A discectomy is performed when a damaged or herniated disc needs to be removed from a patient’s spinal canal. When a spinal disc becomes herniated or damaged, a small piece may break away or become dislodged. Pain is a result of the small piece from the herniated disc pressing and applying pressure against spinal cord or exiting spinal nerves.
As mentioned above, the goal of a surgical discectomy is to remove a damaged spinal disc or the material produced by a herniated disc that’s putting pressure on nerve roots or the spinal cord. Traditionally the procedure is called an open discectomy and involves the surgeon making a small incision in the area of the herniated disc so that he can see firsthand what the problem is and fix it.
Discectomy - The Procedure
On average an open discectomy takes about an hour to complete, but this is dependent on the extent of the damage or disc herniation, the size of the patient being operated on, or multiple other factors that are not as common. The surgery requires the patient to be under the effects of general anesthesia, laying face down so the surgeon has access to their back.
In order for your surgeon to remove the fragment of the herniated disc that is aggravating your condition the surgeon will need to make an incision over the affected area of your back. The incision is commonly only about three centimeters in length, which the surgeon will use to gain access to the damaged disc. The surgeon then uses special instruments to perform a procedure called a laminotomy. This procedure will remove a small amount of bone and ligament from the back of your spine.
When the surgeon has completed the laminotomy he or she will be able to see and protect the spinal nerves while removing the herniated disc fragments. The amount of damaged material that is removed by the surgeon will depend on what condition that remaining disc is in. The surgeon may remove excess fragments with the hope of avoiding further disc herniation in the future. Once the surgeon has finished removing the fragments of disc and cleaning the area surrounding the nerves, the original incision is stitched closed and a bandage is applied.
After a discectomy surgery some patients will actually wake from it feeling complete resolution of their leg pain. More commonly it will take patients several weeks and sometimes months for these symptoms to slowly clear up. In the days following your surgery some pain around the incision area is not uncommon and is usually controlled with oral pain medication. A patient will usually spend the night following a discectomy in the hospital and be discharged the following day. If there are further complication such as infection the patient may be required to stay longer for further treatment. Depending on the extent of the work done by the surgeon, a lumbar corset (brace) may need to be worn to help control some of the pain after the surgery.
Until you are given clearance by your doctor you will need to avoid lifting heavy objects as well as avoiding strenuous activities or exercises that may cause you to bend or twist your back excessively and inappropriately. Even though there are restrictions after discectomy surgery, your doctor will encourage you to continue with gentle activities such as sitting upright and walking.
Discectomy Risks and Complications
Recurrent Disc Herniation - This is one of the most common complications that can occur from a discectomy. Although your surgeon may have removed the fragment of the herniated disc that is causing your painful symptoms, it is possible that in the future another fragment of your spinal disc may herniated and cause your symptoms to flare up again. The chance of this happening is between ten and fifteen percent.
Other common risks or complications that may occur after a discectomy surgical procedure are spinal fluid leaks, excessive bleeding, and infections. These are all treatable but will likely extend your stay in the hospital to more than one night and could possibly require further surgery to correct.
The possibility of the patient not feeling results is dependent on how long they have been feeling symptoms of their condition.