In surgical vocabulary an -ectomy is the removal of a body of tissue, organ, or structure, and in the case of a discectomy this is the removal of an intervertebral disc. A partial discectomy is the excision and removal of a fragment of disc, such as the herniated material or disc bulge causing nerve compression and back pain but this type of back surgery procedure may sometimes be referred to as a discectomy which can cause confusion. Traditional back surgery for a herniated disc is an open discectomy where an incision is made in the back, just above the problematic disc, and the surgeon moves muscles, nerves, and ligaments aside to gain access to the herniation and remove the disc, severing the muscles and ligaments in some cases.
An open discectomy is performed under general anaesthetic and takes around an hour depending on the patient’s size, health status, the severity of the herniation, and other variables. Lee (2009) found that minimally invasive microdiscectomy took an average of 45.8minutes, compared to 73.8minutes in traditional open discectomy surgery. The shorter operating time is not the only benefit of minimal access back surgery as the procedure, usually, causes significantly less trauma to the back’s muscles, nerves, and ligaments, shortens recovery time, reduces the risk of infection and severe blood-loss, and makes scarring, both internal and external, less likely and/or noticeable.
Some patients may not be candidates for minimal access microdiscectomy due to other complications, larger body mass, the necessity for spinal fusion, and previous failed back surgery. Patients should ensure that they discuss their options with their physician prior to scheduling any procedure and that they are comfortable with the likely effects of surgery and their chances of recovery. Around 85-90% of patients undergoing discectomy achieve resolution of their symptoms, with pain often dissipating fairly rapidly, and numbness and weakness taking a little longer to resolve. There are many beneficial actions to take after a discectomy, such as not smoking, avoiding bending and stretching activities for a period of time, and ensuring correct nutrition and hydration. Patients are likely to be given an exercise regime by a physical therapist to promote their recovery.
The video shown is of a discectomy on the neck – in this case the incision is made on the front (anterior) side of the body.
Next Read about: Traditional Open Discectomy