Definition

Intervertebral discs are located between each backbone (vertebra). When damaged, these discs can put pressure on nerves as they leave the spinal cord. An intervertebral diskectomy 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:

• Open procedure—A large incision is made.
• Microdiskectomy—Small incisions are made, and the doctor inserts tiny instruments through these incisions.

Reasons for Procedure

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.

Laparoscopic Diskectomy Copyright © Nucleus Medical Media, Inc.

The best time to have this surgery is debatable. This is because—for some patients—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:

• Rest
• Physical therapy
• Medicines

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.

Possible Complications    TOP

Complications are rare, but no procedure is completely free of risk. If you are planning to have intervertebral diskectomy, your doctor will review a list of possible complications, which may include:

• Bleeding
• Infection
• Nerve damage
• Bladder or bowel incontinence
• Leakage of spinal fluid
• Another herniated disk (may happen within the first three months after surgery)

Factors that may increase the risk of complications include:

• Chronic conditions (eg, diabetes)
• Prior spine surgeries
• Advanced age
• Smoking

Be sure to discuss these risks with your doctor before the surgery.

What to Expect    TOP

Description of the Procedure

There are different types of surgical procedures, including:

Anterior Cervical Diskectomy

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.

Posterior Cervical Diskectomy

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.

Lumbar Diskectomy

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.

Diskectomy The disc is removed from between the vertebrae. Copyright © Nucleus Medical Media, Inc.

Call Your Doctor    TOP

After you leave the hospital, contact your doctor if any of the following occurs:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
• Numbness or tingling
• Pain that you cannot control with the medicines you have been given
• Pain, burning, urgency or frequency of urination, or bleeding in the urine
• Cough, shortness of breath or chest pain
• Loss of bladder or bowel control

In case of an emergency, call for medical help right away.