The spine is made up of 24 vertebrae that stack on top of one another to form the spinal column. These individual bones must simultaneously support the weight of the arms, head, and torso, but also be able to bend, twist, and move about freely. The bones of the spinal column are hollow so that they can perform another function, they protect the delicate spinal cord from damage. The spinal cord sends out and receives nerves so that it can do its own job of stimulating the muscles, receiving sensations, and directing bodily processes. Vertebral discs rest between the vertebra and work as cushions or shock absorbers. If one of these vertebral discs is damaged, it can squeeze the nerves of the spinal cord causing numbness, weakness, and pain in the extremity. Often the only solution to this potentially debilitating problem is a discectomy.
A discectomy is a surgical procedure that removes a herniated vertebral disc from the spinal column. There are a number of ways to perform a discectomy surgery-the choice is tailored to the needs of the individual patient based on the training and expertise of the surgeon. Often in order to access or see the damaged disc, part of the vertebra must be removed through a procedure called a laminotomy (or laminectomy).
After the herniated disc is exposed through a laminectomy, the soft disc is suctioned out of the space between the vertebrae. Occasionally it is necessary to cut out the herniated disc during discectomy since the vertebrae might be pinching the material or the disc may have invaded other regions.
A less invasive discectomy operation is laser discectomy. In this approach, a smaller incision is usually required than in traditional discectomy surgery. A small laser is advanced to the site of the herniated disc and the concentrated light energy is used to ablate or destroy the disc material. Many laser discectomy devices combine a cutting feature with suction to remove the herniated disc as it is freed. Laser discectomy is relatively new and, as such, there are several parameters that are still being established. In other words, the choice of which type of laser is best for the discectomy procedure and appropriate indications (among other factors) are still being determined.
As with any surgery, there are some risks involved with surgical discectomy. Infection, abnormal fluid accumulation, abnormal blood clots, or a reaction to general anesthesia are risks in virtually any surgery. Some risks that are specific to discectomy surgery are those complications that can arise given the location and delicate nature of the procedure. The spinal cord, nerve roots, and nerves are fragile structures and, if they are inadvertently damaged, could lead to permanent disability. While these complications are quite rare, patients that undergo discectomy surgery should be aware that weakness, numbness, and even partial paralysis could occur. Also, it is important to follow any activity restrictions and exercise plans during discectomy recovery. Physical therapy can be an important part of discectomy recovery to restore mobility to the spine and facilitate proper healing.