Types of Discectomy Surgery
Considering surgical treatment options for a herniated disc?
There are various types of disc removal surgeries available to you. The
United Spine & Joint will gladly cover each procedure with you to determine
the best fit for your needs.
Discectomy is a surgical procedure carried out to treat
The condition arises due to compression of nerve root by prolapsed or
protruded disc. Based on the function of the nerve under pressure, pain will
be more severe and can spread to different parts of body.
considered as the final treatment for back pain. It is better
to select a
procedure which is minimally invasive and with least risk factors.
Advancement in medical field and technologies resulted in modern versions of
disc removal surgery. There are various types of discectomy that can be used
based on the region and type of surgery needed.
If you are
interested in learning more please
contact us to determine what option is
best for you, what your insurance will cover and any additional surgery
What is a Discectomy (open)?
This procedure is generally mentioned as
discectomy and is the traditional method to treat pain due to herniated
disc. In this operation, surgeon cut open the region through a small
incision to reach the area and removes the herniated disc and associated
bones to relieve the pressure. As lumbar region of spinal cord is
responsible for certain range of
lower back pain, the surgery is also known as lumbar discectomy.
What is MicroDiscectomy?
Microdiscectomy is a procedure performed to remove a
ruptured or herniated
portion of a disc. A herniated disc occurs when the outer portion of the
disc tears and releases internal disc material out into the spinal canal.
The displaced disc material can press against adjacent
spinal nerves, which can cause a number of painful and bothersome
symptoms. These symptoms include
back pain and numbness, tingling, and weakness in the extremities. Since
herniated discs most frequently occur in the lumbar (lower) spine, the
symptoms are usually felt in the
back, buttocks, legs, and feet.
The goal of a microdiscectomy and arthroscopic microdiscectomy is to remove
any disc material placing pressure on the nerves, thereby alleviating
symptoms. During the procedure, a
removes a portion of bone necessary to access the herniated disc, and then
uses tiny tools to remove any disc material and tissues required for the
decompression. The aim of the procedure is the same as that of a discectomy,
except a microdiscectomy is a minimally invasive procedure performed with
aid of microscopic magnification. With a microdiscectomy, the tissue and
muscle damage is minimal, so scarring is reduced and recovery time is much
quicker than that of traditional open back surgery.
Most cases of a bulging or herniated disc can be treated with conservative
therapies, and surgery is only considered if conservative treatment has
failed as an option for relief. Herniated disc treatment usually begins with
bed rest, hot and cold compression, over-the-counter medication, or physical
therapy. The next step in treatment often involves prescription pain
epidural steroid injections.
Patients who try several months of conservative herniated disc treatment but
still feel severe and limiting pain often are candidates for
United Spine & Joint offers a microdiscectomy alternative that has an
extremely high success rate and leaves most patients with improved symptoms
in as little as a few days. To learn more about our revolutionary
contact us today.
Endoscopic microdiscectomy is a minimally invasive surgery used to treat
symptoms of a herniated disc. During this procedure,
an endoscope (a magnifying camera that can be inserted directly into the
body through a tiny incision) to see and remove herniated disc material in
the spinal column. By removing tiny bits of material pressing on spinal
surgeons at United Spine & Joint often are able to relieve nerve
irritation and painful symptoms in the patient.
A herniated disc occurs when the outer layer of a disc, the annulus fibrosus,
ruptures and expels a portion of the discís interior matter, the nucleus
pulposus. The displaced disc material can press against neighboring nerve
roots and the spinal cord, causing a range of symptoms including
back pain, and tingling, numbness, and weakness in the extremities. The
severity of the symptoms, as well as the location of the body experiencing
the symptoms, is determined by the location of the herniated disc and the
amount of displaced disc material. The purpose of an endoscopic
microdiscectomy, therefore, is to decompress the nerve by removing the
displaced portion of the disc.
