A discectomy, a surgical procedure to remove part or all of a herniated disc in the spine, is often recommended to relieve pain and pressure on the spinal nerves. While many patients experience significant relief following the procedure, it is natural to wonder: Can a discectomy go wrong? The answer is complex, as with any surgical procedure, there are risks and potential complications. Read on to learn about the possible issues that can arise during and after a discectomy to help you make an informed decision about your care.
Understanding Discectomy: What It Involves
A discectomy is usually performed to address a herniated disc in the spine that is pressing on nerve roots or the spinal cord, causing pain, weakness, or numbness. The procedure can be done using various techniques, including open surgery, minimally invasive surgery, or microdiscectomy, which involves a smaller incision and the use of a microscope to guide the surgeon.
The goal of a discectomy is to remove the herniated portion of the disc, relieving the pressure on the nerves and reducing symptoms. However, despite the precision involved, there are inherent risks and potential complications.
Common Risks Associated with Discectomy
Infection
One of the most common risks associated with any surgery, including discectomy, is infection. Postoperative infections can occur at the incision site, in the surrounding tissues, or, in rare cases, deeper within the spine. Infections can delay healing, cause additional pain, and may require further treatment, including antibiotics or additional surgery.
Nerve Damage
The spine houses a network of nerves, and any surgical procedure in this area carries the risk of nerve damage. Although rare, nerve damage during discectomy can result in persistent pain, numbness, tingling, or even paralysis in severe cases. The risk is higher when the surgery involves the spinal cord or major nerve roots.
Bleeding and Hematoma Formation
Bleeding is a risk in any surgery, and discectomy is no exception. Excessive bleeding can lead to the formation of a hematoma, a collection of blood outside of blood vessels, which can compress nearby tissues and nerves. This can cause additional pain and may necessitate further surgery to remove the hematoma.
Dural Tear
The dura mater is a thick membrane that surrounds the spinal cord and nerves. A dural tear, or cerebrospinal fluid (CSF) leak, can occur during discectomy if the dura is accidentally punctured or torn. This can lead to headaches, nausea, and other symptoms. In most cases, dural tears are repaired during the surgery, but if undetected, they can lead to more severe complications, including meningitis.
Recurrence of Herniation
Although discectomy aims to remove the problematic part of the disc, there is a possibility the disc can herniate again. This is known as recurrent disc herniation, and it may occur in the same location or at a different level of the spine. Recurrent herniation may require additional surgery or alternative treatments.
Less Common but Serious Complications
Spinal Instability
In some cases, removing a portion of the disc can lead to spinal instability, where the vertebrae become misaligned or move more than they should. This can cause pain, difficulty with movement, and may eventually require spinal fusion surgery to stabilize the spine.
Failed Back Surgery Syndrome (FBSS)
Failed Back Surgery Syndrome (FBSS) is a condition where patients continue to experience pain after spine surgery, including discectomy. The pain can be similar to or different from the pain experienced before surgery. FBSS can be caused by various factors, including scar tissue formation, nerve damage, or incomplete removal of the herniated disc.
Chronic Pain
Chronic pain is another potential outcome of a discectomy that can occur even if the surgery is technically successful. This pain may be due to nerve damage, scar tissue, or other factors. In some cases, patients may develop complex regional pain syndrome (CRPS), a chronic pain condition that can be difficult to manage.
Cauda Equina Syndrome
Cauda equina syndrome is a rare but serious complication that can occur if the nerves at the base of the spine are compressed during surgery. This condition can lead to severe pain, weakness, loss of sensation in the legs, and bladder or bowel dysfunction. Cauda equina syndrome is a medical emergency and requires immediate treatment to prevent permanent damage.
How to Minimize the Risks
While it is impossible to eliminate all risks associated with discectomy, there are steps patients and surgeons can take to minimize complications.
Choose an Experienced Surgeon
One of the most effective ways to reduce the risk of complications is to choose a surgeon with extensive experience in performing discectomies. A skilled surgeon is more likely to navigate the complex anatomy of the spine and avoid potential pitfalls.
Preoperative Preparation
Proper preoperative preparation, including managing any existing medical conditions, stopping smoking, and maintaining a healthy weight, can improve surgical outcomes and reduce the risk of complications.
Postoperative Care
Following your surgeon’s postoperative instructions is crucial to minimizing risks. This includes taking prescribed medications, attending follow-up appointments, and avoiding activities that could strain the spine during recovery.
Physical Therapy
Physical therapy is often recommended after a discectomy to strengthen the muscles supporting the spine, increase flexibility, and reduce the risk of reinjury. A tailored rehabilitation program can significantly enhance recovery and reduce the likelihood of complications.
When to Contact Your Surgeon
It is essential to know when to seek medical attention after a discectomy. If you experience any of the following symptoms, contact your surgeon immediately:
- Persistent or worsening pain
- Signs of infection (redness, swelling, warmth, or discharge at the incision site)
- Difficulty with bowel or bladder control
- Numbness or weakness in the legs
- Severe headaches, especially when sitting or standing
Early intervention can prevent minor issues from becoming severe complications.
Weighing the Risks and Benefits
A discectomy can offer significant relief from the pain and discomfort associated with a herniated disc, but it is not without risks. Understanding the potential complications and how to minimize them is crucial for making an informed decision. By choosing an experienced surgeon, preparing adequately for surgery, and following postoperative care instructions, patients can increase their chances of a successful outcome. Always discuss the risks and benefits with your healthcare provider to determine the best course of action for your specific condition.
One of the main concerns with surgery is the significant risk of reherniation—where the same disc herniates again through a hole left after surgery. In fact, patients with these large holes in their discs are more than twice as likely to reinjure themselves by having what is known as a reherniation. Fortunately, Barricaid is a bone-anchored barrier designed to close these holes, and 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 today.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.
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