Discectomy is the most common surgical treatment for a herniated disc. It involves removal of the injured part of the disc, relieving pressure on the affected nerve. This may be an open procedure, allowing surgeons direct access to the disc through an incision, or a microdiscectomy, allowing surgeons access to the disc through smaller incisions and use of tiny surgical instruments. Either technique may be used to remove a herniated disc fragment in the lower spine or neck.
Your surgeon may perform discectomy on the cervical spine—the vertebrae of the neck—using an anterior approach, in which the herniated disc is accessed through the front of the neck, or a posterior approach, in which it is accessed from the back of the neck.
If a herniated disc in the neck compresses nearby nerves but not the spinal cord, surgeons may use a posterior approach. In this procedure, your surgeon makes an incision in the back of the neck and removes a small portion of the vertebra to access the disc space. This is called a laminotomy or foraminotomy. Your surgeon then removes the herniated disc fragment, relieving pressure on the affected nerves.
If the herniated disc compresses nerves and the spinal cord, your surgeon may use an anterior approach. In this procedure, a surgeon makes an incision in the front of the neck to access the disc space. He or she may remove a portion of the vertebra in order to remove the herniated disc and relieve pressure on the nerves and spinal cord. After the disc has been removed, your surgeon fuses the two vertebrae surrounding the disc space to stabilize the cervical spine. This is called a spinal fusion.
In lumbar discectomy, which is performed to relieve a herniated disc in the lumbar spine, or the vertebrae in the lower back, surgeons make a small incision and use powerful microscopes and other tools to magnify their view of the space around the disc and the surrounding bones and nerves. Surgeons may need to remove a small piece of the bone covering the spinal canal in order to access the herniated disc fragment. This procedure is called a hemilaminotomy.
Surgeons then carefully remove the injured section of the disc, decompressing the nerve. The incision is closed with stitches.
Most people can return home on the day of surgery. If laminotomy—a procedure to remove part of a vertebra—or spinal fusion is performed in the lumbar spine in addition to discectomy, surgery may take longer and require that you stay in the hospital for one or two days for observation as you heal.
Recovery from Discectomy
Most people can walk within hours of discectomy. An NYU Langone pain management specialist makes sure you have the medications you need to remain comfortable while you recover in the hospital and at home. It may take four to six weeks for you to return to all of your activities, but surgery often provides almost immediate relief from pain that radiated through the arms or legs.