Lumbar Discectomy

Your backbone is made up of a series of vertebrae, uniquely shaped bones that are separated by thin discs that cushion and support them. Each disc has a soft inside and hard outer wall. If the outer layer weakens and cracks, some of the disc’s inner material may become dislodged, a condition known as a herniated disc (or slipped, bulging or ruptured disc).

Material from a herniated disc can place pressure on the spinal cord or nearby nerve roots and cause pain, numbness or tingling in the back, legs and elsewhere. If the herniated disc is in the lumbar region of your spine, and the symptoms persist or worsen despite nonsurgical care, your doctor may recommend lumbar discectomy.

Baptist Health is nationally recognized for excellence in lumbar discectomy and related procedures. We offer a full spectrum of minimally invasive neurologic and orthopedic care and the latest approaches to spine surgery. Best of all, you’ll appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.

What is a Lumbar Discectomy?

A lumbar discectomy procedure can help reduce pressure on nearby nerve tissue caused by a herniated disc. The procedure removes the herniated portion of the disc to relieve pain, numbness and weakness in the back or leg. 

What Can a Lumbar Discectomy Accomplish?

Lumbar discectomy is a safe and well-researched procedure that can relieve pain, numbness and weakness resulting from a herniated disc of the lumbar spine that does not respond to rest, physical therapy and anti-inflammatory medications.

Not all types of back pain can be treated with lumbar discectomy. This procedure is typically recommended if:

• It is difficult to stand or walk because of this condition.
• You are experiencing severe, radiating pain in the back, chest, legs or arms.
• You have not seen improvement in your symptoms after at least six weeks of nonsurgical treatment.
• Material from the herniated disc has entered your spinal canal (the cavity containing the spinal cord) and is pressing on a spinal nerve.

What Can I Expect During the Procedure?

A minimally invasive discectomy is the most common surgery for herniated discs of the lumbar spine. In some cases, however, a traditional open version of this procedure may be performed.

Open Lumbar Discectomy

This procedure is performed while the patient is under general anesthesia, lying in a prone, face down position. The surgery will take about two hours, but scar tissue or other factors may require a longer surgery.

During the procedure, the surgeon will make a small incision in the skin above the spine, and the muscle below will be parted to create an opening for the procedure. It may be necessary for the surgeon to perform a laminectomy or laminotomy to gain access to the slipped disc. This process involves removing some or all of a lamina, one of two bony arches at the back of each vertebra, along with any ligaments covering this area.   

Typically during a lumbar discectomy, the disc will be left mostly intact, with the surgeon removing only the material that is pressing against the nerve and any fragments that may have broken off. 

Minimally Invasive Lumbar Discectomy

If your surgeon determines that your slipped disc can be treated with a minimally invasive lumbar discectomy, this option can help reduce the impact of surgery on surrounding tissue and promote a faster recovery time. Unlike open lumbar discectomy, this minimally invasive alternative may only require local anesthesia. A minimally invasive lumbar discectomy will take one to two hours.

Instead of a large incision, the surgeon will make several smaller incisions in the skin above the spine. An endoscope (a thin tube with a light and small camera) or microscope and other specialized surgical tools will be inserted into these small openings and past surrounding muscle to access the affected area, which is viewed under magnification on a video screen. Without creating a large opening to access the surgery site, the surgeon is then able to remove any disc material that is interfering with surrounding nerve tissue.

Recovery

Following surgery, you will be moved to a recovery room and carefully monitored while the anesthesia wears off. Depending on your overall health and whether you received open or minimally invasive surgery, you may be able to go home the same day. Before you leave, a physical therapist may be on hand to help you become comfortable with certain movements, such as walking or climbing stairs. Beginning to walk immediately after you recover from anesthesia is an important way to support your recovery and help prevent the formation of scar tissue.  

Estimated Recovery Timeline

Your doctor may recommend physical therapy to help you regain muscle strength and increase your flexibility. In the weeks immediately following your procedure, you will need to limit physical activities such as lifting, bending or stooping, and it may be uncomfortable to sit for a prolonged time. Your doctor will monitor your recovery through follow-up visits and let you know when you have healed enough to return to work, usually within two to six weeks. However, if your job involves a significant amount of lifting or the use of heavy machinery, you may need to wait up to eight weeks before returning to work. 

Lumbar Discectomy Possible Risks

Any surgery carries risk, but both open and minimally invasive lumbar discectomies are typically safe and effective procedures. Possible risks include:

• Leaking spinal fluid
• Injury to nearby nerves or blood vessels
• Injury to the protective tissue around the spine

Your doctor will provide instructions about how to avoid these risks after your procedure.

For many patients, a discectomy can relieve pain and other symptoms caused by a herniated disc, but this procedure does not prevent the injury from recurring. To help prevent another incident, your doctor may recommend lifestyle changes such as weight loss and low-impact exercise, and you may be advised to limit movements such as bending or lifting.