Definition
An intervertebral discectomy is surgery to remove all or part of the damaged discs between each vertebra in the spinal column. It is most often done on discs in the lower (lumbar) part of the spine. It may also be done on cervical discs in the neck.
Reasons for Procedure
Discs normally serve as cushions between the bones. They can become damaged or dry with age. Injury can also cause a disc to bulge (herniate). These changes can create pressure on nerves leaving the spine. This can cause pain, numbness, and weakness. This surgery is done when other methods to ease symptoms have not helped.
| Laparoscopic discectomy |
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Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Nerve damage
- Problems with bladder and bowel control
- Leakage of spinal fluid
- Herniated disc (may happen within the first three months after surgery)
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Arranging a ride to and from surgery
- Tests that will need to be done before surgery, such as images to look at the discs and structures in the area
Anesthesia
General anesthesia will be given. You will be asleep.
Description of the Procedure
There are two methods to do this surgery:
- Open—A large incision is made
- Microdiscectomy—Small incisions are made and small tools are inserted through them
There are four types of discectomy:
An incision will be made in the skin on the left or right side of the neck. The doctor will go through a muscle to reach the spine. X-rays will be used to locate and remove damaged disc material. Part of the bone may be removed to give the nerve more space. A bone graft may be placed to fuse the vertebrae. The incision will be closed. A bandage will be placed over the area.
An incision will be made in the skin at the back of the neck. The muscles will be moved aside. A small piece of bone will be removed to get to the disc space (laminectomy). The nerve will be moved aside and the damaged disc material will be removed. The incision will be closed. A bandage will be placed over the area.
An incision will be made in the lower back. The muscles will be moved aside. A small part of the bone may need to be removed to gain access to the nerve and disc. Damaged disc material will be removed. The incision will be closed. A bandage will be placed over the area.
| Discectomy |
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| The disc is removed from between the vertebrae. |
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How Long Will It Take?
It depends on the type of surgery that was done.
Will It Hurt?
Pain and swelling are common in the first few weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is 1 to 2 days. If you have problems, you may need to stay longer.
Post-procedure Care
At the Hospital
The staff will give you pain medicine after surgery.
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It will take a few weeks for the incision and muscles to fully heal. Relief from nerve pain may be felt right away or it may take up to 8 weeks. Physical activity will be limited during recovery. You will need to ask for help with daily activities and delay return to work.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excessive bleeding, or any discharge from the incision
- Pain that you cannot control with medicine
- Numbness or tingling
- Pain, burning, urgency or frequency of urination, or blood in the urine
- Loss of bladder or bowel control
If you think you have an emergency, call for medical help right away.
RESOURCES
North American Spine Society http://www.spine.org
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
CANADIAN RESOURCES
Canadian Orthopaedic Association http://www.coa-aco.org
Canadian Orthopaedic Foundation http://www.canorth.org
References
Lumbar disk herniation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lumbar-disk-herniation. Accessed July 30, 2021.
Minimally invasive lumbar discectomy. Johns Hopskins Medicine website. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/minimally-invasive-lumbar-discectomy. Accessed July 30, 2021.
Spine surgery: minimally invasive lumbar discectomy/percutaneous disc removal. Hospital for Special Surgery website. Available at: https://www.hss.edu/conditions%5Fspine-surgery-minimally-invasive-lumbar-discectomy.asp. Accessed July 30, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
- Review Date: 07/2021
- Update Date: 07/30/2021