Lumbar discectomy is a surgery to remove a herniated or degenerative disc in the lower spine. The incision is made posterior, through the back muscles, to remove the disc pressing on the nerve. Discectomy may be recommended if physical therapy or medication fails to relieve leg or back pain or if you have signs of nerve damage, such as weakness or loss of feeling in your legs. The surgery can be performed in an open or minimally invasive technique.

What is lumbar discectomy?

A discectomy can be performed anywhere along the spine from the neck (cervical) to the low back (lumbar). The surgeon reaches the damaged disc from the back (posterior) of the spine—through the muscles and bone. The surgeon accesses the disc by removing a portion of the lamina. The lamina is the bone that forms the backside of the spinal canal and makes a roof over the spinal cord. Next, the spinal nerve is retracted to one side. Depending on your particular case, one disc (single-level) or more (multi-level) may be removed.

A fusion may be done at the same time as a discectomy to help stabilize the spine for patients who are athletes, perform heavy labor, or have spinal instability. Fusion uses a combination of bone graft and hardware (screws/plates) to connect two vertebrae together. During the healing process, the two vertebrae fuse into one piece of bone. Fusion is rarely needed for a herniated lumbar disc.

Who is a candidate?

You may be a candidate for discectomy if you have:

diagnostic tests (MRI, CT, myelogram) that show a herniated disc
significant pain, weakness, or numbness in your leg or foot
leg pain (sciatica) worse than back pain
symptoms that have not improved with physical therapy or medication
leg weakness, loss of feeling in the genital area, and loss of bladder or bowel control (cauda equina syndrome)

Posterior lumbar discectomy may be helpful in treating leg pain caused by:

  • Bulging or herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall (annulus). Irritation and swelling occur when this material squeezes out and painfully presses on a nerve
  • Degenerative disc disease: As discs naturally wear out, bone spurs form and the facet joints inflame. The discs dry out and shrink, losing their flexibility and cushioning properties. The disc spaces get smaller. These changes lead to stenosis or disc herniation.

What happens after surgery?

Follow the surgeon’s home care instructions for 2 weeks after surgery or until your follow-up appointment. In general, you can expect:

  • Restrictions
    • Avoid bending or twisting your back.
    • Don’t lift anything heavier than 5 pounds. 
    • No strenuous activity including yard work, housework, and sex.
    • Don’t drive the first 2-3 days or while taking pain medicines or muscle relaxers. If your pain is well controlled, you can drive.
    • Don’t drink alcohol. It thins the blood and increases the risk of bleeding. Also, don’t mix alcohol with pain medicines.
  • Incision Care
    • If skin glue covers your incision, you may shower the day after surgery. Gently wash the area with soap and water every day. Don’t rub or pick at the glue. Pat dry.
    • If you have staples, steri-strips, or stitches, you may shower 2 days after surgery. Gently wash the area with soap and water every day. Pat dry.
    • If there is drainage, cover the incision with a dry gauze dressing. If drainage soaks through two or more dressings in a day, call the office.
    • Don’t soak the incision in a bath or pool.
    • Don’t apply lotion/ointment on the incision.
    • Dress in clean clothes after each shower. Sleep with clean bed linens. No pets in the bed until your incision heals.
    • Staples, steri-strips, and stitches are removed at your follow-up appointment.
  • Medications
    • Take pain medicines as directed by your surgeon. Reduce the amount and frequency as your pain subsides. If you don’t need pain medicine, don’t take it.
    • Narcotics can cause constipation. Drink lots of water and eat high-fiber foods. Stool softeners and laxatives can help move the bowels. 

The recovery time varies from one to four weeks depending on the underlying disease treated and your general health. You may feel pain at the site of the incision. The original pain may not be completely relieved immediately after surgery. Aim to keep a positive attitude and diligently perform your physical therapy exercises if prescribed.

The cost of discectomy is based on several considerations. This can include both the extent of the procedure and a patient’s insurance carrier. Medicare can cover this procedure if it is deemed necessary treatment. BEST accepts Medicare, most private health insurances, and works with workers’ compensation claims and personal injury cases at all of our centers. 

Reach out to BEST Health System Today

To learn more about discectomy and if it is right for you, contact BEST Health System today. Our caring and experienced team of treatment professionals can help you develop a personalized treatment plan that is right for you. We are dedicated to getting you the quality of life you deserve.

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