What is Discectomy: Overview, Benefits, and Expected Results

Definition and Overview

Discectomy is the surgical removal of herniated or degenerative disc that stresses the spinal cord or radiating nerves.

In herniated disc, the annulus fibrous gets torn, irritating, compressing, or adding more pressure on the nerves, causing the patient pain, which severity can range from mild to excruciating. In some cases, it progresses and becomes chronic, even disabling. The pain can radiate to other parts of the body such as the shoulders and arms if the herniated disc is in the cervical region (neck) or the legs if it is in the lumbar spine (lower back).

Who Should Undergo and Expected Results

Discectomy is one of the treatment options for people with herniated discs, which typically have the following symptoms:

• Acute or chronic pain around the spinal region, which may extend to the closest body parts
• Tingling sensation
• Muscle weakness
• Numbness
• Muscle spasm
• Paralysis
• Loss of control of the bladder and bowel
  

Slipped discs are caused by several factors such as age, degenerative disc disease, trauma or injury and sedentary lifestyle.

Discectomy is not usually the first form of treatment for patients with herniated discs. It is considered only when non-surgical options, including medications such as anti-inflammatories and epidural injections (which deliver medications directly into the spine), failed to correct the condition. Although spinal surgeries have greatly improved over the years, they still present some serious risks and complications, which the surgeon or spine doctor will discuss with the patient prior to the procedure. Normally, the doctor places the patient under non-surgical treatment for 3 to 4 months. If he remains unresponsive to treatment, discectomy will be considered.

How Does the Procedure Work?

Discectomy or herniated disc repair can be performed using the traditional or open method or by using minimally invasive techniques. The former is normally recommended when the disc has already ruptured and the nucleus has already gone past the disc wall. Between the two, it is the riskier option as it involves making a large incision either on the back or the neck, depending on the location of the herniated disc.

The minimally invasive surgery, on the other hand, is sometimes called microdiscectomy and is often performed in the lumbar area. It involves making small incisions on the lower back where an endoscope is inserted allowing the surgeon to see the exact location and condition of the herniated disc and its surrounding tissues. A laser is then used to remove the disc material that decompresses the nerves. This procedure is more ideal for people with the early slipped disc.

While open discectomy requires hospitalisation, microdiscectomy is often done on an outpatient basis and between the two, it has a shorter recovery time.

In both types of surgeries, however, certain preparations are necessary including going through lab and imaging tests to verify the herniated disc’s location. The surgeon may also perform laminotomy, a surgical procedure that removes a part of the lamina to easily access the herniated disc. Both surgeries require general anesthesia.

Possible Risks and Complications

As a herniated disc repair procedure, discectomy has a high success rate. The minimally invasive surgery, for example, is 90% effective in offering immediate pain relief. However, this also means that the surgery does not offer any guarantee. The herniated disc can still recur, in which case the surgeon may suggest a revision (or another surgery).

As a surgical procedure, the patient can develop an infection, so the surgeon recommends antibiotics. It may also lead to bleeding and damage to the areas of the spine, including the nerves. Patients may also develop allergic reactions to the anaesthesia.

After the procedure, the patient is prohibited from performing strenuous activities, particularly lifting heavy objects, bending and playing sports until he is fully recovered.

References:

• Ehni BL, Satyan K. Lumbar discectomy. In: Benzel EC, ed. Spine Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 78.

• Gardocki RJ, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beaty JH, eds. Campbell’s Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 42.

• Wilson AS, Samartzis D, Shen FH. Anterior cervical discectomy and fusion. In: Shen FH, Samartzis D, Fessler RG, eds. Textbook of the Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015:chap 30.

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## What is Discectomy: Overview, Benefits,⁤ and Expected Results



### Q: What is a Discectomy?



**A:** A⁣ discectomy is a surgical procedure to remove a damaged or herniated intervertebral disc, the cushion-like structure between vertebrae⁤ in the spine. It’s commonly performed ‍to‍ relieve pressure​ on nearby nerves, which can cause pain, numbness, or​ weakness in the back or⁢ extremities.



### Q: When is a Discectomy Necessary?



**A:** A discectomy may be considered when conservative treatments (e.g., physical therapy, medication) fail to alleviate symptoms⁢ caused by a herniated disc. Symptoms may include:



* Radiating pain down ⁤the limbs

* Numbness ​or weakness

* Difficulty walking or standing

* Saddle anesthesia (loss of sensation​ in the genital area)



### Q: What are the Benefits‍ of a Discectomy?



**A:** The primary benefits of⁣ a ​discectomy include:



* **Pain relief:** Removal of the disc material can significantly reduce pressure ‍on nerves and alleviate‌ pain.

*‌ **Improved​ neurological function:** By removing the herniation, the procedure can restore nerve function, improving sensation, strength, and mobility.

* **Prevention of further damage:**⁢ Left untreated, ⁢a herniated disc can compress​ delicate‌ nerve structures, leading to permanent neurological damage. Discectomy can prevent such complications.



### Q: What ​are the Expected Results of a Discectomy?



**A:** Most patients who undergo discectomy experience significant improvement in their symptoms. The recovery⁣ time varies depending on​ the⁢ extent of the surgery and‍ the individual’s overall health, but most people can expect:



* **Immediate pain relief:** Many patients experience relief from their symptoms as‌ soon as ⁢they wake⁣ up from surgery.

* **Gradual improvement:** Continuing pain will subside over the following​ weeks as the nerves heal.

* **Full recovery:** Most patients​ achieve full recovery and return to their ​daily activities within a⁢ few months of surgery.



### Q: What are the Potential Risks of a⁣ Discectomy?



**A:** Like⁢ any surgery, discectomy ⁣carries potential risks, including:



* Bleeding

* Infection

* ‍Damage to surrounding‌ nerves

* Leakage of⁢ spinal fluid

* Recurrent herniation



### Q: What are ⁢the Alternatives to ‍Discectomy?



**A:** Alternatives to discectomy may include:



* **Conservative treatment:** Physical⁤ therapy,⁣ medications, ‍and injections can sometimes manage symptoms without surgery.

* **Other ⁣surgical procedures:** Less invasive options, such as microdiscectomy or laser discectomy, ‌may be appropriate in certain cases.



### Q: How to Prepare for a ⁤Discectomy



**A:** In preparation for discectomy, follow these steps:



* Discuss ‌the procedure and risks with your surgeon.

* Inform your doctor about your⁣ medical‌ history and current medications.

* Stop smoking and ⁤avoid ⁣blood-thinning medications.

* Follow specific preoperative instructions to optimize your recovery.



### Q: How to Recover from a Discectomy



**A:** Post-discectomy recovery ⁤typically involves:



* Rest and avoiding strenuous activities

* Pain ‍management medications

* Physical‌ therapy to⁢ regain mobility and strength

* Gradual return to normal activities



### Conclusion



Discectomy is a common ⁣and effective surgical​ procedure to remove herniated spinal discs and alleviate pain and neurological symptoms. By relieving ⁤pressure on nerves, this procedure can significantly improve a​ patient’s quality of life. While there are​ potential risks associated with any surgical intervention, the benefits of discectomy outweigh these risks for many patients with herniated discs.