During this back surgery procedure the patient will be lying face down after being turned onto their back following the administration of general anaesthetic. The surgeon makes a 2-3cm incision above the spine in the area of the disc pathology and then dissects the spinal muscles to gain access to the lamina covering the spine. A small piece of the lamina is then removed (a laminotomy) or, if several discs are being decompressed a large section of this ligament is excised (a laminectomy). If a large portion of the lamina is removed during an open discectomy then the patient may incur slippage and curvature of the spine (kyphosis) without a stabilization procedure such as spinal fusion. A laminoplasty (a hinge-like formation) may be possible to maintain the intervertebral height, or a laminotomy in some cases where only a small portion of the ligament is removed to allow access.
After removal of the covering ligament, the surgeon will be able to see the spinal nerves exiting the spine and locate the herniated disc causing the nerve compression. The disc fragment or the complete disc will be removed according to the degree of compression occurring. An open discectomy also allows the surgeon the access to remove osteophytes which may be adding to compression of the spinal nerves. This may be difficult in minimally invasive spine surgery where access is restricted to a smaller area. The surgeon may then perform a spinal fusion procedure and/or further discectomy at another level if necessary and close the incision and apply a surgical dressing.
Open Discectomy Risks
As the open traditional discectomy takes longer and exposes more of the internal tissues of the body there is a higher degree of infection risk in comparison to minimally invasive back surgery. Patients undergoing any surgical procedure should watch out for the development of a fever, tenderness and inflammation at the site of the incision, any fluid leakage or change in appearance of the incision, and acute headaches or stiffness of the neck which could indicate an infection that has spread to the spinal fluid. Any such symptoms should be immediately reported to a medical doctor and investigated as prompt action can prevent permanent disability and death from an infection such as spinal meningitis.
Read what to expect after surgery : Post Discectomy