Intervertebral discs are located between each vertebra in the spinal column. When damaged, these discs can put pressure on nerves as they leave the spinal cord. An intervertebral discectomy is a back surgery that removes all or part of these discs. The procedure is most often done on lumbar discs (located in the lower back). It may also be done on cervical discs in the neck. There are two methods for this surgery:
These discs normally serve as cushions between the bones. The discs can become damaged or dry with age. Injury can also cause a disc to bulge (or herniate). These changes can create pressure on nerves leaving the spine. This can cause pain, numbness, and weakness.
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The best time to have this surgery is debatable. For some, having early surgery may not result in less pain or disability. In most cases, surgery is only done after other treatments have failed. Other treatments typically include:
The goal of surgery is to eliminate pain, weakness, and numbness caused by the disc pressing on a nerve. You may feel relief right away, or it may take months for the nerve root to heal. In some cases, your symptoms may not improve. Your doctor will carefully evaluate you before surgery to determine what the best option is.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your doctor will likely do the following:
Leading up to your procedure:
General anesthesia —you will be asleep during the procedure
There are different types of surgical procedures, including:
A cut will be made in the skin on the left or right side of the neck. The doctor will go through a muscle to reach the spine. The disc material will be removed after the doctor uses an x-ray to confirm that it is the correct disc. A portion of the bone may be removed to give the nerve more space. A bone graft may be placed to fuse the vertebrae.
A cut will be made in the skin at the back of the neck. The muscles will be pushed aside. A small piece of bone will be removed to get to the disc space ( laminectomy). Next, the doctor will gently push the nerve aside and remove the disc material.
The doctor will make a 1-1½ inch cut in the skin on the lower back. The muscles will be moved out of the way. A small part of the bone may need to be removed to gain access to the nerve and disc. The disc or disc fragments will then be removed.
The disc is removed from between the vertebrae.
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It depends on the type of surgery you had or needed.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
This surgery is most commonly done in a hospital setting. It may be possible to go home on the same day of the surgery. If you have a cervical discectomy, you may have to stay in the hospital for a few days.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
Bending, lifting, or twisting may be limited for 6 weeks.
You will work with a physical therapist to stretch and strengthen your muscles. This will help to decrease the risk of future back problems.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Bach HG, Lim RD. Minimally invasive spine surgery for low back pain. Dis Mon. 2005;51:34-57.
Lavelle W, Carl A, et al. Invasive and minimally invasive surgical techniques for back pain conditions. Anesthesiol Clin. 2007;25:899-911.
Lumbar disk herniation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 26, 2014. Accessed December 18, 2014.
6/7/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
Last reviewed December 2014 by Michael Woods, MDLast Updated: 12/20/2014