Diskectomy
Multimedia
Definition
Diskectomy is surgery to remove all or part of a cushion that helps protect your spinal column. These cushions, called disks, separate your spinal bones (vertebrae).
Alternative Names
Spinal microdiskectomy; Microdecompression; Laminotomy; Disk removal; Spine surgery - diskectomy
Description
A surgeon may perform disk removal (diskectomy) in different ways.
- Microdiskectomy: When you have a microdiskectomy, the surgeon does not need to do much surgery on the bones, joints, ligaments, or muscles of your spine.
- Diskectomy in the lower part of your back (lumbar spine) may be part of a larger surgery that also includes a laminectomy, foraminotomy, or spinal fusion.
- Diskectomy in your neck (cervical spine) is most often done along with laminectomy, foraminotomy, or fusion.
Microdiskectomy is done in a hospital or outpatient surgical center. You will be given spinal anesthesia or general anesthesia (asleep and pain-free).
- The surgeon makes a small (1 to 1-1/2 inch) incision (cut) on your back and moves the back muscles away from the spine. The doctor uses a special microscope to see the problem disk or disks and nerves during surgery.
- The surgeon finds the nerve root and moves it away. Then the surgeon removes the injured disk tissue and pieces. The surgeon puts the back muscles back in place, and closes the wound with stitches or staples.
- The surgery takes about 1 to 2 hours.
Diskectomy and laminotomy is done in the hospital, using general anesthesia (asleep and pain-free).
- The surgeon makes a larger cut on your back over the spine. Muscles and tissue are moved to expose your spine.
- A small part of the lamina bone (part of the vertebrae that surrounds the spinal column and nerves) is cut away. The opening may be as large as the ligament that runs along your spine. The surgeon cuts a small hole in the disk that is causing your symptoms and removes material from inside. Other fragments of the disk may also be removed.
Why the Procedure Is Performed
When one of your disks herniates (moves out of place), the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of your spinal column.
Many of the symptoms caused by a herniated disk get better or go away over time without surgery. Most people with low back or neck pain, numbness, or even mild weakness are often first treated with anti-inflammatory medicines, physical therapy, and exercise. Only a few people with a herniated disk need surgery.
Your doctor may recommend a diskectomy if you have a herniated disk and:
- Leg pain or numbness that is very bad or is not going away, making it hard to do daily tasks
- Severe weakness in muscles of your lower leg or buttocks
- Pain that spreads into your buttocks or legs
If you are having problems with your bowels or bladder, or the pain is so bad that strong pain drugs do not help, you will probably have surgery right away.
References
Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.
Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.
Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. 2008;78(7):835-842.
Williams KD, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24.
Review Date: 6/4/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Spinal microdiskectomy; Microdecompression; Laminotomy; Disk removal; Spine surgery - diskectomy
After the Procedure
Your doctor or nurse will ask you to get up and walk around as soon as your anesthesia wears off. Most people go home the day of surgery. Do NOT drive yourself home.
Outlook (Prognosis)
Most people have pain relief and can move better after surgery. Numbness and tingling should get better or disappear. Your pain, numbness, or weakness may not get better or go away if your had nerve damage before surgery or if you have symptoms caused by other spinal conditions.
Further changes may occur in your spine over time and new symptoms may occur.
Talk with your doctor about how to prevent future back problems.
References
Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.
Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.
Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. 2008;78(7):835-842.
Williams KD, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24.
Review Date: 6/4/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Spinal microdiskectomy; Microdecompression; Laminotomy; Disk removal; Spine surgery - diskectomy
Risks
Risks for any anesthesia are:
Risks for any surgery include are:
Risks for this surgery are:
- Damage to the nerves that come out of the spine, causing weakness or pain that does not go away.
- Your back pain does not get better or comes back again later.
- Because of the small surgical cut used in a microdiskectomy, the doctor may miss some disk fragments. This could cause you to continue having pain after surgery.
References
Chou R, Loeser JD, Owens DK, Rosenquist RW, et al; American Pain Society Low Back Pain Guideline Panel. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77.
Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.
Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: navigating evaluation and treatment choices. Am Fam Physician. 2008;78(7):835-842.
Williams KD, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.
Jegede KA, Ndu A, Grauer JN. Contemporary management of symptomatic lumbar disc herniations. Orthop Clin North Am. 2010 Apr;41(2):217-24.
Review Date: 6/4/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 6/4/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.