Discectomy Surgery

Back pain is extremely common, and nonsurgical treatments such as anti-inflammatory medications, heat, and physical therapy can help you heal quickly. However, in the case of severe lower back pain that does not improve, even when non-surgical treatment fails to offer relief from pain and numbness, surgery may be considered.

The lower back pain surgery that involves the percutaneous removal of the lumbar (low back) herniated disc is called a discectomy. Discectomy surgery is the surgical removal of lumbar (low back) herniated disc material that presses nerve roots or the spinal cord. 

It is a surgical procedure commonly performed to relieve the pain caused by a bulging, ruptured, or herniated disc on nerve roots. 

It is the straining of the spinal cord or radiating nerves that induce back pain that travels to the legs and produces severe symptoms of muscle weakness or numbness or tingling in the back, arms, hands, shoulders, legs, or feet. The pain can also make it difficult to bend or stand for long periods, and sometimes the pain may worsen in the legs and buttocks due to the sciatic nerve being pressured.

In the U.S, it has been estimated that the medical care system spends over $300 million annually on Discectomy. Because discectomy is often performed after other therapies, such as physiotherapy and steroids, have failed to improve a patient’s condition. It is therefore essential to get a  second opinion on all of your treatment choices before having a discectomy surgery. 

Why is it done?

A discectomy is a procedure that relieves pressure on a spinal nerve caused by a herniated disc. Discectomy may be recommended if:

• Nerve weakness resulting in difficulty standing or walking.
• After six to twelve weeks of conservative treatment, such as physical therapy or steroid injections, your symptoms do not improve.
•  Pains in places such as buttocks, legs, arms, or chest become unbearable.

Types of discectomy

The types of discectomy procedures include:

• A cervical discectomy is a type of neck surgery in which a damaged disc is removed to relieve pressure on the spinal cord or nerve roots, as well as pain, weakness, numbness, and tingling in the affected area. The cervical discectomy procedure is performed through the neck. With a herniated disc in your neck, the pain usually starts in your shoulder and arm. When you cough, sneeze or move in specific postures, this pain may shoot into your arm or leg. Symptoms such as numbness or tingling in the arms, headaches, arm discomfort from the neck, and arm weakness are likely to occur. Loss of bowel and bladder control are also rare but possible outcomes.

• Lumbar Discectomy is a type of discectomy surgery to fix a disc in the lower back. It is the removal of the herniated portion of the lumbar disc. A lumbar herniated disc can cause anything from moderate back and buttock pain to extensive numbness and paralysis, all of which require immediate medical attention. Leg pain, nerve pain, lower back discomfort, and pain that intensifies with activity are all common symptoms.

• Thoracic discectomy: The removal of a disc in the middle of the back is a thoracic discectomy (thoracic spine). The incision for a thoracic discectomy is in the chest. Thoracic discectomy can be performed either through the anterior approach (front interior) or behind and side. Adults in their twenties and thirties are particularly vulnerable. The degenerative changes in the spine that occur with age make it less probable that an actual herniated disc will occur in the elderly. In the thoracic spine area, pressure on and irritation of the nerves cause the symptoms of a herniated disc. This symptom includes total leg paralysis. Other symptoms include pain, muscle weakness, and numbness or tingling in areas of one or both legs. 

• A sacral discectomy is another surgical removal of a disc between your pelvic and hip bones in the back (sacral spine). The abdomen or belly is used to access the lumbar and sacral discs.

How is Discectomy Surgery Done?

When it comes to discectomy surgery, there is no such thing as a one-size-fits-all solution. Your doctor will recommend specific surgical procedures based on various factors, including the exact location of the herniation, the degree of the rupture if you have one or more herniated discs, your overall health, and many more.

However, this surgery is generally carried out under general anesthesia and may require an overnight hospital stay. Surgeons can approach the herniated disc in one of two ways:

• Open surgery: For herniated or ruptured discs in the spine, this is the most common surgical procedure. It is usually performed under general anesthesia and typically requires a one-day hospital stay. During the procedure, the doctor will make a two-to-four-inch incision down the middle of the affected area in your spine. Your doctor will be able to examine and reach the operative region directly through an open surgery incision. Unlike other methods of discectomy surgery, open procedures do not require the use of a microscope or loupes (special eyeglasses) to improve vision.

