The most common type of surgery, both in the neck and the low back, is a discectomy. What is a discectomy and what can you expect after having one? This article has the answers to those questions and more.
What is a discectomy?
The suffix “ectomy” means the surgical removal of something—in this case, a spinal disc. There are partial discectomies, where part of a disc is removed; sometimes a complete discectomy is needed, and the full disc is removed.
What conditions require a discectomy?
There are multiple reasons a disc, or part of a disc, may need to be removed, including spinal tumors, traumas, and deformities. Spinal infections may also lead to a discectomy. Discs themselves have very poor blood flow (they depend on the blood supply at the edges of the discs for nutrients), so an infection will typically find its way to the edge of the bone and make its way across a disc. As a result, most infections requiring discectomies are complete discectomies rather than partial.
A complete discectomy would have required a fusion—until now. Read about a better option that promotes spinal health.
But by far the most common reason for a discectomy is a herniated disc. (A herniated disc is when the outer layer of a disc breaks and the inner part of the disc, the nucleus, pushes through. The displaced disc often compresses nearby nerves or neural elements and causes pain.)
What can I expect during and after a discectomy?
A discectomy is a very safe procedure with a high success rate; more than 90 percent of patients are satisfied with the results.
It’s a short surgery of about 45 minutes and requires no hospital stay. It does require a small, one-inch incision. Most patients are up and walking the same day of surgery, and driving comfortably two to three days later. It may be necessary to take a pain reliever (like Tylenol or Advil) for mild back pain for a period of days to a couple of weeks after surgery.
What You Should Know About Disc Removal
The typical discectomy for a herniated disc removes approximately 10 percent of the disc. If it’s your first discectomy (your first herniated disc), there will likely be enough healthy disc remaining to keep your spine stable.
However, the chances of a recurrent disc herniation are 10 to 15 percent. In most cases, a second discectomy can be done without causing instability. But the risk of recurrence goes up after a second herniation—somewhere in the neighborhood of 15 to 20 percent. A third disc herniation at the same level will cause spinal instability. Once a level of your spine loses more than ⅓ of your disc it begins to have difficulty carrying your body’s mechanical load; your bones may also start slipping apart, a condition called spondylolisthesis. (Note that, for some patients, instability happens during their first discectomy, if a good portion of the disc needs to be removed.)
BalancedBack Total Joint Replacement is another option for patients suffering from recurrent disc herniations who hope to avoid fusion. BalancedBack surgeons remove your disc and the facet joints completely, and replace them with an implant that performs the same functions. So rather than removing a joint (like fusion), it replaces your joint, allowing you to keep moving naturally after surgery. That means you have a better chance of being comfortable and pain-free in any position and doing almost any activity, even after a complete discectomy.