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Understanding Lumbar Discectomy: Surgical Techniques and Procedures


4.21 - What-Is-the-Surgical-Technique-for-Lumbar-Discectomy

A discectomy is a fairly common procedure performed to relieve nerve pressure or irritation. If a herniated disc requires this type of surgery, it will likely be in the lower back area, since this is where the most movement of the spine occurs. This article offers a brief overview of the surgical techniques for a lumbar discectomy.

The Open Technique

With an open technique, the surgeon makes a large incision through the muscles in the back to access the affected disc. Oftentimes, a
laminectomy, which involves removing a portion of the lamina (a bony part of a vertebra), is also performed to provide sufficient access to the affected part of the spinal disc in the lumbar region. The affected nerve is then pushed aside temporarily. Muscles are also retracted to ensure the disc can be viewed and accessed in a safe and effective way.

Next, part of the disc is removed. The amount that is removed depends on the degree of herniation and how much disc material has leaked out. The overall condition of the disc is also considered when determining how much disc removal is necessary. One of the benefits of the open technique is that the disc can be clearly viewed in a more direct manner. If the affected disc must be fully removed, an open technique can be beneficial, since the disc will need to be replaced with an artificial one. 

Another option is to have a fusion procedure performed after the lumbar discectomy. A fusion procedure, as the name implies, involves fusing together spinal bones to stabilize the spine and prevent excessive movement. The main drawback of a fusion is that range of motion in the lower back area may be limited to some extent.

The Minimally Invasive Technique

A microdiscectomy is a minimally invasive alternative to a traditional open discectomy. It involves a technique that focuses on minimal disruptions to the spine, its supporting muscles, and other soft tissues. The affected spinal disc is reached by making a small incision and inserting a series of increasingly larger tubes, referred to as dilators, into the initial tube. This technique allows the surgeon to view the disc with specialized tools that are also used to remove disc material. There is usually no need for a fusion procedure after having a microdiscectomy. If a fusion is necessary, the surgeon will likely recommend an open procedure. Benefits associated with a microdiscectomy include:

• Shorter recovery times
• Less post-surgery discomfort
• Less disruption to muscles, which reduces the risk of scar tissue and infection

Determining Which Type of Surgery Is Right for You

There is no one surgical technique for a
lumbar discectomy that is right for everybody. Your surgeon will determine the appropriate procedure for your situation by considering the following factors:

• Your level of discomfort
• Your overall health and wellbeing
• Your personal preferences
• Whether you will need a fusion along with a lumbar discectomy
• The location of the affected spinal disc

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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