Discectomy

Discectomy . It is a surgery to remove all or part of a pad that helps protect the spine . These pads, called discs, separate the bones of the spine (vertebrae).

Summary

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  • 1 Description
  • 2 Procedure
    • 1 Risks
    • 2 Before the procedure
    • 3 After the procedure
  • 3 Forecast
  • 4 Alternative names
  • 5 Bibliography
  • 6 Sources

Description

Removing the disc (discectomy) can be done by a surgeon in different ways.

  • Microdiscectomy: When you have a microdiscectomy, the surgeon does not need to do a lot of surgery on the bones, joints, ligaments, or muscles of your spine.
  • Dyscectomy in the lower backlumbar spine ) may be part of a larger surgery that also includes a laminectomy , a foraminotomy, or a spinal arthrodesis .
  • A discectomy in the neck ( cervical spine) is most often done in conjunction with a laminectomy, a foraminotomy, or a spinal arthrodesis.

Microdiscectomy is done in a hospital or outpatient surgical center, with spinal or general anesthesia (with the person asleep and without pain).

  • The surgeon makes a small (1 to 1.5 inch) incision (cut) in the backand moves the back muscles away from the spine. The doctor uses a special microscope to see the disc or discs and nerves of the problem during surgery.
  • The surgeon finds the nerve rootand pushes it aside; Then it removes the tissue and fragments from the injured disc. The surgeon puts the back muscles back in place and closes the wound with sutures or staples.
  • The surgery takes approximately 1 to 2 hours.

The discectomy and laminotomy are done in the hospital, using spinal anesthesia or general anesthesia (with the person asleep and without pain).

  • The surgeon makes a larger cut in the back above the spine, and muscles and tissues are displaced to expose the spine.
  • A small part of the lamellar bone (part of the vertebrae that surrounds the spine and nerves) is cut and separated. The opening can be as large as the ligament that runs the length of the spine. The surgeon makes a small hole in the disc that is causing the symptoms and removes material from inside. Other fragments of the disc may also be removed.

Process

When one of the discs presents a hernia (it gets out of place), the soft gel inside presses through the wall of the disc. The disc can then put pressure on the spinal cord and the nerves that are leaving the spinal column.

Many of the symptoms caused by a herniated disc improve or disappear over time without surgery. Most people with low back pain or neck pain, numbness, or even mild weakness are often treated first without anti-inflammatory drugs, physical therapy, and exercise. Only a few people with a herniated disc need surgery.

Your doctor may recommend a discectomy if you have a herniated disc and:

  • Pain or numbness in the leg that is very intense or is not disappearing, making it difficult to perform daily tasks.
  • Intense weakness in the muscles of the lower leg or buttocks.
  • Pain that spreads to the buttocks or legs.

If you are having bowel or bladder problems, or the pain is so severe that strong pain relievers do not help, you will probably have surgery right away.

Risks

The risks of any anesthesia are:

  • Drug reactions
  • Respiratory problems

The risks of any surgery are:

  • Bleeding
  • Infection

The risks of this surgery are:

  • Damage to the nerves leaving the spine, causing weakness or pain that does not go away.
  • The back pain does not improve or comes back again later.
  • Due to the small surgical incision used for microdiscectomy, the doctor may overlook some disc fragments, which could cause pain to continue to develop after surgery.

Before the procedure

Always tell your doctor or nurse what drugs you are taking, including medicines or herbs you have bought without a prescription.

During the days before surgery:

  • Prepare your home for when you leave the hospital after surgery.
  • If you are a smoker, you need to quit. Your recovery will be slower and possibly not as good if you continue to smoke. Ask the doctor for help.
  • Two weeks before surgery, your doctor or nurse may ask you to stop taking drugs that make it harder for your blood to clot. They include acetylsalicylic acid (aspirin), ibuprofen (Advil and Motrin), naproxen (like Aleve and Naprosyn), and other drugs like these.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see a regular doctor.
  • Tell your doctor if you have been drinking a lot of alcohol.
  • Ask your doctor which drugs you should still take on the day of surgery.
  • Always let your doctor know if you have a cold, flu, fever, herpes outbreak, or any other illness you may have.
  • You may want a physical therapist to learn some exercises to do before surgery and to practice using crutches.

On the day of surgery:

  • You will generally be asked not to drink or eat anything for 6 to 12 hours before the procedure.
  • Take the drugs your doctor recommended with a small sip of water.
  • Bring your cane, walker, or wheelchair if you already have one. Also wear shoes with flat, non-slip soles.
  • The doctor or nurse will tell you what time you should arrive at the hospital.

After the procedure

The doctor or nurse will ask you to get up and take a walk as soon as the effect of the anesthesia wears off. Most people go home the same day as surgery. DO NOT drive yourself home.

Forecast

Most people have pain relief and are better able to move after surgery. The numbness and tingling should improve or go away. Pain, numbness, or weakness may not improve or go away if you had neurological damage before surgery or if you have symptoms caused by other conditions of the spine.

Additional spinal changes may occur over time and new symptoms develop.

Talk to your doctor about how to prevent future back problems.

Alternative names

  • Microdiscectomy of the spine
  • Micro decompression; Laminotomy
  • Disk removal
  • Spinal surgery: discectomy

 

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