Discectomy is surgery to remove lumbar (low back) herniated disc material that is pressing on a nerve root.
It's often done as microdiscectomy, which uses a special microscope to view the disc and nerves. This larger view allows the surgeon to use a smaller cut (incision). And this causes less damage to surrounding tissue.
Before the disc material is removed, a small piece of bone (the lamina) from the affected vertebra may be removed. This is called a laminotomy or laminectomy. It allows the surgeon to better see the herniated disc.
You may be asleep or have medicine to relax you during surgery. And the area will be numbed if you're awake. It's often numbed even if you are asleep. You might go home the same day you have surgery. Or you might need to stay in the hospital or surgery center overnight.
Surgery for a lumbar (low back) herniated disc works well for many people, but not for everyone. For some people, it can get rid of all or most of their symptoms.
In a study of people who had sciatica caused by a herniated disc, the chances of having no symptoms or almost no symptoms 3 months to 2 years later was a little higher with surgery than with nonsurgical treatment. But, overall, most people felt better with or without surgery.
In a study of people who had 6 to 12 weeks of severe sciatica related to a herniated disc, one group was assigned to have surgery soon (the surgery group). The other group (the nonsurgical group) was assigned to try nonsurgical treatments for 6 months, followed by surgery if their symptoms didn't improve. Both groups were asked about their recovery 2 months after surgery or the start of nonsurgical treatment. People in the surgery group felt better (closer to complete recovery) than people in the nonsurgical group. But after 1 year, both treatment groups rated their recovery about the same.
If you don't choose surgery now, you can change your mind later if your symptoms haven't gotten better or have gotten worse even with other treatments. Surgery seems to work just as well if it's done within 6 months after symptoms start.
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
As with any surgery, there are some risks.
Microdiscectomy is surgery to remove part or all of a bulging or damaged (herniated) disc in the spine. A herniated disc in the low back (from the first lumbar vertebra to the sacrum) is called a lumbar herniated disc. It if irritates or presses on the spinal nerves, it can cause pain and numbness in the buttock and leg.
Most people can get better on their own. But for some people, surgery may help the pain and numbness. It may also improve movement.
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You will probably be able to go home the same day as your surgery, or the next day.
After surgery, you may have less leg pain and numbness. And you may be able to move your leg better. Some people feel better very soon after surgery. But if you had leg pain or numbness for a long time before surgery, it may take longer to feel better.
Your back will probably feel stiff and sore. You may find it uncomfortable to sit or stand in one position for very long. This usually gets better after several weeks. But your back could be a little stiff for up to 6 months. You will have a small scar on your back, but it may fade with time.
Many people are able to go back to work and their daily routine as soon as the pain improves. If you work in an office, you may go back to work in a week or two. If your job requires physical labor (such as lifting or twisting), you may be able to go back to work in 4 to 8 weeks.
Walking and doing back exercises can help you get better faster. Your doctor may recommend that you work with a physical therapist to make the muscles around your spine stronger and more flexible. You will need to learn how to lift, twist, and bend in ways that keep your back safe.
You may be asleep or have medicine to relax you. And the area will be numbed if you're awake. It's often numbed even if you are asleep. You will not feel pain during the surgery.
The doctor will make a 1- to 2-inch cut (incision) in the skin over the spine. The doctor will put surgical tools through the incision and will use a special microscope (scope) to view the area.
The doctor may first remove a small amount of bone and other tissue from the spine. This helps the doctor see the area around the disc. Then the doctor removes the bulging disc material. Next, the doctor closes the incision with stitches.
Surgery is done to decrease pain and allow you to regain normal movement and function.
You and your doctor may consider surgery if:
Surgery is an emergency if you have cauda equina syndrome. Signs include:
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