When facing the prospect of a discectomy, a common question that arises is whether hardware is required as part of the surgical procedure. A discectomy is a surgical intervention performed to treat various spinal conditions, particularly herniated discs. While hardware such as screws, rods, and plates are often used in spine surgeries, it is essential to understand whether they are necessary for a successful discectomy. In this article you will learn about the role of hardware in discectomy, discussing its pros and cons to help you make an informed decision.
Discectomy Defined
Before diving into the hardware aspect, it is crucial to understand what a discectomy involves. A discectomy is a surgical procedure performed to relieve pressure on the spinal nerves by removing a portion of a damaged or herniated disc. This procedure aims to alleviate pain, weakness, and other symptoms associated with disc problems.
When Hardware May Be Necessary
Hardware refers to metal screws, plates, rods, or cages used to stabilize the spine and prevent movement that may irritate the nerve or cause further damage. It may also be used to fill the space left by the removed disc and promote fusion of the adjacent vertebrae. Hardware is usually made of titanium or stainless steel, which are biocompatible materials that do not cause allergic reactions or infections.
The decision to use hardware in a discectomy largely depends on the patient’s condition and the surgeon’s recommendation. Generally, hardware is more commonly used in more complex cases where spinal stability is a significant concern. This includes patients with severe herniations, instability, or those requiring spinal fusion.
In less complex cases, a discectomy may be performed without the use of hardware. It is essential to have a thorough discussion with your surgeon to determine the best approach for your specific condition.
Hardware and Different Types of Discectomy
The need for hardware depends on the type of discectomy and the extent of disc removal. Some types of discectomy that may require hardware are:
- Anterior cervical discectomy and fusion (ACDF) – ACDF surgery is a type of discectomy performed from the front of the neck to remove a herniated disc in the cervical spine (the upper part of the spine). After removing the disc, the surgeon inserts a bone graft or a synthetic spacer into the empty disc space and secures it with a metal plate and screws. This restores the normal height and alignment of the spine and fuses the vertebrae together.
- Posterior lumbar interbody fusion (PLIF) – This is a type of discectomy performed from the back of the lower spine to remove a herniated disc in the lumbar spine (the lower part of the spine). After removing the disc, the surgeon inserts a bone graft or a synthetic cage into the empty disc space and secures it with metal rods and screws. This restores the normal height and alignment of the spine and fuses the vertebrae together.
- Laminectomy and discectomy – This is a procedure that involves removing part of the lamina, the bony arch that covers the spinal canal, along with part or all of a disc. It is usually done for lumbar (lower back) disc herniations that affect multiple nerve roots or the spinal cord. This procedure involves removing an entire disc or part of the lamina, which can create instability in the spine and increase the risk of further disc degeneration or spinal deformity. Hardware can restore and maintain the normal alignment and height of the spine and facilitate fusion.
Some types of discectomy that may not require hardware are:
- Microdiscectomy – This is a minimally invasive type of discectomy that involves making a small incision in the back and using a microscope and tiny instruments to remove only the portion of the disc that is pressing on the nerve. The rest of the disc is left intact, and no hardware is needed.
- Endoscopic discectomy – This is another minimally invasive type of discectomy that involves making a small incision in the back and inserting an endoscope (a thin tube with a light and a camera) through it. The surgeon then uses a laser or radiofrequency device that passes through the endoscope to vaporize or shrink the herniated disc material. No hardware is needed.
Hardware in Discectomy: The Pros
The use of hardware has some advantages and disadvantages. Some of the advantages are:
- Stability – Hardware, such as screws and plates, can provide immediate stability to the spine after a discectomy. This stability is crucial, especially when dealing with severe spinal issues. It ensures the spine remains properly aligned during the healing process.
- Fusion support – In some cases, a discectomy is performed in conjunction with spinal fusion. Hardware plays a significant role in stabilizing the spine during the fusion process, which promotes the formation of a solid bone bridge between vertebrae.
- Reduced risk of reherniation – The use of hardware can minimize the risk of reherniation by maintaining the space between vertebrae and preventing discs from shifting or bulging.
- Faster recovery – Hardware can often lead to quicker discectomy recovery by providing immediate support to the spine. Patients may experience less pain and shorter hospital stays, accelerating the rehabilitation process.
Hardware in Discectomy: The Cons
Some of the disadvantages of using hardware in discectomy are:
- Risk of complications – While hardware can be beneficial, it also comes with potential risks. Infections, hardware failure, and allergic reactions to materials used in the hardware are all possible complications that may arise.
- Additional surgery – Hardware used in discectomy may need to be removed in the future if it causes issues. This entails an additional surgical procedure, which can be a significant inconvenience and carry its own set of risks.
- Increased cost – The use of hardware in discectomy can significantly increase the overall cost of the procedure, including the expenses related to the hardware itself, a longer hospital stay, and post-operative care.
- Limitation of motion – In some cases, hardware can limit the natural motion of the spine. This may lead to reduced flexibility and discomfort, especially with long-term use.
Discectomy may or may not require hardware depending on various factors. Hardware can stabilize and fuse the spine after disc removal, but it can also increase the cost and complexity of surgery and cause potential complications. Therefore, it is important to consult with your surgeon about the best option for your condition. In the end, the key to a successful discectomy is not just the presence or absence of hardware but also the collaboration between the patient and medical professionals to determine the best course of action for a successful recovery and improved spinal health.
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 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 844-705-1081.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.
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