Spinal discectomy is a procedure used to treat a ruptured or herniated disc, most commonly in the region of the lumbar spine. The intervertebral discs lie between the bodies of the vertebrae (bones of the spine). When the outer part of these discs becomes damaged or torn, the inner part of the disc can bulge through and press against the spinal cord or nerves causing the pain, discomfort, or other symptoms that people with this problem experience. A Spinal Discectomy aims to remove the bulging part of the disc and alleviate the pain and other symptoms.
The patient is in placed in a prone position (lying on their front) and an incision is made over the region of the spine where the disc has herniated. The involved region of the spine is exposed by dissecting the muscle away from the bones of the spine. A laminotomy (removal of part of the lamina of a particular vertebrae) is then performed where a small amount of bone and ligament is removed to create a window through which the spinal nerves can be seen. The nerves are protected, and then once the ruptured part of the disc has been identified, it is removed along with any other fragments of the disc that have been extruded or have the potential to. The muscles and incision is then closed, and dressings applied. The surgeon often uses magnification to assist with the surgery.
Other procedures may be done in combination with discectomy and the need, or potential need for this, would be discussed with you in detail by your surgeon prior to your surgery.
The surgery is performed under general anaesthesia. The surgery usually takes one to two hours. You will usually spend one to three days in hospital.
After your surgery
Initially after the surgery you will have a dressing over incision, and will likely experience some pain or discomfort around the incision. Analgesia (pain relief) will be given to you from the time of surgery, and will most likely be oral tablets.
Any arm or leg pain that you experienced due to the pressure from the disc on the nerves or spinal cord may be gone when you wake up, but can often take days or weeks to resolve.
You will begin gentle activities as early as the first day after the surgery, such as sitting upright or walking. Specific instructions on the activities that you should avoid such as bending or twisting will be given to you by your surgeon. Once you have left hospital and returned home, you will be given further instructions on when you are able to return to driving or other activities.
The long term outcome
The majority (80 - 90%) of patients who undergo the procedure have relief of all, or certainly most, of their symptoms and can return to normal activity. The remaining 10% of patients continue to experience symptoms.
A Spinal Discectomy, as with all surgical procedures, has associated risks and complications. The most common complication, at 5% -15%, is a recurrent herniated or ruptured disc. This is where another fragment of the disc herniates causing similar symptoms to those experienced previously. Other risks are bleeding, infection, damage to the surrounding nerves or spinal cord, injury or a tear in the dura mater (protective layer of the spinal cord), or a spinal fluid leak.
There are other risks associated to this procedure, and it is important that you have a thorough conversation with your surgeon about the possible complications prior to surgery.
Pre-existing medical conditions can alter the level of risk associated with any procedure, and it is important that you notify your surgeon and anaesthetist of any medical problems prior to surgery. It is also important to follow your surgeon's instructions both before, and after, surgery to ensure that these risks are minimised.
The components that determine the cost of the procedure are the surgical theatre costs, hospital costs, anaesthetic fee and the surgeon's fee. Prices vary and may depend on; the extent/complexity of the procedure, the physical attributes of individual patients, and the surgeon performing the operation. A Lumbar Spinal Discectomy typically costs around $12000.