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Lumbar Discectomy Surgery
Relevant information about Lumbar Discectomy Surgery.
Lumbar discectomy is a surgical procedure in which part of a spinal column disc located in the low back is removed. The spinal column discs are pads that separate the vertebrae. This procedure is usually done when a herniated or damaged disc in the low back is putting pressure on one of the nerves located in the zone. Its main goal is to relieve the symptoms generated by this pressure on the spinal column nerves.
This surgical procedure is generally used to treat herniated disc problems in the lumbar zone. A herniated disc, also called prolapsed disc, may happen when due to a big pressure, a spinal column disc bulges out from between two vertebrae, thus compressing the spinal canal. When the herniated disc is in the lumbar region, this will cause sharp and continuing back pain, a weakening of the muscles in the leg, and some loss of sensation in the leg and foot. In addition, it may also be difficult to raise the leg when it is held in a straight position.
The Lumbar Discectomy Surgery is usually done with the patient kneeling face down in a special frame. The frame supports the patient so the abdomen is relaxed, freeing it of pressure and the position used lessens blood loss during surgery, also giving the surgeon more room to work. There are two main Discectomy procedures. One is to make a laminotomy and later perform the Discectomy. The other is called Microdiscectomy. The first procedure is the traditional method of removing a spinal column disc. The Lamiotomy part of this procedure begins with an incision made down the middle of the low back. After that is done, the tissues are separated in order to expose the bones along the low back. Next, a cutting tool is used to remove a small section of the lamina bone. The ligamentum flavum, which is placed between the lamina and the spinal cord, is then cut, leaving a small incision. This exposes the nerves inside the spinal canal and allows seeing the compressed nerve or nerves. The nerves are moved aside in order to exanimate the damaged disc. At this point of the operation, the Discectomy part of the procedure begins. A hole is made in the outside rim of the disc. Next, forceps are placed inside the hole, allowing cleaning out and removing disc material. If the nerve is still compressed, a larger opening is cut in the neural foramen, which is the nerve passage between the spinal disc vertebrae. To keep scar tissue from growing onto the nerve, a special foam pad or a piece of fat may be implanted over the treated zone. Finally, the incision is closed and sutured. The second procedure is done using a surgical microscope. An incision about two inches is made over the problem disc, in the low back. The skin and soft tissues are separated in order to expose the bones of the spinal column’s back. The lamina bones above and below the damaged disc are spread apart using a retractor. Then, a tiny incision is made in the ligamentum flavum, exposing the compressed nerve. Next, a special hook is placed under the nerve and used to lift it. After this, the damaged disc becomes visible. The outer ring of the disc is then sliced open, to allow removing the material from the inside of the disc. The area around the compressed nerve is inspected, and any disc fragments are removed. If the nerve continues to be compressed, a larger opening for the neural foramen is made. Finally, the nerves, muscles, and soft tissues are put back in place, and the skin is stitched together.
Patients usually stay only one day at the hospital. Pain medications are given. Although a shower may be taken 1 or 2 days after the surgery, it is recommended not to submerge in water until the wound has healed. Patients may return to work after 10 to 14 days. However, prolonged sitting and heavy lifting must be avoided during the first 6 weeks.
Two possible complications may happen. First of all, nerve damage may occur during the surgery. This usually occurs when a surgical instrument damages one of the nerves from the zone. Consequence of this is muscle weakness and loss of sensation to the areas supplied by the damaged nerve. Then, after the surgery, the disc may re rupture. In this case a new surgery is required. However, both complications are rare.
The lumbar Discectomy will end with the numbness and pain symptoms, allowing the patient to recover mobility.
The operation does not repair the damaged spinal column disc. A damaged disc has more chances of having a new rupture in the future.
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