What is a Discectomy and When Do I Need It?

Back pain is something many, if not all, of us experience at some point. If you have chronic back pain caused by a damaged disk, then your doctor may talk to you about a discectomy or diskectomy.

What is a Discectomy?

Your spinal discs are cushions that separate your spinal bones (vertebrae) and prevent them from grinding against each other. Healthy discs are important to support a pain-free, active life. Discectomy is the removal of all or part of a damaged disc. It is done in order to restore pain and function after a herniated disk.

When is a Discectomy Needed?

A discectomy is typically done to treat a herniated disc. This happens when part of a disc slides out from between the vertebrae and bulges into the spinal canal. This can happen due to degenerative disc disease (a disease of aging) or physical trauma/injury. Some people are more prone to herniated discs than others, and it runs in families.

Most discs are treated conservatively by reducing activity level (bed rest is no longer recommended) and taking nonsteroidal anti-inflammatory medication. You may also be recommended physical therapy.
However, a discectomy is recommended if:

• You have severe leg or arm pain or numbness that does not reduce over time, which is interfering with daily activities
• Weakness in muscles of your arm, lower leg, or buttocks
• Pain spreading into the buttocks or legs
• Pain that is not helped by medication
• Problems with bowels or bladder

The latter two indicate that surgery should take place urgently. If you have back pain and incontinence, this is a medical emergency and you should seek immediate care.
The vast majority of people with herniated discs do not need surgery.

What to Expect From this Treatment?

There are three levels of discectomy. The most basic is a microdiscectomy, where the surgeon makes a small hole through your back, moving back muscles and nerves out of the way to remove the injured disc tissue.
This surgery is straightforward, takes one or two hours, and can be done in a clinic. In some cases, you may be able to have it done under local anesthesia. If you do need general anesthesia, you will need somebody to drive you home after the procedure.

You may need a discectomy and laminotomy for more complicated situations, which is always done in a hospital under general anesthesia. This requires curing away part of the lamina bone, the bone that protects your spinal column.
You will be expected to quit smoking about four weeks before your surgery. If you are having problems quitting, talk to your doctor about a cessation program. You may also be asked to stop taking medicines that make it harder for your blood to clot, such as aspirin or ibuprofen. On the day of the surgery, you will be asked to fast, but should take any medicines you need to take with a small sip of water.

Recovery & Life After

After the procedure, you will be asked to get up and walk as soon as your anesthesia has worn off enough that it is safe for you to do so, and you should be able to go home the same day. However, recovery usually takes 6 to 8 weeks from a microdiscectomy, potentially longer from a discectomy and laminotomy.

If you have stitches, you must come back to have them removed about a week. You may not be able to shower for a few days. Avoid sitting still for more than 20 minutes. You may have difficulty walking and need a cane or a walker. Your surgeon may recommend physical therapy.

However, most people experience a significant reduction in pain quickly and fully recover. Because people with one herniated disc are at higher risk of having another, you should monitor your spine. You should reduce the risk of future injury, such as lifting correctly. If you are recommended physical therapy, talk to your therapist about the best ways to reduce risk for you and your lifestyle.

If you have chronic back pain that is not responding to treatment, fill out the form below to schedule an appointment with North Lakes Pain to get the needed help.