Lumbar herniated discs are a leading cause of leg pain, spinal instability, immobility, and an overall sense of discomfort. In some cases, pain relief can be achieved with conservative, nonsurgical treatments such as stretching programs, ice, and pain medications. In fact, 85 percent of patients1 with painful herniated discs will see their symptoms resolve without the need for surgery.
With that said, patients with more advanced lumbar disc herniation may require surgery to achieve relief from pain and discomfort. In this article, learn all about discectomy and laminectomy procedures, including the key differences between them.
Comparing a Discectomy and Laminectomy Procedure
Discectomy
A discectomy is the most common procedure for relieving painful symptoms due to a herniated disc in the lumbar spine. During discectomy surgery, a spine surgeon removes disc material to decompress nerve roots and reduce painful symptoms, discomfort, and activity restrictions associated with lumbar disc herniation.
Discectomies can either be limited or aggressive, depending on the amount of disc material that needs to be removed, as well as the patient’s risk of reherniation. Limited discectomy involves removing any free disc material without probing the inner core of the disc, whereas an aggressive discectomy involves removing all free fragments and additional material from inside the disc.
Laminectomy
A laminectomy procedure involves removing the entire bony lamina covering the spinal canal, a portion of the enlarged facet joints, and the thickened ligaments overlying the spinal cord and nerves. Hemilaminectomy procedures, a more limited laminotomy that involves making a smaller hole in the bone, are often performed in advance of discectomy surgery to create a window in the lamina for the spine surgeon to access and remove any of the herniated disc fragments. For some patients, this procedure can achieve pain relief as a separate, standalone surgery to decompress the spine.
Hemilaminectomy
Hemilaminectomy (sometimes called a “laminotomy”) is essentially the same procedure, but it’s a more conservative approach because it removes less bone and leaves the natural support of the lamina in place to decrease the chance of spinal instability.
Minimizing Your Risk of Reherniation with Barricaid
Whether you’re in need of a laminectomy and discectomy, a laminectomy by itself, or a standalone discectomy procedure, you need to be informed and reassured about your recovery, results, and likelihood of reherniation.
Risk Factors for Reherniation
Your spine surgeon can answer questions regarding your specific case, including your risk of recurrent disc herniation and the condition of your other lumbar discs. Certain risk factors can contribute to an increased likelihood of reherniation and the potential for repeat surgery, such as:
- Large holes in the lumbar herniated disc
- High body mass index (BMI)
- Sedentary lifestyle
- Diabetes
- History of tobacco use
Patients with large holes in the treated disc have up to a one in four chance2 of experiencing recurrent disc herniation and needing another discectomy surgery. Not only is reherniation painful and inconvenient for patients, but reoperations to address a second herniation tend to be less successful3 than the original surgery.
Prevention of Reherniation
If you have a large hole in your disc, the Barricaid device may be an optimal addition. Barricaid—a new and innovative device—is designed to achieve superior outcomes by reducing the chance for reoperation and reherniation when compared to discectomy alone. Your spine surgeon can implant Barricaid during your laminectomy and/or discectomy procedures if you’re a good candidate for the device.
Patients treated with Barricaid show 50 percent or higher reductions in repeat herniation and reoperation when compared to other discectomy patients. Many Barricaid patients, such as our friend Diego, are able to maintain an active lifestyle following discectomy with no restrictions.
Looking Ahead: Are You a Barricaid Candidate?
Interested in exploring whether you’re a good Barricaid candidate? Take the quiz and consult with a spine specialist to find out what best suits your unique situation and needs.
While this blog is meant to provide you with the information you need to make an informed decision about your treatment options, it is not intended to replace professional medical care or provide medical advice. If you have any questions about the Barricaid, please call or see your doctor, who is the only one qualified to diagnose and treat your spinal condition. As with any surgical procedure, you should select a doctor who is experienced in performing the specific surgery that you are considering.
If you have any questions about the Barricaid, you may ask your doctor. For additional information, please visit www.barricaid.com. For complete risk-benefit information: www.barricaid.com/instructions-for-use.
References
1. Alexander M. Dydyk, Ruben Ngnitewe Massa, Fassil B. Mesfin, “Herniated Disc,” StatPearls, U.S. National Library of Medicine, 2020, https://www.ncbi.nlm.nih.gov/books/NBK441822.
2 Frederic Martens et al, “Patients at the Highest Risk for Reherniation Following Lumbar Discectomy in a Multicenter Randomized Controlled Trial,” JB & JS Open Access 3, no. 2 (2018): E0037, doi: 10.2106/JBJS.OA.17.00037.
3 Dante Leven et al, "Risk Factors For Reoperation In Patients Treated Surgically For Intervertebral Disc Herniation," The Journal Of Bone And Joint Surgery-American 97, no. 16 (2015): 1316-1325, doi:10.2106/jbjs.n.01287.
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