What is Lumbar Discectomy?
Discs are shock absorbers that sit between each vertebra for support and cushioning. They also allow the body to bend and move without the bones being rubbed together. Lumbar discectomy is a surgery to remove the degenerative or herniated disc in the lower back. You can opt for the surgery when the outer wall of one of the discs dry out and becomes weak with age or injury. The result of which is bulging disc that can press on the spinal cord and cause weakness, pain or tingling in nearby parts of the body.
Lumbar discectomy can be performed with open or minimally invasive technique.
Causes of herniated disc/slipped, ruptured or bulging disc
A herniated disc happens when the inner portion of the cushion-like discs bulge out due to the wear and tear, aging, or weakness. The ruptured disc pushes out through the tough exterior and compresses the spinal nerve causing numbness and pain. This eventually ends up affecting the arms and legs.
Patients can opt for lumbar discectomy when
- Nonsurgical treatments aren't able to cure the pain
- You have trouble standing or walking due to weakness in the nerve
- Unbearable pain starts to spread to other parts of the body like buttocks, arms or chest
- If your diagnostics tests reflect ruptured disc
Types of Lumbar Discectomy
This surgical procedure involves the removal of the damaged disc that is pressing on the spinal cord or the nerve root. The same can be performed in the below-mentioned ways:
Open discectomy: In this surgery, an incision is made from the middle of your back over the affected bone. The size of the incision can vary depending upon how many discectomies have to be performed.
Microdiscectomy: The doctor will make a much smaller incision to insert a thin tube with a camera. The next step is to remove the damaged disk.
Lumbar laminectomy is a surgery that involves the removal of the lamina, the back part of the bone that works as a protective cover for the spinal canal. When the lamina is removed, there is a certain release pressure on your nerve, and relief from sciatica and leg pain. The lamina can be removed with a separate surgery or along with discectomy.
It is a surgical procedure which is usually undertaken after a laminectomy or discectomy. The doctor will join two or more vertebrae to make it one single structure. The main goal for the surgery is to stop movement between the bones and prevent back pain.
Artificial disk surgery
In this surgery, the doctor will replace the damaged or worn disc material with an artificial or synthetic disk. The new disc can be made of plastic or metal. Artificial disk surgery is only suggested for a few patients as it only works on a few discs of the lower back. This procedure helps in keeping the spine stable for easy movement and also in relieving back pain.
The procedure of Lumbar Discectomy
In most cases, the ruptured or damaged disc heals with the help of nonsurgical treatment within a few months. If that's not the case, then you should consult a neurosurgeon or orthopedic surgeon who will recommend you all the possible options. The decision for the surgery depends on the patients. For a better picture, the patient can opt for presurgical tests such as blood test, electrocardiogram, chest X-ray, etc.
Lumbar discectomy is performed in five steps as mentioned below:
First step: The patient is prepared for the surgery and rolled over in a comfortable position resting upon his/her stomach. The chest and sides are well supported by pillows followed by cleansing the area where the incision has to be made.
Second step: Now the doctor will pass a thin needle through the skin to the bone with the help of a fluoroscope. It is done to access the affected vertebrae and disc.
Rest of the surgery is done by an open discectomy, microdiscectomy or minimally invasive discectomy.
Third step: Next, a small opening of the lamina is made with the help of tools and a laminotomy is performed.
Fourth step: In this step, the ruptured part of the disc is removed to relieve the spinal nerve root. The doctor first looks through a surgical microscope for the herniated disc. Synovial cyst, bone spurs that are putting pressure on the nerve root are also removed but not the entire disc is removed. If required, spinal fusion is also performed during the surgery.
Fifth step: This is the final step in which the retractor is removed and the incision is closed. The muscle and skin incisions are sewn together with the help of staples or sutures. Lastly, the steri-strips are placed over the incision.
Benefits of Lumbar Discectomy
Lumbar discectomy proves to be an effective way to relieve pain, numbness, and weakness. The recovery time varies for every patient, however it usually takes a few months to see signs of improvement. Besides, the patient can opt for physical therapy or rehab for better results. Walking and light exercises as advised by the doctor are other ways to regain movement in the spine.
Some of the things you should be careful after the surgery are:
- Avoid lifting heavy objects
- Make sure you eat high-fiber foods and drink lots of water
- Avoid bending or stretching
- Don't sit for a longer duration of time