Discectomy, also known as a lumbar discectomy or lumbar herniated discectomy, is a surgical procedure aimed at treating spinal conditions such as herniated or ruptured discs by removing the damaged portion of a disc or the whole damaged disc in the spine. A discectomy is usually performed with a spinal laminectomy to treat herniated or slipped discs.
The spine comprises 33 vertebrae with spinal discs or intervertebral discs between each vertebra. These discs act as a cushion to absorb stress and shock within the spine while allowing movement. The spinal disc often deteriorates due to age, injury, or wear-and-tear, leading to herniation or rupture. This compromised disc can exert excessive pressure on the surrounding spinal nerves or spinal cord.
As a result, you may experience a range of debilitating symptoms, including severe pain, numbness, and tingling sensations. In more severe cases, these conditions can lead to mobility issues that significantly impact daily activities.
There are variations of discectomy procedures, some of which include:
Microdiscectomy: also known as microdecompression, is the most commonly performed discectomy, where a small part of the disc is removed to relieve pressure on the spinal nerve.
Percutaneous discectomy: also known as a percutaneous disc decompressor, is a minimally invasive procedure that uses a small needle to remove portions of the herniated disc.
Endoscopic discectomy: an endoscopic discectomy uses a tubular retractor to visualise and observe your spine. Once the herniated disc is located, a laser is used to remove parts of the disc and harden the remaining disc to prevent further complications.
Laser discectomy: a minimally invasive procedure that does not remove any herniated disc; instead, the disc's nucleus pulposus is burned to alleviate symptoms.
How does a discectomy work?
A discectomy procedure seeks to fix a damaged spinal disc causing nerve or spinal cord compression. It is often pursued when alternative methods like physical therapy or medication fall short or the disc injury is particularly pronounced.
Before a discectomy, comprehensive diagnostic tests such as magnetic resonance imaging (MRI) or X-rays are conducted to pinpoint the exact location and extent of the damaged disc. Your neurosurgeon uses this information to plan the most effective surgical approach tailored to each patient's condition.
Once in the operating room, the patient is administered general or spinal anaesthesia to eliminate any pain or discomfort during the procedure. An incision is made over the affected part of the spine. Using specialised tools, the damaged disc or part of it is removed.
After successfully removing the damaged disc material, the surgical incision is closed.
Benefits of discectomy
Effective spinal decompression
Enhanced mobility and flexibility
Improved postural alignment
Elevated quality of life
Reduced reliance on pain medication
Increased comfort during daily activities
What conditions can a discectomy treat?
Discectomy can be used to treat the following conditions:
Herniated discs: also known as slipped discs, this condition displays symptoms such as pain that radiates from the back and down the legs, numbness, muscle weakness, and even incontinence. A spinal laminectomy may also be performed for severe herniated discs with a discectomy.
Degenerative disc disease:degenerative disc disease occurs when the disc's integrity disintegrates over time. When the invertebrae discs wear down, it results in pain and discomfort.
Spinal stenosis:spinal stenosis occurs when the spinal canal narrows and puts pressure on the spinal nerve, causing pain in the lower back. A spinal stenosis can also be treated with a spinal laminectomy.
Sciatica: often linked to a herniated or slipped disc, sciatica is characterised by pain that radiates from the lower back and down the leg of the affected side.
Spondylolisthesis:spondylolisthesis occurs when a vertebra slips out of place onto the vertebra below.
What results can I expect from a discectomy?
After a discectomy, you can usually expect reduced pain. The most immediate and noticeable benefit for many patients is a significant reduction in pain, particularly in the back, legs, or neck, depending on the location of the herniated disc.
Improved range of motion: relief from nerve pressure often results in an increased range of motion, allowing you to move more freely and without discomfort.
Enhanced daily functionality: an easier time engaging in everyday activities such as walking, sitting, and lifting objects. Tasks that previously caused pain or discomfort are now more manageable.
Gradual return to physical activities: you should be able to gradually return to regular physical activities, following your neurosurgeon’s guidelines.
Emotional relief: many patients report feeling emotionally relieved after the procedure. The elimination of chronic pain often leads to improved mental well-being.
Need for post-operative care: expect to engage in physical therapy or rehabilitation programs to strengthen the muscles around the spine and to accelerate healing.
Varying results: results can vary from person to person based on various factors like health conditions, the location of the herniated disc, and the duration of symptoms.
Consultation is key: the only way to get a truly accurate idea of what to expect post-discectomy is through a thorough consultation with your neurosurgeon, who can tailor the prognosis and treatment plan to your specific needs.
How many discectomy sessions are needed?
The number of treatment sessions required for a discectomy varies considerably depending on the specific type of discectomy performed, the severity, the location of the spinal disc issue, and the occurrence of herniation.
Generally, a discectomy is a surgical procedure, so the actual operation is typically completed in one session. After your discharge from the hospital (3-7 days) post-surgery, you will be requested to visit our clinic within a week or two for a follow-up. You will also be asked to visit us for a routine check-up to monitor your general well-being.
It is crucial to consult with a qualified neurosurgeon for a comprehensive evaluation to determine the most appropriate treatment protocol, including the required treatment sessions for your specific condition.
Frequently asked questions
Are there any potential risks or complications after discectomy?
Yes, there are potential risks or complications, such as infection, bleeding, nerve injury, and leakage of spinal fluid. Always consult your neurosurgeon for a comprehensive understanding tailored to your health status.
How soon can I return to work or regular activities?
This depends on your job and the type of discectomy performed, but many patients can expect to return to work within 4 to 8 weeks.
Is it possible to have a herniated disc again after a discectomy?
Yes, it is possible to have another herniated disc after a discectomy. The rate of repetition varies but is generally considered to be around 5-18%. Proper postoperative care and lifestyle modifications can help mitigate this risk.