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How Large Are the Incisions Made during Discectomies?


Similar to other spine surgeries, a discectomy requires an incision to be made in order to access the affected area. The size of the incision varies based on the surgical approach recommended for the procedure. To give you a better idea of what to expect with a discectomy, this article provides information about the typical incision size.

Open Discectomy vs. Microdiscectomy

On average, incisions made for discectomies range in length between 1 and 2 inches. This depends on the type of discectomy performed. There are two main approaches to performing a discectomy today:

• Open discectomy – With a traditional, or open, discectomy, a single and longer incision is made to reach the affected disc.
• Microdiscectomy – If a less invasive microdiscectomy is performed instead, the incision is usually 1 to 1 1/2 inches long or a bit smaller.

Whether or not the incision is less invasive depends on where it is made. For example, if the affected disc is reachable from one side of your spine, the incision is usually smaller than what would be necessary for more direct access.

Factors that Determine Incision Size

As mentioned above, the type of
discectomy performed is the main determining factor in terms of incision size. Smaller incisions are more common with endoscopic surgical techniques that increase accuracy and visibility, while larger incisions are necessary for open procedures that require direct visualization of the disc and the surrounding area.

The Trend toward Smaller Incisions

When possible, surgeons usually prefer to make smaller incisions rather than larger ones. One of the main advantages associated with smaller incisions is a reduced risk of unintentional damage to nearby nerves and other structures. Even with a smaller incision, muscles and other soft tissues that need to be moved can be gradually separated with dilators. In this case, dilators that are progressively larger are inserted to move soft tissues out of the way. Keeping incision size for a discectomy small also benefits patients by:

• Reducing post-surgery discomfort
• Shortening overall recovery time
• Often allowing the procedure to be done on an outpatient basis
• Minimizing the risk of surgical site infections
• Protecting nearby discs

Choosing the Best Incision Size for the Patient

The goal of a discectomy is to relieve severe or persistent disc-related nerve pain in a way that is best for the patient. This sometimes means an open discectomy with a larger incision is a better option under certain circumstances. However, if conditions are suitable, it is often possible to make smaller incisions instead. Patient-specific issues that typically determine the appropriate incision size include:

• The location of the affected disc
• Overall patient health and potential surgery risks
• Whether or not a fusion will be necessary to restore spinal stability

Details such as incision size and back surgery recovery time vary among individuals and depend on factors such as disc height and the size of the hole left in the outer ring of the disc after surgery. If the hole in the disc is larger than a standard pencil eraser, the patient has a significant risk of experiencing a reherniation. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. These reherniations often require additional surgery or even a larger spinal fusion operation. Barricaid is a bone-anchored device shown to reduce reherniations by closing the hole in the disc after a discectomy, 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, you may ask your doctor or contact us at 844-288-7474.

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