Discectomy

Discectomy is a surgery to remove all or part of a spinal disc that has herniated. A herniated or ruptured disc allows the jelly-like center of the disc to leak and irritate the nearby nerves, causing pain. Most people with a herniated disc can manage their pain conservatively without the need for surgery.

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Best candidates for discectomy

Patients with simple spine problems are the best candidates for minimally invasive or endoscopic discectomies. Other, more complex spine conditions often require other types of surgery; however, we can treat some complex cases with endoscopic spine surgery on a case-by-case basis.

We will need you to undergo the following imaging tests and exams to ensure that discectomy is the best treatment option for you:

MRI and/or CT scans of your spine
Spine X-rays that show movement
A physical exam to ensure you're not a high risk for complications
Answer detailed questionnaires and complete pain drawings

You may also need to undergo physical therapy and spinal injections before surgery to comply with your health insurance requirements and to reduce risks of unnecessary surgery.

Benefits of discectomy:

Pain relief
Increased movement

Risks of discectomy:

All surgeries have some level of risk. Studies show that complications occur less in endoscopic and minimally invasive surgery than in open surgery; however, the risks are similar to more traditional spinal procedures:

Injury to the nerve root
Leaking of spinal fluid (may cause headaches)
Blood clots
Allergic reactions or complications from anesthesia
Infection

What to expect

The type of discectomy performed and equipment used varies. Your spine surgeon can provide a recommendation specific to your situation. In many cases, the surgeon's decision is based on the technique they've successfully performed for past patients with problems similar to yours.

Open microdiscectomy: The most commonly used approach to safely and successfully remove disc fragments. The surgeon will open up your back and move the muscles to see your spine.

Minimally invasive discectomy: This method uses a smaller incision, and uses specialized devices to go through the muscles of the spine and view the area with a microscope.

Endoscopic discectomy: The least invasive procedure, this technique uses an endoscope (a long, thin tube with a camera and light on the end), and allows your surgeon to precisely target the problem.

Discectomy and spinal fusion: During this procedure, your surgeon removes the entire disc and replaces it with hardware so that the spine bones can fuse together. This technique delivers the best results for herniated discs.

How to prepare for surgery

Depending on the type you're having, you may receive general anesthesia (puts you to sleep), local anesthesia (you remain awake but don't feel pain), or conscious sedation (you remain awake but don't feel pain or remember the procedure after). Open and minimally invasive discectomies usually use general anesthesia. Endoscopic discectomies may use local anesthesia or conscious sedation. An anesthesiologist will ask you questions to evaluate the right amount of anesthesia you'll need during surgery. Your care team may also order blood work or other preoperative tests depending on any underlying health conditions you may have. You may also need approval from your other providers before moving forward with endoscopic spine surgery.

To prepare for surgery you must:

Maintain a healthy lifestyle and balanced diet
Minimize the use of narcotics (painkillers)
Work with your provider on changes to blood thinners or blood pressure medication
Avoid eating after midnight the day before surgery

Recovery

Recovery times vary based on both the surgery type and the problem you are having. People who have undergone simple discectomies, like minimally invasive or endoscopic spine procedures, may recover within 2 to 4 weeks. Those with more complicated cases may take longer to recover. For simple disc herniations, you recovery timeline may look like the following:

Day of or day after surgery you'll be up and walking
Two weeks after therapy you can most likely return to a desk job
Six weeks after therapy, after clearance from your surgeon, you can resume usual activities, including heavy lifting and twisting

Many people feel noticeably better after surgery, but for others it may take several weeks up to years for some symptoms to improve.

After surgery, you must:

Avoid showering until the next day
Avoid baths for a month (soaking your incision in water may increase your risk of infection)
Avoid lifting heavy objects for a month
Use ice, heat, or anti-inflammatory medicine for mild pain relief

In rare cases, your surgeon may temporarily prescribe narcotic pain medication.

Signs of healing

During your recovery, you may experience the return of sensation as previously numb areas begin to normalize, muscle twitching, restless legs. These symptoms are a normal part of your recovery and not a cause for concern. If you experience intense pain at the incision site or develop fever and chills, contact our team immediately.

Follow-up care

You will have a follow-up appointment with your spine provider six weeks after surgery. We may schedule you for another follow-up up to six months after your surgery, depending on where you are in your recovery progress. Physical therapy can improve the results of your surgery.

Success Rate

Discectomies are highly successful surgeries. Your chances of success depend on your age, overall health, and the severity of your disc's herniation. Your surgeon will be able to best estimate the likelihood and degree of your improvement.

Why choose University of Utah Neurosurgery Spine Group?

We are the destination for complex spine patients in the Mountain West. Our spine surgeons perform a high volume of procedures each year, and are both experienced and successful. We also publish our research findings for other physicians and surgeons to learn.

With the University of Utah Health Neurosurgery Spine Group, you will receive care from an experienced team of experts who are national leaders in spine surgery and train residents, fellows, and other physicians.