Lumbar discectomy is a spinal surgery that involves removal of damaged intervertebral disc to relieve pressure on the spinal nerves (decompression) in the lumbar (lower back) region. Minimally invasive technique is implemented to perform the surgery.
The lumbar region forms the lower portion of the spine and comprises of five vertebrae (L1-L5).
What are the indications of lumbar discectomy?
It is indicated in cases of severe nerve root compression due to a ruptured disc. Symptoms of nerve impingement include back pain or radiating pain into the hips, buttocks or legs, numbness or tingling sensation and muscle weakness in the back and lower extremities.
What is the procedure of Minimally Invasive Lumbar discectomy?
The procedure will be performed with the patient lying on their stomach. A small incision is made over the lower back and the surgeon gently separates the muscles to access the affected disc. A tubular retractor can be inserted to produce a portal through which the surgeon can perform the surgery. Through the tubular retractor, a portion of lamina, the bony vertebral component that covers the posterior wall of the spinal canal, is removed to expose the compressed area of the spinal cord or nerve roots. Removal of the lamina releases the source of compression from the herniated disc or bone spurs. The complete procedure is known as decompression. After the completion of the procedure, the incision is closed leaving behind a minimal scar.
What is the recovery period of Minimally Invasive Lumbar discectomy?
Recovery period depends on the body’s healing capacity. The post-surgical hospitalization includes the rehabilitation program. If required your surgeon may prescribe pain medications or a brace and follow-up physical therapy upon discharge.
The period of your rest or inactivity depends on a few factors such as the type of surgical procedure and the approach used to access your spine, the size of the incision and presence of any complications. Return to work or normal activity depends on the type of work or activity you plan to perform. Usually 3 to 6 weeks is the ideal time of healing.
Strictly adhere to the post-operative instructions suggested by your spine surgeon to promote healing and reduce the possibility of post-operative complications.
What are the advantages of Minimally Invasive Lumbar discectomy?
Some of the benefits include:
Discuss with your surgeon if you have any concerns regarding the surgery.
Minimally Invasive Cervical Discectomy
A cervical discectomy is an operative procedure which relieves pressure on the spinal nerves and/or spinal cord by removing the total or a part of the damaged intervertebral disc. Cervical discectomy is performed using minimally invasive approach in selected patients, if appropriate.
What is minimally invasive cervical discectomy?
Cervical discectomy is a surgical procedure which relieves compression on the nerve roots and/or the spinal cord because of a herniated disc or a bone spur. This procedure involves making an incision on the front side of the neck (anterior cervical spine), followed by the removal of disc material and/or a portion of the bone around the nerve roots and/or spinal cord to relieve the compression on neural structures and provide them with an additional space.
Cervical discectomy is also referred to as decompressive spinal procedure as the surgeon removes compression on nerve roots by removing the total or a part of the disc and/or bony material that is causing pain. Your surgeon may choose a minimally invasive approach based on your condition and the specific surgical goals.
Minimally invasive cervical discectomy involves a small incision(s) and muscle dilation to separate the muscle fibers surrounding the spine, unlike conventional open spine surgery which requires muscles to be cut or stripped.
Who needs this surgery?
Herniated disc is a condition in which the soft, gel-like center of the disc (nucleus pulposus) has pushed out through the disc’s tough, outer ring (annulus fibrosus). Besides, bony out growths also known as bone spurs or bone osteophytes are formed due to the accumulation of calcium in the spine joints. The pressure induced by a herniated disc or bone spur on nerve roots, ligaments or the spinal cord may cause pain in the neck and/or arms, numbness or weakness in the arms, forearms or fingers, and lack of coordination.
As most nerves to the body (e.g., arms, chest, abdomen and legs) pass through the neck region from the brain, pressure on the spinal cord in the neck region (cervical spine) can be very problematic. Patients with these symptoms are candidates for cervical discectomy procedure only after non-surgical treatment methods fail. Cervical discectomy can reduce the pressure on the nerve roots leading to pain relief.
Your surgeon recommends you for minimally invasive cervical discectomy procedure after examining your spine, medical history, and imaging results of cervical vertebrae such as X-ray, CT (computed tomography) scan or MRI (magnetic resonance imaging). Surgery is recommended only after non-surgical treatment approaches fail. Before recommending surgery, your surgeon considers several factors such as your health condition, age, lifestyle and anticipated level of activity following surgery. A thorough discussion with your surgeon regarding this treatment option is advised before scheduling the surgery.
How is minimally invasive cervical discectomy performed?
The procedure is performed with you resting on your back after injecting the sleep inducing medication (general anesthesia). Your physician makes a very small incision at the center your neck on the front side, and gently separates the muscles and soft structures apart. Then a series of small tubes called dilators are inserted through the incision towards the spine. The sources of compression such as bone spurs and/or disc material are removed. Finally after the procedure, your surgeon removes the tubes, brings back the soft tissues and muscles to their normal place, and closes the incision.
Sometimes, spinal fusion may also be done along with cervical discectomy which involves placing bone graft or bone graft substitute between two affected vertebrae to allow bone to grow between the vertebral bodies. The bone graft acts as a platform or a medium for binding the two vertebral bones, and grows as a single vertebra which stabilizes the spine. Spinal fusion also may be performed through the minimal invasive approach using “tubes”.
In some instances, your surgeon performs the surgery using a posterior approach that requires the incision to be made on the back of your neck. Posterior cervical discectomy may also be done using minimally invasive surgical technique.
How much time will it take for complete recovery?
A specific post-operative recovery/exercise plan will be given by your physician to help you return to normal activity at the earliest possible. After surgery, your symptoms may improve immediately or gradually over the course of time. The duration of hospital stay depends on the treatment plan. In few instances, surgery may also be performed on an outpatient basis. You will be able to wake up and walk by the end of the first day after the surgery. Your return to work will depend on your body’s healing status and the type of work/activity that you plan to resume. Discuss with your spinal surgeon and follow their instructions for optimized healing and appropriate recovery after the procedure.
What are the possible risks or complications?
All surgeries carry risk and it is important to understand the risks of the procedure in order to make an informed decision to go ahead with the surgery. In addition to the anesthetic complications, spinal surgery is associated with some potential risks such as infection, blood loss, blood clots, nerve damage, and bowel and bladder problems. Failure to fuse the vertebral bones with the bone graft (fusion failure) is an important complication of spinal fusion which requires an additional surgery.
Before scheduling the surgery, discuss the benefits, risks and complications related to minimally invasive cervical discectomy procedure with your surgeon.