Discectomy or Microdiscectomy for a Herniated Disc
Discectomy is surgery to remove herniated disc material that is pressing on a nerve root or the spinal cord.
Before the disc material is removed, a small piece of bone (the lamina) from the affected vertebra may be removed. This is called a laminotomy or laminectomy. It allows the surgeon to better see the herniated disc.
Microdiscectomy uses a special microscope to view the disc and nerves. This larger view allows the surgeon to use a smaller cut. This causes less damage to surrounding tissue.
During discectomy, the surgeon removes the part of the disc that is herniated and is pushing into the spinal canal. Any loose fragments of disc are also removed.
It is usually done in a hospital. You are asleep or numb during the surgery. You will probably stay in the hospital overnight.
What To Expect After Surgery
After surgery, you will be encouraged to get out of bed and walk as soon as the numbness wears off. You can use prescription medicines to control pain while you recover. You can slowly resume exercise and other activities.
Other things to think about include the following:
Why It Is Done
Surgery is done to decrease pain and allow you to regain normal movement and function.
You and your doctor may consider surgery if:
Surgery is considered an emergency if you have cauda equina syndrome. Signs include:
How Well It Works
Although surgery doesn't work for everyone, it works well for many people.
A study called SPORT randomly assigned about 500 people to two groups. Some had surgery, and some did not. The study found that after 2 years most people felt better and were able to be active, whether they had surgery or not. People who had surgery were slightly more likely to feel better. But the difference wasn't big enough to prove that one treatment is better than the other.1
Another study followed about 500 people over 10 years. Some had surgery, and some did not. This study showed that people who started with medium to very bad pain tended to feel better sooner if they had surgery. But after 5 to 10 years, the number of people in both groups who were able to do their daily activities was about the same whether they had surgery or not.2, 3
As with any surgery, there are some risks.
What To Think About
Discectomy may provide faster pain relief than nonsurgical treatment, although it is unclear whether surgery makes a difference in what treatment may be needed later on.4
When comparing conventional open discectomy with microdiscectomy, people have reported being equally satisfied with both techniques.5
Spinal fusion is a procedure that joins together bones in the back. It is sometimes effective for neck problems. A cervical (neck) discectomy is usually combined with a fusion. But for the low back (lumbar spine), the procedure is controversial and complex and is not commonly performed with a discectomy. If a doctor suggests that you get a lumbar spinal fusion with a discectomy, get a second medical opinion to help you decide whether fusion is needed.
Percutaneous discectomy is a procedure using a special tool through a small incision in the back to cut out or drain the herniated disc, thereby reducing its size. Percutaneous discectomy is considered less effective than open discectomy.4
A newer form of discectomy using laser beams (laser discectomy) is still in the research stage.
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