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Does a Microdiscectomy Involve Bone Removal?


Whether performed endoscopically or with similar techniques, a microdiscectomy is considered a minimally invasive procedure. This is why it is often an appealing option for a patient with a herniated disc that is irritating a nearby nerve. This article takes a closer look at what happens when the smaller incision associated with this operation is made and clarifies what might happen with bone removal.

Getting to the Affected Spinal Disc

The incision made for a microdiscectomy typically ranges in size from an inch to an inch and a half. Back muscles are lifted but not cut. These muscles are usually on top of the lamina, a bony arch that is part of a vertebra where the affected disc is located. The lamina is one of the small parts of a bone that may be removed during a microdiscectomy, but this is not always necessary.

Removing Part of the Spinal Bone

A microdiscectomy is sometimes performed with a
laminectomy, in which case a bone—the lamina—is removed. The two are usually performed together when a fusion is also occurring. However, a microdiscectomy can be a standalone procedure without a laminectomy included. The two procedures are more likely to be performed together if there is a need to create more space around the affected nerve in the spinal canal. A fusion may be needed if there is existing instability either before or after bone removal.

Removing Part of the Facet Joint

It is also possible for a portion of the inside part of a spinal joint called a facet joint to be removed when a microdiscectomy is performed. This is done for the purpose of accessing the affected disc, and it is more likely to be a necessary step if the problem area of the disc is difficult to reach via other options. Removing part of the facet joint is also another way to provide added nerve pressure relief, which may eliminate the need for an accompanying laminectomy.

Creating a Small Opening in Part of a Vertebra

A small hole is sometimes made in the lamina when a microdiscectomy is performed. In this instance, the purpose is usually to access the affected disc in a safer and more precise way. When a small opening in a spinal bone is created, it is referred to as a laminotomy.

Doing What Is Beneficial for the Patient

The goal with any type of spine surgery is to do what is best for the patient. This sometimes means removing a small part of a spinal bone, creating a strategically placed hole in a bone, or removing a smaller inside part of a spinal joint. Keep in mind any of these steps that may be part of a microdiscectomy are still performed in the least disruptive way possible. Also, because spinal muscles are not cut, having a small piece of bone removed usually has little or no impact on healing and recovery.

Although microdiscectomy surgery is generally a very successful procedure, a hole is left in the outer wall of the disc. In fact, patients with these large holes in their discs are more than twice as likely to reinjure themselves by having what is known as a reherniation. These reherniations often require additional surgery or even fusions. Fortunately, there is a new treatment specifically designed to close the large holes that are often left in spinal discs after discectomy surgery. Barricaid is a bone-anchored device proven to reduce reherniations, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us at 844-288-7474.

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