Lumbar Discectomy

Lumbar discectomy refers to a group of surgeries that relieve nerve pressure in the lower back caused by a slipped or herniated disc. These surgeries remove the damaged part of the disc pressing on nearby nerves. This helps ease sciatic pain and other nerve-related symptoms. Several surgical methods are available, ranging from minimally invasive techniques to traditional open surgery.

Why Lumbar Discectomy May Be Needed

Slipped discs can be incredibly painful. These discs are meant to be the cushions between the bones of the spine, when they are compromised, they cause back pain. When they herniate and compress onto the nerves, they cause excruciating sciatic pain travelling down the lower limbs.

Discectomies are routine effective surgical procedures to treat sciatica caused by slipped discs with relatively low risks. The offending disc material that compresses the nerves is removed after a small hole in the lamina is made, thus alleviating the pain.

Indications for Lumbar Discectomy

Lumbar discectomy is considered when symptoms persist despite non-surgical treatment or when nerve compression causes significant problems. Common reasons for surgery include:

• Slipped Disc causing sciatica symptoms that has failed conservative management
• Severe compression on nerves
• Presence of neurological deficits such as numbness or weakness

Types of Lumbar Discectomies

Lumbar discectomy can be performed using various surgical techniques. The approach depends on the patient’s condition, the size and location of the disc herniation, and the surgeon’s expertise.

Minimally Invasive Tubular Microdiscectomy

This minimally invasive “keyhole” technique involves:

• An approximately 2 cm incision on the side of the spine
• Use of sequential dilators to gently split muscle fibers
• Resection of bone and ligament to access the disc
• Retraction of nerves with specialized equipment
• Removal of the offending disc material causing nerve compression

Minimally Invasive Endoscopic Discectomy

This minimally invasive “pinhole” technique involves:

• Two 1 cm incisions on the side of the spine
• Use of endoscopes or viewing scopes along with specialized instruments
• Resection of bone and ligament
• Retraction of nerves
• Removal of disc material causing compression through the small incisions

Open Discectomy

Discectomies can also be performed via an open technique. This traditional approach involves:

• A midline incision over the back of the spine
• Dissection of muscle tissue to expose the bony structures
• Removal of a small section of bone to access the disc
• Retraction of nerves
• Removal of the offending disc material causing compression

Planning the Right Surgical Approach

Your orthopaedic spine surgeon carefully assesses your symptoms, physical examination findings, and imaging results to determine if lumbar discectomy is the right treatment for you. They consider factors such as the size and position of the herniated disc, your anatomy, any previous surgeries, and your clinical goals. After this evaluation, your surgeon recommends the surgical technique that best suits your condition.