Healthy Living: Neurology
Discectomy for Back Pain
Spinal discectomy is a procedure that addresses some causes of back pain. Knowing the structure of the back helps to understand how a discectomy may help. Your spine has 24 vertebrae, or bones, that are each cushioned by discs. Intervertebral discs act like shock absorbers for the spine. They have a tough outer ring of tissue that surrounds a soft, jelly-like center. They can become thinner and more prone to problems through repetitive movement, injury or poor posture.
Herniated Discs
When a disc moves out of place, or herniates, surgery may be necessary to relieve the resulting pain on the spinal column caused by the soft, inner gel pushing through the wall of the disc. This procedure is called a discectomy.
Not everyone who has a herniated disc needs surgery. Most patients with this condition can be treated more conservatively through medication and physical therapy. But for some people, discectomy may be recommended if:
- Other forms of treatment fail to improve symptoms after six weeks
- A disc fragment lodges in the spinal column and presses on a nerve
- You have difficulty standing or walking
- You have pain that radiates into your buttocks or legs
Discectomy Procedure
Spinal discectomy is usually performed in the hospital under general anesthesia. After the surgeon makes an incision a little longer than 1-inch over the herniated disc:
- Muscles and tissue are moved aside to expose the spine.
- A small part of the bone that surrounds the spinal column and nerves, called the lamina, is removed to access the herniated disc. This part of the surgery is called a laminectomy or laminotomy.
- Small instruments are then used to cut a hole into the disc that is causing the problems to remove material from inside as well as any pieces that may have broken loose. This relieves pressure, and most of the disc remains intact.
- The incision is then closed using stitches or staples.
The procedure lasts approximately one hour depending on the extent of disc herniation, patient size and other factors. Patients typically spend one night in the hospital before going home to recuperate.
After a Discectomy
Most patients experience a reduction in herniated disc symptoms following surgery, and physical therapy may help maximize recovery. Exercise and other activities should be resumed gradually:
- First few weeks – Walking only
- Two weeks after surgery – Bicycling and swimming
- Two to four weeks after surgery – Return to work (if you work in an office)
- Four to eight weeks after surgery – Return to work (physically demanding jobs such as lifting items or operating machinery that vibrates)
While spinal discectomy can relieve symptoms, it will not stop the process that caused a herniated disc in the first place. To prevent re-injury, limit activities that require considerable or repetitive bending, as well as twisting and lifting. For more information about spinal discectomy, talk with your doctor.