A lumbar discectomy is a surgical procedure to fix a herniated disc in the lower part of the spine, which often places pressure on nearby nerves. A herniated disc occurs when a spinal disc becomes damaged and then either bulges or breaks. The lumbar discectomy can relieve symptoms of a disc herniation, such as weakness, numbness, and intense pain. During this surgery, the herniated part of the disc is taken out, along with any fragments that broke off.
Prior to undergoing a lumbar discectomy, patients will have an imaging test to confirm the diagnosis and the exact location of the herniated disc. The doctor may order a computed tomography (CT) scan or a magnetic resonance imaging (MRI) test. Patients must disclose all other medical conditions they have. Those who take certain medications or supplements, such as blood thinners, aspirin, or St. John's wort, may need to discontinue these for a period of time.
The entire procedure typically takes about one hour to complete. A lumbar discectomy is usually performed under general anesthesia, so the patient can expect to be unconscious throughout it. Patients are then placed on their abdomens to allow the surgeon access to the spine. The area is then sterilized and the surgeon will make an incision.
Special instruments are used to gently separate a small area of the muscle from the bone surrounding the disc. The surgeon will likely use microscopic imaging tools to gain a better view of the area so that he can remove any portions of disc bone that are compressing the nerves. Loose bone fragments are also removed and the surgeon may apply antibiotics directly to the area to avoid infection. Although the muscles will naturally come back together, the surgeon may use a few stitches to help them heal. He will use stitches or surgical tape to close the incision.
A lumbar discectomy does not typically require an overnight hospital stay. The patient is encouraged to walk soon after waking up, as well as frequently during the first few weeks of recovery. Walking will help discourage scar tissue from forming. Patients should avoid strenuous activities or any activities that cause pain. Recovery may take two to four weeks; however, those with physically-intense jobs should wait six to eight weeks before returning to work.
Before undergoing a lumbar discectomy, patients should be aware of the potential risks. Blood clots and infections can occur, which will require additional treatment. The operation may also fail or the patient's symptoms may only be partially alleviated. There is also the possibility of damage to the nerves or to the spine.