Discectomy is a surgery to remove all or part of a herniated disc that hasn’t responded well to nonsurgical treatment. The discs are the rubbery structures that separate and provide cushioning between the spinal vertebrae. A herniation occurs when pressure on the disc causes a tear or crack in the outer band, allowing the gel-like center to leak out. Disc herniations most often occur in the neck or low back.
Why are herniated discs so painful?
When the inner part of the disc, the nucleus pulposus, leaks out, it releases a chemical that causes irritation and swelling to nearby nerve roots. The herniated disc may actually compress the nerve. Depending on where the irritated nerve root is located, there may be dull or sharp pain the radiates down an arm or leg. There may be weakness, tingling, or numbness in that extremity. If the herniation occurs in the low back, the person may experience difficulty walking, standing, bearing weight, and have reduced reflexes in the knee and ankle. In severe cases, there may be changes in bladder or bowel function.
Which conservative treatments are considered before surgery?
Many cases of disc herniation do not require surgery and are successfully treated with a combination of nonsurgical therapies. Some of these options include medications to relieve pain and inflammation, muscle relaxers to calm spasms, and heat and cold therapy. Epidural steroid injections may also be effective in relieving pain and inflammation. Physical therapy may be recommended to build strength, flexibility, and maintain functional abilities. Therapy may include special exercises, orthopedic manipulation, ultrasound, and transcutaneous electrical nerve stimulation.
When is surgery recommended?
Sometimes conservative treatments do not provide enough symptomatic relief, and the condition interferes with daily activities. The pain may continue to be severe. Neurological symptoms may become significant, and there may be muscle weakness or loss of bladder and bowel function. The surgeon may want to ensure that there is not long-term nerve damage.
How are discectomies performed?
At Atlanta Brain and Spine Care, many of the discectomies we do are performed using minimally invasive techniques. Small incisions are used to access the spine and perform the discectomy. Minimally invasive techniques have a number of advantages over open surgeries including a reduction in blood loss, less soft tissue damage, shorter operative times, and faster recovery times with less post-operative pain. Discectomies are performed under general anesthesia, and many patients are able to go home the same day as their surgery.
Atlanta Brain and Spine Care
The neurosurgeons at Atlanta Brain and Spine Care offer patients access to some of the world’s most advanced surgical treatments and procedures. Contact us to schedule an appointment with a spine specialist.
