted the surgery.
- Infections. Discectomy can result in an infection on the surgical site when proper precautions are not taken. However, a skilled surgeon will disinfect the area and guide you on proper care for the incision areas.
- Reaction to anesthesia. For both open and minimally invasive discectomy, your doctor will use anesthesia to number the point of incision. This helps avoid pain and discomfort associated with the procedure. The doctor will check you for anesthesia sensitivity before the procedure to avoid complications. Therefore, you must give your full medical history before undergoing a
If you experience any of the following symptoms after your discectomy procedure, you must seek immediate medical attention:
- Sudden numbness on your extremities
- Signs of infections like redness, throbbing, or puss around the incision area
- Loosening or falling out of the stitches
- Extreme pain that does not respond to medications
- Bleeding through the bandage or the strips
Find an Experienced Neurosurgeon Near Me
Your surgeon will likely recommend discectomy when other treatment methods like physiotherapy and medications fail to offer relief for your condition. If you experience the symptoms of a herniated disc, you need to visit a neurosurgeon for an assessment. If you are in the Los Angeles area, we invite you to contact Dr. George Rappard’s Clinic at 424-777-7463 or visit our facility for an evaluation and treatment.