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Lumbar Discectomy

What does “Lumbar Discectomy” mean?

Here is the meaning of each word:

  1. Lumbar: the area of the spine located in the low-back
  2. Discectomy: surgical procedure where a piece of the disc is removed

Altogether, “Lumbar Discectomy” means removing a piece of a herniated disc from the low back.

What is a Lumbar Discectomy?

A Lumbar Discectomy is a surgical procedure usually done for a disc herniation in the low-back. This requires making an incision in the skin. The muscles are then separated from the spine and pushed out of the way. A small piece of bone (lamina) is then removed to see the disc herniation and the spinal nerve below the bone. The disc herniation is then carefully removed. Some surgeon also remove a portion of the inside of the disc (disc nucleus), but not the whole disc. If the whole disc were removed, no cushion would be remaining between the vertebrae.

Why is a Lumbar Discectomy done?

A Lumbar Discectomy is done for a disc herniation in the low-back which is either pushing (compressing) on a spinal nerve or the cauda equina (bundle of nerves below the spinal cord).

What is the difference between a Lumbar Discectomy, a Lumbar Microdiscectomy, a Lumbar Endoscopic Discectomy, and a Lumbar Percutaneous Discectomy?

  1. A Lumbar Discectomy is an open surgery, done with a larger cut (incision) and more of a dissection (moving more of the anatomy aside to be able to see the disc). It is usually done for larger, complicated disc herniations.
  2. A Lumbar Microdiscectomy is done with a smaller cut (incision) than a Lumbar Discectomy and small metal retractors (device which moves tissue out of the way). A Microscope is often used to see the disc.
  3. A Lumbar Endoscopic Discectomy is done through a small tube which is placed into the spine. A small scope is then placed through the tube to see the disc. This procedure is usually done for smaller, uncomplicated disc herniations.
  4. A Lumbar Percutanous Discectomy is done through a needle. It is usually done for very small disc herniations and can only remove very small amounts of disc material.

How is a Lumbar Discectomy done?

Here are some of the steps of how a Lumbar Discectomy is performed:

  1. This surgery is done in an Operating Room.
  2. An intravenous catheter (IV) is placed before surgery and antibiotics are given.
  3. In the Operating Room, the patient is initially place on the back (supine) and a General Anesthetic is given.
  4. The patient is then carefully placed on the stomach (prone).
  5. The low-back (lumbar spine) is cleaned with a sterile surgical solution and sterile sheets (drapes) are placed around the surgical site.
  6. The surgeon makes a cut (incision) over the spine.
  7. The tissue and muscles under the skin are freed up from the bone and moved to the side.
  8. The lamina bone on the back of the spine is seen and a portion removed.
  9. The ligament under the lamina (ligamentum flavum) is now seen and a portion of it removed.
  10. The spinal nerve and dura (lining of the spinal cord and spinal fluid, which contains the cauda equina) is now seen.
  11. The disc herniation behind the spinal nerve is located and removed.
  12. The tissue and skin are closed with stitches (sutures).
  13. A bandage (dressing) is placed on the surgical site.
  14. The patient is turned on the back (supine) and awoken from Anesthesia.
  15. The patient is brought to the Recovery Room.

How long does it take to perform a Lumbar Discectomy?

A Lumbar Discectomy may take 1-2 hours or more to complete.

What is the recovery like from a Lumbar Discectomy?

Here are some of the steps during a recovery from this type of surgery:

  1. The patient is usually admitted to the hospital for at least an overnight stay.
  2. After discharge, activity restrictions about lifting, bending, twisting, running, etc. will be given.
  3. The wound will heal in 2-4 weeks.
  4. The surgeon will typically evaluate the patient again within several weeks.

What kind of benefit can patients gain from a Lumbar Discectomy?

A Lumbar Discectomy will remove pressure on the spinal nerve or cauda equina. The symptoms often improve over weeks and months following the surgery.

Depending on how long a nerve was compressed and the severity of the compression, some symptoms may remain.