Discectomy is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. Before the disc material is removed, some of the bone from the affected vertebra may be removed using a laminotomy or laminectomy to allow the surgeon to better see the area.
Microdiscectomy uses a special microscope or magnifying instrument to view the disc and nerves. The magnified view makes it possible for the surgeon to remove herniated disc material through a smaller incision, thus causing less damage to surrounding tissue.
Before a discectomy, your doctor will confirm that a herniated disc is causing your symptoms by using an imaging study, such as magnetic resonance imaging (MRI) or computed tomography (CT scan).
During discectomy, the surgeon removes the fragments of disc material that have protruded into the spinal canal. The disc space may also be explored, and any loose fragments of disc that could eventually press on nerves can be removed.
These procedures are commonly performed in a hospital, using general anesthesia. In some cases discectomy can be performed in an outpatient surgical center.
What To Expect After Surgery
After a discectomy, you will be encouraged to get out of bed and walk as soon as the anesthetic wears off. You can use prescription medications to control pain during the recovery period and will be advised to resume exercise and other activities gradually. Other considerations include the following:
- To maintain mobility of the nerve root and decrease the risk that scar tissue will form and press on it, use walking as your primary form of exercise for the first several weeks.
- You may begin bicycling and swimming about 2 weeks after surgery.
- Avoid any activities that cause pain.
- Avoid sitting for longer than 15 to 20 minutes.
- If you work in an office, you may return to work within 2 to 4 weeks. If your job requires physical labor (such as lifting or operating machinery that vibrates) you may be able to return to work 8 to 12 weeks after surgery.
Many people are able to resume work and daily activities soon after surgery. In some cases, your health professional may recommend a rehabilitation program after surgery, which might include physical therapy and home exercises.
Why It Is Done
When surgery is used to treat a herniated disc, it is done to decrease pain and allow for more normal movement and function. Surgery is considered if the following conditions are present:
You have a history of persistent leg pain, as well as weakness and limitation of daily activities. Results of a physical examination find that you currently have weakness, loss of motion, abnormal sensitivity, or reflex change.
Diagnostic testing, such as magnetic resonance imaging (MRI), computed tomography (CT), or myelogram, indicates that your herniated disc can be treated surgically.
Discectomy is also done if:
- A ruptured disc or free fragments of disc material are clearly the cause of nerve root compression, and symptoms fail to improve after at least 4 to 6 weeks of nonsurgical treatment.
- You have signs of serious nerve damage (that may be getting worse) in the leg, such as severe weakness, loss of coordination, or loss of feeling.
- You have pain that is severe and disabling.
- There is a structural problem in the bones that can only be treated with surgery (in this case, nonsurgical treatment would not be appropriate).