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What is a Discectomy? Types of Discectomy Why is Discectomy Performed? Diagnosis and Treatment of Discectomy Discectomy Procedure Risks & Complications of Discectomy Frequently Asked Questions

What is a Discectomy?

Discectomy is the surgical removal of a portion or the entire spinal disc. The disc is removed by first cutting the external annulus fibrosus and removing the nucleus pulposus to relieve pressure on the nerve root. A discectomy treats degenerated, herniated, or ruptured spinal discs. Spinal discs are located between each vertebra of the spine and act as cushions to protect it. It can relieve nerve compression and pain due to a herniated disc. Discectomy is a common but major surgery with significant risks and possible complications.

Types of Discectomy

There are three ways a surgeon may choose to perform a discectomy:

Open or conventional discectomy

Open or conventional discectomy in which the surgeon makes a comparatively large incision to allow a clear view and also removes some muscles and ligaments.

Microdiscectomy

Microdiscectomy is minimally invasive with a small incision. The surgeon does not remove any muscle or bone but instead inserts a tube with a small camera/instrument to remove the damaged part of the disc.in which the surgeon makes a comparatively large incision to allow a clear view and also removes some muscles and ligaments.

Laser discectomy

Laser discectomy is in wider use now. This procedure does not require an incision. Instead, the surgeon burns off the prolapsed tissue with a laser inserted through a needle.

discectomy

Why is Discectomy Performed?

  • Surgery is done to decrease pain and allow you to regain normal movement and function.
  • If a patient has severe leg pain, numbness, or weakness that prevents them from performing their daily activities
  • If leg symptoms do not improve after at least 6 weeks of non-surgical treatment.
  • If sciatica pain lasts more than 12 weeks, microdiscectomy may provide relief.
  • The disc may still be intact, but part of it may be bulging or protruding and pressing on spinal nerves or the spinal cord.
  • Book an Appointment today and get yourself treated by our team of expert orthopedists. Timely treatment can prevent serious consequences.

Diagnosis and Treatment of Discectomy

  • The surgeon may perform a complete physical exam to assess that the patient is in the best possible condition to undergo surgery.
  • A series of blood tests and urine tests are performed to ensure the patient's health status and rule out underlying chronic diseases.
  • The doctor performs computed tomography (CT Scan), magnetic resonance imaging (MRI), and myelogram.
  • The patient will be evaluated with the results of these investigations by the cardiologist and the anesthesiologist and declared fit for surgery as long as there are no serious problems.

Discectomy Procedure

Before the Procedure

  • If the patient is a smoker, should stop smoking several days before surgery or stop smoking completely.
  • The surgeon will stop certain medications such as warfarin and/or aspirin 2 weeks before surgery as they increase the risk of bleeding while performing surgery.
  • The patient is advised to enter the hospital the night before surgery for the administration of certain medications and for certain routine blood tests.
  • The patient must be fasting since midnight the night before.
  • On the morning of surgery, the operative site is cleaned and any hair over the area is shaved.

During the Procedure

  • Once the patient is anaesthetised, they are turned to lie on their stomach (prone position) with adequate padding.
  • The patient's back is rubbed with sterile soap to create a sterile field, which is then covered before surgery begins
  • A small incision is made over the region where the disc is herniated.
  • In the next step, a small piece of bone called the lamina is removed from the vertebra, creating a small window through which the spinal nerves can be visualised.
  • Once the ruptured disk is identified, it is removed along with other disk fragments that may have become or are likely to become detached.
  • The layers of tissue are then sutured, and finally, the skin incision is sutured.
  • At the end of the surgery, a bandage is applied over the incision.

After the Procedure

  • After surgery, the patient is taken to the recovery room and vital signs are monitored for a few hours.
  • After the anaesthesia wears off, the patient will be given clear fluids.
  • When bowel function returns to normal, a solid diet will be provided, which is usually required 2 days after surgery.
  • The next day, the patient will be encouraged to sit in a chair for about 20 minutes.
  • Sitting and walking should be limited to 20 minutes to avoid straining your back.
  • Prescription pain relievers should be taken to relieve pain. Physical therapy will begin 1 to 2 days after surgery.
  • The physical therapist will show you how to perform proper body movements and exercises to strengthen your back muscles.
  • Braces or a corset may be required to provide additional back support.
  • After regaining adequate mobility, the patient is usually discharged, subject to regular follow-up during the recovery period.

Risks & Complications of Discectomy

A discectomy is generally a safe option for patients who do not get relief from non-surgical treatments. Risks may include:

  • Side effects of anaesthesia such as headache, nausea, and confusion
  • Infection
  • Bleeding and blood clots
  • Damage to nerves or blood vessels
  • Cerebrospinal fluid leak
  • Failure of surgery to provide symptom relief.
  • Herniated disc recurrence

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Frequently Asked Questions

1. Is discectomy a major surgery?

Discectomy is a common but major surgery with significant risks and possible complications. Consider getting a second opinion on all of your treatment options before having a discectomy.

2. How long a discectomy surgery may take?

It may take about 1 hour and the surgeon can help you by explaining the details of the procedure.

3. When can a person walk after a discectomy?

A person should start out walking slowly within a day or two with the help of a physiotherapist. After a month start walking for 30 minutes at least twice a day. However, a walking schedule will be guided by your doctor based on your recovery speed.

4. What are the precautions to be taken after a discectomy?

Do not lift heavy objects or sit for a long time. Also, do not do excessive stretching.

5. What is the success rate of a discectomy?

The success rate of lumbar discectomy is around 70% to 90%.

6. How much does a discectomy cost?

Depending on the level and scope of the intervention, it can cost between INR 25,000 and INR 1,05,000.

7. How long does one need to stay in the hospital after a discectomy?

A patient will stay in the hospital for about 3 days.

8. Is discectomy surgery painful?

Pain and fatigue are often severe during the first few days after a lumbar microdiscectomy.

Citations

https://en.wikipedia.org/wiki/Discectomy#:~:text=A%20discectomy%20(also%20called%20open,root%20or%20the%20spinal%20cord.
https://www.mayoclinic.org/tests-procedures/diskectomy/about/pac-20393837
https://www.ncbi.nlm.nih.gov/books/NBK544281/
https://medlineplus.gov/ency/article/007250.htm
https://radiopaedia.org/articles/discectomy