A disc that is herniated occurs when a fragmented part of a damaged vertebral spinal disc dislodges itself from the original disc and then presses against a nerve attached to the spine, or when the fragment of spinal disc presses against the spinal cord itself.
Herniated Disc Surgery or Lumbar Discectomy is spine surgery done under general anaesthesia to remove a herniated disc from the spinal canal. The surgical procedure is fairly short taking only about an hour, but this will depend on a variety of factors such as the size of the patient and the extent of the herniated disc. The traditional surgery, known in medical terms as an open Discectomy whereby the surgeon, after making the opening incision, assesses the herniated disc so as to remove it, and relieve the pressure of the disc pressing on the nerve.
The patient, after being given a general anesthetic, lays face down on the operating table, and the surgeon makes a 3cm length incision in the patient’s back. The muscles are carefully parted from the bones of the spine, and with the use of special instruments, the surgeon performs a laminotomy which involves removing a minute amount of the ligament and bone from the spine in order to have a better view of the damaged disc and to keep the spinal nerves intact and out of the way while the laminotomy is being done. When the site of the herniated disc is reached the disc fragment can then be removed. The condition and appearance of the herniated disc is then assessed, and more fragmented disc parts might have to be removed to prevent further fragmentation of discs which could herniate at a later stage. The disc is then cleaned up from the surrounding area of nerves and the wound is then closed up and bandaged. One night in hospital with discharge taking place the day after surgery is the norm, and a lumbar corset brace may be used in cases of severe pain.
Further risks of surgery are bleeding, spinal fluid leaks and infections all of which can be treated although they may need either additional surgery and/or longer hospitalization. After surgery recovery can sometimes be immediate relief from the pain of the herniated disc, although it is normal for it to take some time for all symptoms to slowly disappear completely. The wound will take time to heal, but can be kept under control with oral pain medication. Patients are advised to sit upright and walk, which are gentle activities and not to lift heavy objects or do excessive bending and twisting of the back and all strenuous activities and exercise should be avoid until their doctor advises otherwise.
The success of herniated disc surgery is 85-90% and most patients undergoing this procedure find relief from the worst of their symptoms. Some 10% who have had the operation might still have persistent symptoms. The risk of the re-occurrence of another herniated disc after a Discectomy (herniated disc surgery) and this re occuring from a different disc has a 10-15% chance of happening. Herniated disc surgery is not to be undertaken lightly and should be discussed fully with your doctor and surgeon so as to be aware of all the risks and benefits involved.