Discectomy literally means “cutting out the disc.” A discectomy can be performed anywhere along the spine from the neck (cervical) to the low back (lumbar). The surgeon reaches the damaged disc from the back (posterior) of the spine—through the muscles and bone. The surgeon accesses the disc by removing a portion of the lamina. The lamina is the bone that forms the backside of the spinal canal and makes a roof over the spinal cord. Next, the spinal nerve is retracted to one side. Depending on your particular case, one disc (single-level) or more (multi-level) may be removed.
A variety of surgical tools and techniques can be used to perform a discectomy. An “open” technique uses a large skin incision and muscle retraction so that the surgeon can directly view the area. A “minimally invasive” technique or a microendoscopic discectomy uses a small skin incision. A series of progressively larger tubes, called dilators, are used to tunnel through the muscles. Special instruments help the surgeon see and operate in a smaller space. A minimally invasive incision causes less disruption of the back muscles and may decrease recovery time. Your surgeon will recommend the technique most appropriate for your specific case.
A fusion may be done at the same time as discectomy to help stabilize the spine for patients who are athletes, perform heavy labor, or have spinal instability. Fusion uses a combination of bone graft and hardware (screws/plates) to connect two vertebrae together. During the healing process, the two vertebrae fuse into one piece of bone. Fusion is rarely needed for a herniated lumbar disc.
Most herniated discs heal after a few months of nonsurgical treatment. Your doctor may recommend treatment options, but only you can decide whether surgery is right for you. Be sure to consider all the risks and benefits before making your decision. Only 10% ofpeople with herniated disc problems have enough pain after 6 weeks of nonsurgical treatment to consider surgery.