Does Discectomy Help with Back Pain?

Back pain is a common issue affecting millions of people worldwide, often stemming from problems in the spinal discs. One surgical option for alleviating back pain is discectomy, a procedure that removes herniated disc material pressing on a nerve root or the spinal cord. But does discectomy really help with back pain? As you read this article, you will learn about the effectiveness of discectomy for back pain relief, the procedure’s mechanics, potential benefits, risks, and what patients can expect during recovery.

Understanding Discectomy

A discectomy is a surgical procedure primarily used to treat herniated discs in the spine. A herniated disc occurs when the soft inner material of a spinal disc bulges out through the tough outer layer, potentially compressing nearby nerves and causing pain, numbness, or weakness in the back, legs, or arms. A discectomy aims to relieve these symptoms by removing the portion of the disc that is causing nerve compression.

Types of Discectomy

There are different types of discectomy procedures, including:

• Open discectomy – A traditional procedure that involves a larger incision to access and remove the affected disc material
• Microdiscectomy – A minimally invasive procedure that uses a small incision and an operating microscope to remove the herniated portion of the disc
• Endoscopic discectomy – An even less invasive method using a small camera and specialized instruments
• Percutaneous discectomy – A less common, minimally invasive technique using small instruments and imaging guidance to remove herniated disc material

When Is Discectomy Recommended?

Discectomy is typically recommended when:

• Conservative treatments such as physical therapy, medications, and injections have failed to provide relief
• The patient experiences severe persistent pain that interferes with daily activities
• There are signs of nerve compression, such as weakness, numbness, or loss of bladder/bowel control
• Imaging studies confirm the presence of a herniated disc that corresponds with the patient’s symptoms

How Does Discectomy Relieve Back Pain?

Discectomy directly addresses back pain caused by nerve compression from a herniated disc. By removing the bulging disc material, the pressure on the affected nerve is relieved, which often leads to a significant reduction in pain and related symptoms. This procedure is particularly effective for patients whose pain radiates down their legs (sciatica) or arms, as these symptoms are typically caused by nerve irritation from a herniated disc.

Effectiveness of Discectomy for Back Pain Relief

The effectiveness of discectomy largely depends on the underlying cause of the back pain. Discectomy is highly effective in cases where back pain is due to a herniated disc compressing a nerve. Studies have shown that a significant number of patients experience rapid pain relief and improved function following the surgery.

Short-Term Pain Relief

Research indicates discectomy can provide immediate pain relief for most patients. Many report a noticeable reduction in leg pain (sciatica) shortly after the procedure. However, relief from back pain may take longer, and the degree of relief can vary from patient to patient.

Long-Term Outcomes

Long-term outcomes of discectomy can vary. While short-term results are generally positive, the long-term effectiveness of discectomy in treating back pain can vary. A systematic review in the European Spine Journal reported that:

• 60–90 percent of patients experience good to excellent outcomes in the first two years post-surgery.
• The success rate tends to decrease over time, with about 70 percent reporting satisfactory results after five years.
• Some patients may experience a recurrence of symptoms or develop new issues in adjacent discs.

Factors Influencing the Success of Discectomy

Several factors can affect the success rate of discectomy for back pain relief:

• Patient selection – Patients with clear evidence of nerve compression from a herniated disc tend to have better outcomes.
• Severity of herniation – The extent of disc herniation and nerve compression can influence how much pain relief is achieved.
• Surgeon’s expertise – The skill and experience of the surgeon play a crucial role in the success of the procedure.
• Patient’s health condition – Preexisting conditions such as diabetes, obesity, or smoking habits can affect recovery and outcomes.
• Postoperative care – Following rehabilitation protocols and adopting a healthy lifestyle can enhance long-term results.
• Underlying spinal condition – Patients with degenerative disc disease or other spinal issues may have less favorable outcomes

Risks and Complications of Discectomy

As with any surgical procedure, discectomy comes with potential risks and complications. These can include:

• Infection – Although rare, infections can occur at the incision site or deeper in the spine.
• Nerve damage – There is a small risk of nerve injury during the procedure, which can lead to numbness, weakness, or chronic pain.
• Recurrent disc herniation – There is a possibility the disc may herniate again after the surgery.
• Bleeding or blood clots – Bleeding during surgery or blood clots post-surgery, although uncommon, are potential complications.

Alternatives to Discectomy

Before opting for discectomy, patients and their healthcare providers often explore less invasive alternatives:

Conservative Treatments

• Physical therapy
• Pain medications
• Epidural steroid injections
• Chiropractic care
• Acupuncture

Minimally Invasive Procedures

• Percutaneous disc decompression
• Laser disc decompression
• Spinal cord stimulation

These alternatives may be suitable for some patients, particularly those with less severe symptoms or contraindications to surgery.

Recovery and Rehabilitation after Discectomy

Recovery from a discectomy can vary depending on the type of procedure performed and the individual patient’s condition. Generally, patients can expect the following phases:

• Immediate post-surgery – Most patients are able to go home the same day or after an overnight stay. Pain and discomfort at the incision site are common and can be managed with medications.
• Short-term recovery (2–6 weeks) – Light activities and short walks are encouraged to aid recovery. Patients are usually advised to avoid bending, lifting heavy objects, or twisting during this period.
• Long-term recovery (6 weeks to 3 months) – Physical therapy may be recommended to strengthen the back muscles, increase flexibility, and prevent future disc problems. By three months, most patients can return to normal activities, although full recovery may take longer for some.

Preventing Recurrence of Back Pain

To maximize the long-term benefits of discectomy and prevent future back problems, patients are often advised to:

• Maintain a healthy weight
• Engage in regular exercise, focusing on core strengthening
• Practice good posture and ergonomics
• Avoid smoking
• Manage stress through relaxation techniques

Discectomy can be an effective treatment for back pain caused by herniated discs, particularly when conservative measures have failed. While many patients experience significant short-term relief, long-term outcomes can vary. The success of the procedure depends on proper patient selection, surgical technique, and postoperative care.

It is crucial for patients to have realistic expectations and understand that discectomy is not a cure-all for back pain. A comprehensive approach, including lifestyle modifications and ongoing spine health maintenance, is essential for achieving the best possible outcomes.

If you are considering discectomy surgery for back pain, consult with a spine specialist to determine if it is the right option for your specific condition. Remember every patient’s situation is unique, and what works for one person may not be the best solution for another.

By understanding the benefits, risks, and alternatives to discectomy, you can make an informed decision about your back pain treatment and take an active role in your spine health journey.

Although discectomy surgery is generally a very successful procedure, patients with a larger hole in the outer ring of the disc have a significantly higher risk of reherniation following surgery. Often, the surgeon will not know the size of the hole until he or she begins surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce reherniations, was specifically designed to close the large hole often left in the spinal disc after discectomy. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us today.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.