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When is a Discectomy Needed?

When intervertebral disc disease, such as herniation of a disc, occurs in the neck or lower back, the treatment of choice to relieve pain and allow the patient to resume normal activities is removal of the damaged disc and stabilization of the vertebrae. This is accomplished through a surgical procedure known as discectomy.

The discs are pads of jelly-like tissue that sit between the bones of the vertebrae and serve to provide cushioning and shock absorption. The discs consist of two layers that are similar in structure to a jelly donut. The outside shell, analogous to the pastry portion of the donut, is called the annulus, while the soft jelly center is called the nucleus pulposus. In the case of intervertebral disc disease, tears occur in the annulus that allow the nucleus pulposus to leak into the spinal canal, where they can create pressure against the nerves of the spinal cord, resulting in pain or loss of function. A surgeon may recommend a discectomy either when the disc has ruptured and its contents need to be removed or when it is bulging and likely to rupture.

How is a Discectomy Performed?

A discectomy can be performed at any site along the length of the spine, from the neck down. The procedure varies slightly based on the location of the disc that needs to be removed. In this surgery, the surgeon makes a tiny incision in the back to access the offending disc. The disc material that is pressing against a nerve is removed, usually using very small instruments and an endoscope.

Because there are ligaments that run between the ribs and the vertebrae that help support the discs, disc disease in the upper back is uncommon. Lower back, or lumbar, disc disease, however, is very common and is treated similarly to disc disease in the neck. In a lumbar discectomy, the surgeon makes an incision through the skin and muscles of the back and removes the damaged disc, replacing it with a bone graft. As with anterior cervical discectomy, tiny instruments, endoscopy, and laser surgery are often used to make the incision as small as possible.

What to Expect after Discectomy

Discectomy provides rapid relief of symptoms associated with disc disease. This procedure requires caution in performing certain movements, such as bending and twisting, for some time after surgery. You may need help for a short time dressing or performing other activities that require bending and balance. Discectomy is a good option for many patients with disc disease, and can even be performed at multiple levels along the spine if needed.


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