• Microdiscectomy: Microdiscectomy surgery is one of the most effective ways to relieve the pressure on the spinal nerve caused by a herniated disc. This minimally invasive technique uses a special microscope and only requires a small surgical incision. Microdiscectomy is performed with the least invasiveness possible. This form of surgery is usually recommended to patients with signs of nerve damage and not finding relief from non-surgical procedures. It entails inserting a unique instrument through a small incision along the side of the afflicted section of your spine, usually less than one inch. The operative surgeon visualizes the surgical area using a magnifying endoscope or microscope during microdiscectomy.
• In comparison to an open discectomy, the incision in the midline of the lower back is small. If you do not require additional surgical therapies, microdiscectomy may be an alternative. In comparison to open surgery, microdiscectomy has a faster recovery period, less pain, and a lower risk of infection.

Discectomy surgery aims to remove only the herniated portion of the disc; however, the surgeon may need to remove the entire disc in some circumstances. If the entire disc is removed, the surgeon will need to fill the space with bone, which can come from a donor.  Based on your diagnosis, age, medical history, general health, and potentially your personal preference, your surgeon will advise you on which operation is best for you and how long you will need to stay in the hospital.

What are the Benefits of Discectomy Surgery?

If other treatment choices with a lower risk of consequences have been ineffective, your doctor may recommend a discectomy for you. This procedure aims to relieve pain and pressure on the spinal cord or the nerve root, improve mobility, and help you restore normal function related to sitting, standing, and walking.

The overall recovery time is also concise, even for the ‘open’ surgical procedures. Most patients can return to work within 2 to 4 weeks, and within 10 to 12 are expected to return to most activities. It’s particularly beneficial for patients suffering from sciatica, a condition where the sciatica nerve is compressed or irritated, causing patients a good deal of pain and other uncomfortable symptoms. 

What are the Risks?

Discectomy is considered a safe procedure with a positive outcome. But as with any surgery, it also carries the risk of complications. Following a discectomy, the most prevalent risk is herniation, which can necessitate repeat surgery. Other risks of surgery include:

• An allergic reaction or respiratory problems may occur as a result of anesthesia.

• Around 5-10% of patients who have a discectomy will develop recurrent disc herniation.

• The tools and incisions used during surgery will cause nerve injury.

• Persistent pain if the herniated disc is not removed correctly and placed.

• A complication that might result in nerve injury is a leak of cerebrospinal fluid.

• Patients who are generally of poor health, the elderly, and diabetics have slightly increased risk factors.

• Blood clot, especially a deep vein thrombosis, occurs in the veins of the legs.

• Infection around the spine, in both internal and external diseases.

• Incomplete fusion: Sometimes, the bone graft accompanies discectomy, and spinal fusion does not fully fuse.

Alternative to Discectomy Surgery

An alternative to Discectomy Surgery is the Deuk Laser Disc Repair

Where to get it: Deuk Spine Institute

How it works: Deuk Laser Disc Repair is a laser spine surgery performed to cure pain or neck pain associated with herniated discs, bulging discs, sciatica, spinal stenosis, pinched nerves, and other conditions that cause chronic pain.

This precision laser procedure is uniquely recognized for its gentle, minimally invasive method. Without removing stabilizing joints, bones, or ligaments, the surgeon utilizes an endoscope (a small tube with a light and camera attached) to reach the source of back pain.  The method avoids explicitly drilling, implanting, or fusing.

It specializes in spine disc repair and addresses spine concerns such as Laminectomy and microdiscectomy, using unique techniques to vaporize the herniated tissue and provide the best laser spine surgery available.

The Deuk laser disc repair procedure has a 95% success rate in eliminating pain, with 0 complications and infections. Patients are pain-free and able to leave the recovery room within an hour. With no internal damage or scarring, the wound will heal within days. It has also been peer-reviewed and approved by the FDA for back pain caused by annular ribs, herniated discs, bulging discs, degenerative discs, and spinal stenosis.

