Lumbar discectomy is a surgical procedure performed for the removal of a herniated or ruptured disc from the lumbar (lower) region. Intervertebral discs are fibrocartilaginous cushions between adjacent vertebrae. The normal intervertebral disc is composed of a semi-liquid substance (nucleus pulposus) at the centre surrounded by a fibrous ring (annulus fibrosis). A herniated disc, also known as a bulging disc, is a condition in which the inner gelatinous substance of the disc is forced out through a tear in the outer, fibrous ring (annulus fibrosus). This material may compress the spinal cord or the nerves around the spinal cord. Lumbar discectomy is performed to remove the damaged disc and relieve the pressure on the nerve, alleviating the pain.
This procedure is performed under sterile conditions in an operating room with the patient under general or spinal anaesthesia. The patient is placed in a face down position. During the procedure, the surgeon will make a small incision, in the midline, over the affected disc in the lumbar region. After accessing the vertebrae, a small portion of bone from the back of the vertebra is removed along with partial removal of the ligamentum flavum, a membrane over the nerve roots. The surgeon then visualizes the discs and the nerves through a surgical microscope. This enlarges the view of the surgical site, minimizing damage to the surrounding tissues. The spinal nerve root is then lifted with a special hook, to gain access to the injured disc, and the ruptured or herniated disc is removed. Any loose disc fragments are also removed. After the completion of the procedure, the surgical wound is irrigated with antibiotic solution and closed.
Following the surgery, you will be discharged home on the same day or the next day after surgery. The surgery provides significant pain relief, however tingling or numbness, leg pain, pain at the incision site, and back muscle spasms may occur in a few patients. Your doctor will prescribe medications for the management of these complications which should improve within one to two weeks of the surgery.
Risk and Complications
Lumbar discectomy is comparatively safe with minimal complications. Some of the potential risks of this procedure include infection, nerve injury, spinal cord injury, ongoing pain and problems with anaesthesia.
Talk to your surgeon for any concerns you have about Lumbar Discectomy surgery.
The spinal cord is protected by a bony column of vertebral bones, arranged one above the other. Injury or wear-and-tear can cause parts of the vertebrae to compress the nerves of the spinal cord, leading to pain, numbness or tingling in the part of the body that the nerve supplies. Lumbar decompression is a surgical procedure performed to relieve pressure over the compressed nerves in the lower spine (lumbar region). It is usually indicated in patients with herniated lumbar disc, spinal stenosis, spinal injury or spinal tumours, who have not found adequate pain relief with conservative treatment.
Lumber decompression is performed under general anaesthesia. Your surgeon makes a small incision in the midline over your lower back. The layers of muscle are separated, and the affected nerve root is identified. The lamina (bony arch of your vertebra) may be removed (laminectomy) and the facet joints may be trimmed to reach the compressed nerve. Your surgeon removes any bone spurs or disc material that is pressing on the spinal nerve. The incisions are closed with absorbable sutures and covered with a dressing.
As with any procedure, lumbar decompression may involve certain risks and complications such as infection, bleeding, leakage of cerebrospinal fluid, bladder or bowel incontinence, weakness, numbness and pain.