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Are Discectomies Orthopedic Surgical Procedures?


8.18 - Is Discectomy an Orthopedic Surgery

When a person is facing debilitating back pain caused by a herniated or damaged spinal disc, a discectomy is often recommended as a potential solution. This orthopedic surgical procedure aims to alleviate pain and improve mobility by removing some or all of the affected disc. This article explains what a discectomy entails, explores its orthopedic significance, discusses its benefits and risks, and provides insights for those considering this treatment option.

Discectomy Defined

A discectomy is a surgical procedure performed by orthopedic surgeons and neurosurgeons to treat conditions such as herniated discs, degenerative disc disease, and disc bulges. It involves the partial or complete removal of the damaged or herniated intervertebral disc, which cushions the spine's vertebrae. This form of back surgery aims to relieve pressure on the spinal nerves and reduce pain caused by the disc impinging on nerve roots.

Understanding the Orthopedic Significance

Discectomy is a type of orthopedic surgery, which is the branch of medicine that deals with the diagnosis and treatment of disorders of the bones, joints, muscles, ligaments, tendons, and nerves. Discectomy primarily focuses on treating spinal disc issues, which are common causes of back and leg pain. By alleviating pressure on the affected nerve, patients typically experience relief from pain, weakness, and numbness, allowing them to regain mobility and resume normal activities. This procedure is considered a valuable option for individuals who have not found relief through nonsurgical treatments.

Discectomy Procedure

During the discectomy procedure, the patient is typically under general anesthesia. The surgeon makes an incision in the back (for lumbar discectomy) or the neck (for cervical discectomy) to access the affected disc. There are different ways to perform a discectomy, depending on the location and extent of the herniated disc. The goal of the surgery is to remove only the portion of the disc that is pressing on the spinal cord or nerve roots while preserving as much of the healthy disc as possible. 

One of the most common methods is called microdiscectomy or minimally invasive discectomy. This technique uses a small incision (less than an inch) and a microscope or a tiny camera to guide the surgeon's instruments. The surgeon makes a small opening in the back muscles and inserts a tube through which he or she can access the spine. The surgeon then uses special tools to remove the herniated disc material and decompress the nerve.

Another method is called open discectomy. This technique uses a larger incision (about 2 inches) and requires more cutting of the muscles and bones to expose the spine. The surgeon then removes the herniated disc material and decompresses the nerve using a microscope or magnifying glasses.

In some cases, if the entire disc must be removed, the surgeon may need to fill the space with a piece of bone (from a donor or from your own pelvis) or a synthetic bone substitute. This is called a fusion. The surgeon may also use metal screws, rods, plates, or cages to stabilize and join the adjacent vertebrae together.

Benefits of Discectomy

The benefits of discectomy surgery may vary depending on your individual condition and expectations. Some possible benefits are:

  • Pain relief – One of the primary benefits of discectomy is the significant reduction or elimination of pain caused by the herniated disc pressing on nerves.
  • Increased mobility – By addressing the root cause of pain and weakness, discectomy can lead to increased mobility and range of motion.
  • Minimally invasive options – Advancements in surgical techniques have made discectomy a less invasive procedure, resulting in shorter recovery times and less scarring.
  • High success rates – Discectomy has shown high success rates in alleviating symptoms and improving quality of life for many patients.

Risks and Considerations

Discectomy is generally considered safe and effective for relieving nerve compression caused by herniated discs. However, it carries some risks and potential complications. These can include:

  • Infection – As with any surgical procedure, there is a risk of infection at the site of the incision.
  • Nerve damage – Although rare, there is a slight possibility of nerve damage during the surgery.
  • Recurrence – In some cases, the herniated disc may recur over time, necessitating additional treatment.

Recovery and Rehabilitation

A The recovery process after discectomy depends on several factors, such as your age, health, type of surgery, and level of activity. In general, you can expect to:

  • Stay in the hospital for one or two days after surgery
  • Wear a brace or collar to support your spine for several weeks
  • Take pain medication as prescribed by your doctor
  • Avoid bending, twisting, lifting, or driving for four to six weeks
  • Gradually resume your normal activities as instructed by your doctor
  • Participate in physical therapy to strengthen your muscles and increase your range of motion
The results of discectomy may not be immediate. It may take several weeks or months for your symptoms to improve and your nerves to heal. Most people experience significant pain relief and increased function after discectomy. However, some people may still have residual pain or disability, or they may develop new symptoms in the future.

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 at 844-288-7474.

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