Discectomy surgeries have been used to treat symptoms of herniated discs for
years. But in the past, these procedures involved removing the entire disc
through large incisions, which means substantial muscle and tissue damage,
long hospital stays, and lengthy recovery times. Endoscopic surgery options
such as endoscopic microdiscectomy drastically reduces all of these side
effects because itís performed through a tiny incision about the size of a
dime. Using mirco-instruments and an endoscope, the surgeon carefully
suctions out disc material and irrigates the area, effectively decompressing
the irritated nerve with minimal damage to surrounding tissues and muscles.
Compared to a
fusion, the endoscopic method shortens recovery time, minimizes
scarring, and allows most patients to be up and walking the same day of the
If you have a
disc or bulging disc, itís unlikely that youíll have to resort to back
surgery to treat your symptoms. Most cases of herniated discs are treated
using conservative therapies, such as hot and cold compresses, bed rest,
physical therapy, and over-the-counter medication. Steroid injections and
prescription pain medication can also be helpful for those with severe and
recurring pain, but both of those options can have significant side effects.
If youíve been suffering from debilitating and painful symptoms of a
herniated disc and have tried conventional treatments, you may be a
candidate for an endoscopic microdiscectomy. The experienced surgeons at
United Spine & Joint have performed tens of thousands of these procedures
with an extremely high success rate. For more information,
contact us today.
Automated Percutaneous Lumbar Discectomy
Automated percutaneous lumbar discectomy is a minimally invasive procedure
used to treat symptoms of a bulging disc or small
herniated disc in the
lower back. A bulging disc occurs when the nucleus of the disc protrudes
outward, but doesnít completely rupture the outer layer (annulus fibrosus)
of the disc. Bulging discs can press against neighboring nerves and cause
symptoms including pain, numbness, and weakness in the back or limbs,
depending on the location of the affected disc. Thus, the aim of any
discectomy is to decompress the nerves by removing deviated disc material
and disc fragments.
Percutaneous discectomy is different from
microdiscectomy or other types of discectomy, because itís performed
through a tiny needle in the skin instead of an incision. In some types of
percutaneous discectomy, an automated suction-cutting device inserted
through the needle is used to extract the disc material.
This procedure is sometimes an effective alternative to traditional open
back surgery, but it canít be used in cases where the lumbar disc has
completely herniated. Since itís a minimally invasive procedure, it is
performed using only local anesthesia and in some cases, mild sedation.
Scarring is minimal, and recovery time is substantially shorter than that of
open back surgery.
Itís important to understand that most bulging discs can be treated with
conservative therapy such as bed rest, exercise, a heating pad, and
medication. Also, there are several lifestyle modifications you can make to
reduce your symptoms. These include using good posture,
maintaining a healthy weight, and protecting your back while lifting. If
youíve tried conservative treatments but are still experiencing painful and
debilitating bulging disc symptoms,
call the specialists at United Spine & Joint. We offer a type of
minimally invasive discectomy that has been successful in treating thousands
of patients with bulging and herniated discs. For more information,
contact us today.
Anterior cervical discectomy (ACD)
This type of
is meant for pain due to large bone spurs. General anesthesia is given for
patients as it is an open type of surgery. During ACD, the region is cut
open from front of neck which makes the C2 region exposed under cervico-thoracic
junction. This path is less complicated compared to other open surgical
procedures. In this method, only a thin layer of muscle has to be cut open
leading to the plane. This helps to reduce post operative pain and other
complications during surgery.
Anterior cervical fusion (ACF)
cervical discectomy and fusion or anterior cervical fusion are mainly
performed on patients with spinal instability (with subluxations or
situation is confirmed based on various radio-diagnostic tests. The
herniated disc or bone spurs are removed and a
bone graft is replaced taken
from the hip of patient or from a donor.
This type of laser assisted
surgical procedure is emerging as an effective method to
treat back pain due to herniated discs. This is an out patient protocol
and takes less than one hour to complete. Surgical procedure include
incision of a needle to the herniated disc and the herniated part of nucleus
pulpous alone is burned.
