What Is a Discectomy?
A discectomy (also spelled diskectomy) is a procedure to treat problems caused by a herniated disc. During this procedure, your spine surgeon removes the fragments of a spinal disc that have burst or broken away from their normal location between your spinal bones and press on a spinal nerve.
Your spinal discs are the rubbery shock-absorbers between each of the bones that make up your spine (vertebrae). They contain a gel-like center that can sometimes push out through the tough outer layers. When the soft fragments are expelled, this is called a herniated disc. Herniated discs can press on your spinal cord or nerves and may cause pain, numbness, or weakness.
Not everyone with a herniated disc needs surgery. However, many disc herniations are complex conditions. This complexity requires a personalized treatment plan from a spine specialist to see a successful reduction in your symptoms.
Types of Discectomies
Spine surgeons decide whether surgery best fits your needs based on many factors:
- Your symptoms
- Your imaging scan results
- Their own surgical experience with each technique
- Medical evidence on patient outcomes
Surgical Location
Discectomies are performed on every part of your spine:
- Cervical spine, the portion of vertebrae in your neck
- Thoracic spine, the portion of vertebrae in your upper and mid-back
- Lumbar spine, the portion of vertebrae in your lower back
Types of Surgical Approaches
Your surgical incision approach and technique depends on where the disc fragment is located in relation to your spine and nerves:
- Anterior, an approach from the front of your body
- Lateral, an approach from your side
- Posterior, an approach from the back side of your body
Discectomy Surgical Techniques
Discectomies are often categorized by the surgical equipment and technique used. Your spine surgeon will discuss which type of discectomy they recommend for you and your specific back problem. In many cases, their decision is based on the technique they've successfully performed for past patients with similar problems to yours.
- Open microdiscectomy: This is the most common approach to safely and successfully remove disc fragments. Your surgeon moves the muscles to see your spine.
- Minimally invasive discectomy: This technique uses specialized retractors (instruments that hold the incision open during surgery) to go through the muscles of the spine. Your surgeon also uses a special operating microscope to safely see your spine.
- Endoscopic discectomy: This technique uses an endoscope—a thin, long tube with a camera and light at the end to see your spine. This technique is the least invasive type of spine surgery. It allows our surgeons to precisely target the problem.
- Discectomy and spinal fusion: During this procedure, your surgeon removes the entire disc and replaces it with hardware so that the spine bones can grow back together (fuse). This technique often delivers the best results for herniated discs.
- Discectomy and arthroplasty: Your surgeon removes the entire disc and replaces it with a disc replacement device (arthroplasty). We rarely use this technique because it's not appropriate for most herniated disc cases.
When to Consider a Discectomy
People with severe cases of herniated discs are the best candidates for discectomies. Surgery is the patient's best treatment for alleviating severe symptoms. Herniated disc patients must experience severe symptoms to be considered for a discectomy:
- Back pain
- Loss of sensation
- Loss of movement
Discectomy surgeries are among the most successful surgeries for back pain. Advances in discectomy techniques and technology, such as minimally invasive and endoscopic approaches, have provided many benefits that patients didn't previously have:
- Reduction in surgical risks
- Faster recovery time
- Return home the same day (outpatient surgery doesn't require an overnight hospital stay)
In some cases, these advanced techniques have also made spine surgery safe for patients previously not eligible for surgery, such as elderly and obese patients. Your spine surgeon will discuss the specific risks and types of surgical techniques with you.
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How to Prepare for Surgery
You won’t need to do anything special to prepare for a discectomy. Depending on the type of discectomy you’re having, you may receive one of the following:
- General anesthesia—Puts you to sleep
- Local anesthesia—You don’t feel pain but are awake
- Conscious sedation—You remain awake but don’t feel pain or remember the procedure afterward.
Open and minimally invasive discectomies usually use general anesthesia. Endoscopic discectomies may use local anesthesia or conscious sedation.
Discectomy Recovery Time
Recovery timelines vary based on both the surgery type and type of spine problem(s). People who have undergone simple discectomies, like minimally invasive or endoscopic spine procedures, may recover quicker within 2–4 weeks. However, more complex herniated cases may take longer to recover
For simple disc herniations, your recovery timeline may look like the following:
- Day of surgery or following day: You’ll be up and walking.
- Two weeks after surgery: You can most likely return to a desk job. But you may need to wait longer if you have an active job involving bending, lifting, or twisting.
- Six weeks after surgery: You can resume usual activities, including heavy lifting and twisting, if your surgeon clears you.
It will take some time for your spine and nerves to recover and heal. It’s not uncommon to have some herniated disc symptoms while recovering from surgery. Recovery typically takes longer if you suffered from severe symptoms prior to surgery. Many people feel noticeably better after surgery, but for others it may take several weeks or years for some symptoms to improve.
Discectomy Risks
The most common risk after a discectomy is herniating the disc again (re-herniation), which requires revision surgery. In one study, as many as 18% of patients experienced re-herniation. It’s important to follow your surgeon’s instructions and activity restrictions to lower your chances of re-herniation.
Why Choose University of Utah Health?
We are the destination for complex spine patients in the Mountain West. Our spine surgeons perform a high volume of procedures each year. This leads to more experience and successful outcomes. We also publish our research findings for other physicians and surgeons to learn. At U of U Health, you will receive care from an experienced team of experts:
- National leaders in spine surgery
- Surgeons who train residents, fellows, and other physicians
- Utah’s first spine surgeon in Utah to perform endoscopic spine surgery
Schedule an Appointment
We prefer a provider referral to see one of our spine surgeons, but it’s not required. Call 801-587-2225 to make an appointment or complete our form to request a spine evaluation.