Here’s a video providing a more detailed explanation of the Deuk Laser Disc Repair Surgery:

Preparation for Discectomy Surgery

The steps you take before the surgery can make a significant difference in your prognosis. You can prepare for a discectomy by doing the following:

• Provide answers to all questions on your medical history and medications. A current list of your medical conditions, medications, and allergies should be carried with you at all times.

• You are getting preoperative testing as directed. Your age, health will determine the type of testing you receive and the treatment you are having done. A chest X-ray, blood tests, and other diagnostics may be performed before surgery if necessary.

• As recommended, no eating or drinking before operation. Because you can choke on stomach contents during anesthesia, if you eat or drink too soon to the commencement of operation, your procedure may be canceled.

• As soon as possible, quit smoking. Even if you only give up for a few days, it can help your body repair.

• Follow instructions on using or discontinuing drugs and prescriptions. Doing this entails abstaining from aspirin, ibuprofen, and blood thinners.

What to Expect after Discectomy Surgery

After surgery, you should expect your back to be stiff or uncomfortable. However, this will gradually improve over days or weeks following the surgery. It may also be difficult to sit or stand in one position for long periods in the weeks following your surgery.

Ultimately, It could take up to 8 weeks to resume your normal activities. Your doctor may also recommend that you work with a physiotherapist to strengthen the muscles that surround your spine and trunk. You can also care for yourself by:

• Use of pain relievers precisely as prescribed. If the doctor gave you a prescription medicine for pain, take it as prescribed.

• You can eat your regular diet. Also, drink plenty of fluids (unless your doctor tells you not to).

• Avoid strenuous activities and rest when you feel tired. Getting enough sleep will help you recover.

• Do back exercises as instructed by your doctor to improve the strength and flexibility of your back.

The importance of follow-up care in your treatment and safety cannot be overstated. Make and keep all of your appointments, and if you have any concerns, call your doctor or the nurse call line. It is also a good idea to keep track of the test results and medications you are currently taking.

Discectomy Surgery Recovery

Recovery from surgery is a gradual process. The length of your recovery is also dependent on the treatment, the type of anesthesia used, your overall health, your age, and other factors. Your doctor may urge you to walk rather than sit for lengthy periods, to avoid alcohol, to avoid strenuous activities like yard work, housework, and sex, and to avoid driving for the first 2-3 days or while on pain medication. You will also receive physical therapy to aid in your recovery.

Total recovery time takes a few weeks, ranging from two to four weeks. If you have a job that requires heavy lifting or operating heavy machinery that vibrates, it might take longer for you to return to complete activities.

There will also be discomfort and soreness after your surgery. If your discomfort worsens or changes in any way, contact your doctor right away because it could be a symptom of a problem. Surgeons also recommend a physical therapist to help with exercises and explain activities that should be avoided. 

Discectomy Surgery Cost

A discectomy is a highly specialized procedure that necessitates the services of a surgeon with special training and extensive experience. As a result, it may be more costly than other types of back surgery. The cost of the surgery varies, ranging from $15,000 to $40,000. Any follow-up visits or care may not be included in this pricing.

Also, having health insurance may cover a significant percentage of this cost. If you don’t have insurance, be sure to talk with your hospital, surgeon, and all other medical professionals before receiving the procedure.

Discectomy Success Rate

Medical studies have shown that good results are achieved in 80% to 90% of the cases treated with open discectomy. Studies also show that people experiencing radicular pain, or pain that travels down the legs, may experience more pain alleviation than those who receive an open discectomy for low back pain.

If you have back or leg pain or weakness, be sure to talk to our doctors at Deuk Spine Institute about your discomfort and consider all available options before undergoing any surgical procedure.

At Deuk Spine Institute, we specialize in minimally invasive surgical techniques and comprehensive spine treatments to cure back and neck pain.

If you are suffering from back or neck pain and considering surgery, send us your MRI scan for a free review or schedule an in-person appointment at our clinic in Florida, and we can determine the best options for you.