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 bulge can cause minor symptoms and responses well to conservative treatments. Large disc herniation can cause weakness, numbness, or tingling. The patient may have trouble preforming 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 piece of the bone is removed so the herniated disc can be seen. The disc material that is protruding outwards pressing on the nerve is removed. Once room for the nerve has been made then the muscle and soft tissue is sewn back together.
The patient is able to go home later that day. Once home the patient may ambulate as tolerated. Restrictions include not 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 in 2 weeks’ time 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 post-operative pain remains
- The pain is lessened and resolves as time goes on
- The pain is still the same and resolves over time