Back pain can significantly affect quality of life, and when conservative treatments fail, surgery may be discussed and potentially recommended. Two common procedures used to treat spinal issues are discectomy and decompression surgery. While both surgeries aim to alleviate pain and discomfort caused by nerve compression, they differ in terms of technique, purpose, and the specific conditions they address. In this article, you will learn some of the important ways these two types of surgery are different.
Understanding Discectomy
A discectomy is a surgical procedure that involves the removal of a portion of a damaged or herniated intervertebral disc. The goal of a discectomy is to relieve pressure on the spinal nerves, which can be caused by a herniated or bulging disc. This pressure often leads to pain, numbness, or weakness, particularly in the legs, arms, or lower back, depending on where the affected disc is located.
Types of Discectomy
There are several variations of discectomy, with the most common types including:
- Microdiscectomy - A minimally invasive procedure where a small portion of the herniated disc is removed through a small incision using a microscope or endoscope. This is often used to treat lumbar disc herniations and offers a quicker recovery time compared to open discectomy.
- Open discectomy - Involves a larger incision and is typically performed when more extensive disc removal is necessary. This technique provides the surgeon with a better view of the affected area but may require a longer recovery.
Discectomy is often recommended when nonsurgical treatments such as physical therapy, medications, and steroid injections fail to alleviate symptoms caused by a herniated disc. According to a study published in Medical Principles and Practice, microdiscectomy procedures have shown success rates of up to 84 percent in properly selected patients.
Understanding Decompression Surgery
Decompression surgery, on the other hand, refers to procedures that aim to relieve pressure on the spinal cord or nerves by removing bone or soft tissue that is compressing these structures. This compression can be caused by conditions such as spinal stenosis, bone spurs, or tumors.
Decompression surgery includes various techniques, such as:
- Laminectomy - Involves the removal of the lamina (a part of the vertebra) to create more space for the spinal cord and nerves. Laminectomy is commonly used to treat spinal stenosis, a condition characterized by the narrowing of the spinal canal.
- Laminotomy - A less invasive form of laminectomy in which only a small portion of the lamina is removed. This relieves nerve pressure while maintaining spinal stability.
- Foraminotomy - Focuses on enlarging the openings where nerve roots exit the spinal canal, relieving compression caused by bone spurs or bulging discs.
These decompression surgeries are performed when spinal compression leads to symptoms such as pain, numbness, tingling, or weakness, especially in the arms or legs. Like discectomy, decompression surgery may be recommended when conservative measures fail to provide relief.
Key Differences between Discectomy and Decompression Surgery
Although both procedures aim to relieve pressure on spinal nerves, the techniques and conditions they treat are different. Below are some key differences:
Purpose and Conditions Treated
- Discectomy - Specifically targets herniated or damaged discs that compress spinal nerves. It is primarily used for conditions such as lumbar or cervical disc herniation.
- Decompression surgery - Treats a wider range of conditions that cause spinal cord or nerve compression, such as spinal stenosis, bone spurs, and tumors. Decompression surgery may involve removing bone or tissue that compresses the spinal nerves or spinal cord.
Surgical Techniques
- Discectomy - The focus is on removing the damaged portion of the disc that is pressing on a nerve. In microdiscectomy, a small incision is made, and a microscope or endoscope is used to carefully remove the herniated part.
- Decompression surgery - Involves removing bone, ligament, or soft tissue that is causing compression. Depending on the type of decompression surgery (laminectomy, laminotomy, or foraminotomy), the surgeon may remove portions of the vertebra or widen the spinal canal.
Recovery Time
- Discectomy - Recovery tends to be faster, especially for microdiscectomy surgery, after which patients can often return to light activity within a few weeks. Full recovery typically takes 4 to 6 weeks, but this may vary depending on the individual and the extent of the procedure.
- Decompression surgery - Since it often involves more extensive removal of bone or tissue, the recovery time can be longer. For instance, recovery from a laminectomy may take 6 to 12 weeks, and patients may need more time before resuming regular activities.
Postoperative Care and Outcomes
Both procedures generally have high success rates in reducing pain and improving quality of life, but the postoperative care and potential complications can vary.
- Discectomy - Patients often experience immediate relief from leg or arm pain caused by the herniated disc. However, they may need to follow a physical therapy regimen to regain full mobility and strengthen the back.
- Decompression surgery - Recovery may include more intensive rehabilitation, as the removal of bone or tissue can affect spinal stability. In some cases, spinal fusion may be required to provide additional support.
When Each Procedure Is Recommended
Surgeons recommend discectomy or decompression surgery based on the underlying cause of the symptoms.
- Discectomy - Is typically suggested for a patient with a herniated disc that is pressing on spinal nerves, causing symptoms such as sciatica, radiculopathy, or lower back pain. Candidates for this surgery have usually tried conservative treatments such as physical therapy, anti-inflammatory medications, or epidural steroid injections without sufficient relief.
- Decompression surgery - Is recommended for patients with spinal stenosis or other forms of nerve compression caused by bony growths or thickened ligaments. These conditions lead to narrowing of the spinal canal and chronic pain, numbness, or weakness. Surgery is usually considered when symptoms become severe enough to limit daily activities or when there is a risk of permanent nerve damage.
While discectomy and decompression surgery share the goal of relieving spinal nerve pressure, they are distinct procedures used to address different conditions. Discectomy is primarily aimed at removing part of a herniated disc, while decompression surgery involves removing bone or soft tissue to widen the spinal canal or nerve openings. The choice between these surgeries depends on the specific diagnosis, the severity of the condition, and how the patient responds to nonsurgical treatments. If you are experiencing persistent back or leg pain, consult with a spine specialist to determine which procedure might be most appropriate for your situation.
Although discectomy surgery is generally a very successful procedure, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce the risk of reherniation, was specifically designed to close the large hole often left in the spinal disc after discectomy. In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 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 directly.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.