What To Expect After
discectomy, you will be encouraged to get out
of bed and walk as soon as the anesthetic wears off. You
can use prescription medicines to control pain during
the recovery period and will be advised to resume
exercise and other activities gradually. Other things to
think about include the following:
- You can sit as long as you are comfortable, but
most people avoid sitting for longer than 15 to 20
minutes. After surgery, sitting can be uncomfortable
for a while.
- Use walking as your primary form of exercise for
the first several weeks. Getting up frequently to
walk around will help decrease the risk that excess
scar tissue will form. Scar tissue can keep the
nerve root from gliding freely as you move, and can
press on the nerve root. Walking will also provide
exercise for your heart and lungs without stress to
your back or the incision line (scar).
- Avoid any activities that cause pain.
- You may begin bicycling and swimming about 2
weeks after surgery as directed by
your doctor or
- If you work in an office, you may return to work
within 2 to 4 weeks. If your job requires physical
labor (such as lifting or operating machinery that
vibrates) you may be able to return to work 4 to 8
weeks after surgery.
Many people are able to resume work and daily
activities soon after surgery. In some cases, your
doctor may recommend a rehabilitation program after
surgery, which might include physical therapy and home
Why Is Discectomy
When surgery is used to treat a herniated disc, it is
done to decrease pain and allow for more normal movement
Surgery is considered an emergency if you have
equina syndrome. Signs include:
- New loss of bowel or bladder control.
- New weakness in the legs (usually both legs).
numbness or tingling in the buttocks,
genital area, or legs (usually both legs).
Surgery may be considered if tests show that your
symptoms are due to a
and your doctor thinks surgery may help relieve the
symptoms. In deciding whether to have surgery, you and
your doctor will consider factors such as:
- A history of
persistent leg pain, weakness, and
limitation of daily activities that has not gotten
better with at least 4 weeks of nonsurgical
- Results of a physical examination that show you
have weakness, loss of motion, or abnormal sensation
(feeling) that is likely to get better after
- Diagnostic testing, such as magnetic resonance
imaging (MRI), computed tomography (CT), or
myelogram, that indicates your herniated disc would
respond to surgery.
Should I have surgery
for a herniated disc?
People with milder symptoms tend to do well without
surgery. People with prolonged symptoms that are severe
enough to interfere with normal activities and work and
require strong pain medicines may gain
surgery. A study begun in 1990 followed about 500 people
with low back pain caused by a herniated disc. Some had
surgery and some did not. Follow-up information was
gathered 5 years and 10 years after the beginning of the
- People with moderate to severe pain who had
surgery noticed a greater improvement than those who
did not have surgery.
- Those who had surgery noted more relief from the
symptoms they considered most important than those
who did not have surgery.
- At 5 years, 70% of those who had surgery
reported improvement in their most important
symptom, as compared with 56% of those who
received nonsurgical treatment.
- At 10 years, 71% of people who had surgery
were satisfied with their current situation,
compared with 56% of those treated
- But the type of treatment did not make a
significant difference with regard to work and
disability. The percent of people working at the
time of the 10-year follow-up was similar,
regardless of whether they had chosen surgical or
Risks of Discectomy
As with any surgery, there are some risks. There is a
risk of damaging the nerve roots or spinal structures
during surgery. There is also some risk of infection
following surgery, which may require antibiotics and
additional surgery. Some people may get a
thrombosis (blood clot) or embolus (the clot breaks away
and causes a blockage of blood flow in the lung). These
conditions can lead to death, but dying from these
conditions is rare.
Because there are risks with general anesthesia, your
doctor and medical staff will carefully monitor you
during your surgery and recovery.
Before the surgery, there is no sure way that your
surgeon can know how your nerves will respond after the
pressure of the
disc herniation is removed. So there is
a risk that your pain may not improve with surgery, or
your pain may only partly improve.
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. When comparing conventional open discectomy with
microdiscectomy, people have reported being equally
satisfied with both techniques.
Spinal fusion is a procedure that joins together
bones in the back. It is sometimes effective for neck
problems, and can be combined with a discectomy. 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
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.
A newer form of discectomy using laser beams
discectomy) is still in the research stage.