Diskectomy

Definition

Diskectomy is surgery to remove all or part of a cushion that helps protect your spinal column. These cushions, called disks, separate your spinal bones (vertebrae).

Alternative Names

Spinal microdiskectomy; Microdecompression; Laminotomy; Disk removal; Spine surgery - diskectomy

Description

A surgeon may perform disk removal (diskectomy) in different ways.

Microdiskectomy is done in a hospital or outpatient surgical center. You will be given spinal anesthesia or general anesthesia (asleep and pain-free).

Diskectomy and laminotomy is done in the hospital, using general anesthesia (asleep and pain-free).

Why the Procedure Is Performed

When one of your disks herniates (moves out of place), the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of your spinal column.

Many of the symptoms caused by a herniated disk get better or go away over time without surgery. Most people with low back or neck pain, numbness, or even mild weakness are often first treated with anti-inflammatory medicines, physical therapy, and exercise. Only a few people with a herniated disk need surgery.

Your doctor may recommend a diskectomy if you have a herniated disk and:

If you are having problems with your bowels or bladder, or the pain is so bad that strong pain drugs do not help, you will probably have surgery right away.

Risks

Risks for any anesthesia are:

Risks for any surgery include are:

Risks for this surgery are:

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs or herbs you bought without a prescription.

During the days before the surgery:

On the day of the surgery:

After the Procedure

Your doctor or nurse will ask you to get up and walk around as soon as your anesthesia wears off. Most people go home the day of surgery. Do NOT drive yourself home.

Outlook (Prognosis)

Most people have pain relief and can move better after surgery. Numbness and tingling should get better or disappear. Your pain, numbness, or weakness may not get better or go away if your had nerve damage before surgery or if you have symptoms caused by other spinal conditions.

Further changes may occur in your spine over time and new symptoms may occur.

Talk with your doctor about how to prevent future back problems.

References

Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.

Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.

Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. 2008;78(7):835-842.

Williams KD, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.

Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24.