Overview
Introduction
Lumbar discectomy is a surgical procedure to remove part of a problem disc in the low back. The discs are the pads that separate the vertebrae. This procedure is commonly used when a herniated, or ruptured, disc in the low back is putting pressure on a nerve root.
What Parts Of The Spine And Low Back Are Involved?
Surgeons perform lumbar discectomy surgery through an incision in the low back. This area is known as the posterior region of the low back. The main structure involved is the intervertebral disc, which acts as a cushion between each pair of vertebrae. The two main parts of the disc are the annulus and the nucleus. The lamina bone forms the protective covering over the back of the spinal cord. During surgery, this section of bone is removed over the problem disc. The surgeon also checks the spinal nerves where they travel from the spinal canal through the neural foramina. The neural foramina are small openings on each side of the vertebra. Nerves that leave the spine go through the foramina, one on the left and one on the right.
How Will I Prepare For Surgery?
The decision to proceed with surgery must be made jointly by you and your surgeon. You should understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.
Once you decide on surgery, your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn't eat or drink anything after midnight the night before.
What Happens During The Operation?
Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with a ventilator. A ventilator is a device that controls and monitors the flow of air to the lungs. Some surgeons have begun using spinal anesthesia in place of general anesthesia. Spinal anesthesia is injected in the low back into the space around the spinal cord. This numbs the spine and lower limbs. Patients are also given medicine to keep them sedated during the procedure.
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 and free of pressure. This position lessens blood loss during surgery and gives the surgeon more room to work.
The two main discectomy procedures are:
- Aminotomy and discectomy
- Microdiscectomy
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