Diskectomy is a surgical procedure to remove the damaged portion of a herniated disk in your spine. A herniated disk can irritate or compress nearby nerves and cause pain, numbness or weakness. These symptoms can affect your neck or back or may radiate down your arms or legs.
Diskectomy works best on radiating symptoms. It's less helpful for actual back pain or neck pain. Most people who have back pain or neck pain find relief with more-conservative treatments, such as pain medications or physical therapy.
Your doctor may suggest diskectomy if conservative, nonsurgical treatments haven't worked or if your symptoms worsen. There are several ways to perform a diskectomy. Many surgeons now prefer minimally invasive diskectomy, which uses small incisions and a tiny video camera for viewing.
A diskectomy is performed to relieve the pressure a herniated disk (also called slipped, ruptured or bulging disk or disk prolapse) places on a spinal nerve. A herniated disk occurs when some of the softer material inside the disk pushes out through a crack in the tougher exterior.
Your doctor may recommend diskectomy if:
- You have trouble standing or walking because of nerve weakness
- Conservative treatment, such as medication or physical therapy, fails to improve your symptoms after six weeks
- A disk fragment lodges in your spinal canal, pressing on a nerve
- Pain radiating into your buttocks, legs, arms or chest becomes too much to manage
Diskectomy is considered a safe procedure. But as with any surgery, diskectomy carries a risk of complications. Potential complications include:
- Leaking spinal fluid
- Injury to blood vessels or nerves in and around the spine
- Injury to the protective layer surrounding the spine
You may need to avoid eating and drinking for a certain amount of time before surgery. Your doctor will give you specific instructions.
Surgeons usually perform diskectomy using general anesthesia, so you're unconscious during the procedure. You'll receive the anesthetic medication as a gas — to breathe through a mask — or by an injection into a vein. Small amounts of spinal bone and ligament may be removed to gain access to the herniated disk.
Ideally, just the fragment of disk that is pinching the nerve is removed, relieving the pressure but leaving most of the disk intact.
If the entire disk must be taken out, your surgeon may need to fill the space with a piece of bone — taken from a cadaver or from your own pelvis — or a synthetic bone substitute. The adjoining vertebrae are then fused together with metal hardware.
After surgery, you're moved to a recovery room where the health care team watches for complications from the surgery and anesthesia. You may be healthy enough to go home the same day you have surgery, although a short hospital stay may be necessary if you have any serious pre-existing medical conditions.
Depending on the amount of lifting, walking and sitting your job involves, you may be able to return to work in two to six weeks. If you have a job that includes heavy lifting or operating heavy machinery, your doctor may advise you to wait six to eight weeks before returning to work. Limit activities involving lifting, bending and stooping for four weeks after diskectomy. You may also need to limit the amount of time you spend sitting for four weeks following the surgery.
A physical therapist can teach you exercises to improve the strength and flexibility of the muscles around your spine.
Diskectomy reduces herniated disk symptoms in most people who have clear signs of nerve compression, such as radiating pain. However, diskectomy may not be a permanent cure, because it doesn't do anything to reverse the process that allowed the disk to become herniated in the first place. To avoid re-injuring your spine, your doctor may recommend weight loss, a low-impact exercise program, and ask that you limit some activities that involve extensive or repetitive bending, twisting or lifting.
Jun. 27, 2014
- Open discectomy. North American Spine Society. http://www.knowyourback.org/Pages/Treatments/SurgicalOptions/LumbarDiscectomy.aspx. Accessed April 19, 2014.
- McKean SC, et al. Principles and Practice of Hospital Medicine. New York, N.Y: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=749. Accessed April 20, 2014.
- Chou R. Subacute and chronic low back pain: Surgical treatment. http://www.uptodate.com/home. Accessed April 20, 2014.
- Hussein M, et al. Surgical technique and effectiveness of microendoscopic discectomy for large uncontained lumbar disc herniations: A prospective, randomized, controlled study with 8 years of follow-up. European Spine Journal. In Press. Accessed April 19, 2014.
- Chang X, et al. The safety and efficacy of minimally invasive discectomy: A meta-analysis of prospective randomised controlled trials. International Orthopaedics. In Press. Accessed April 19, 2014.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed April 20, 2014.
- Herniated disk. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00334. Accessed April 19, 2014.