A discectomy involves removing the portion of the disc that is herniated. This will take the pressure off the nerve and or spinal cord. A discectomy and fusion is done when the discectomy makes the spine unstable and it must be stabilized. This involves inserting screws and rods to hold the spine steady, or placing a device that replaces the disc.
Disc herniation range in size, from very small to large. Sometimes there is an extruded fragment a piece of disc that break off and compress upon the spinal cord and nerves. Small disc bulges can cause minor symptoms and usually responds well to conservative treatments. A large disc herniation can cause weakness, numbness, or tingling. The patient may have trouble performing simple tasks due to the weakness. If weakness occurs surgery is usually required.
A small incision is made and retractors are placed to move the soft tissue and muscles out of the way. Once the area is exposed some pieces of bone are removed so the herniated disc can be visualized. The disc material that is protruding and pressing on the nerve is removed.
The patient is typically able to go home later that day. Once home the patient may ambulate as tolerated. Restrictions include: no sitting for longer than 20-30 minutes, no lifting, pushing, or pulling more than 10lbs, and no repetitive bending. The patient will follow up in the office at 2-3 weeks after surgery to have the staples removed. Depending on the patient’s job they can return to work in 2-8 weeks’ time.
Patients usually fall into one of three categories with regards to their symptoms when they wake up:
- All the leg pain is gone and anticipated post-operative pain is left to manage.
- The pain is lessened and resolves as time goes on.
- The pain is still the same and resolves over time.
Disectomy Before
Disectomy After
