To gain access to the injured disc, the surgeon enters through the back of the spine. They remove some of the lamina, a bone that comprises the back end of the spinal canal and retracts the spinal nerve. One or more fragments of the disc are removed. Cysts and spurs are also dissected to relieve pressure on the spinal nerve roots. A discectomy may be performed through an open technique or via micro-endoscopic discectomy.
Of course, open surgery involves tissue disturbance and a larger incision. Dilators are special tubes that are used to tunnel through the muscle. Many patients who qualify for minimally invasive surgery will prefer this option as it involves a faster recovery and less interference in terms of retraction. The orthopaedic surgeon will decide on the most suitable method for each case.
A lumbar discectomy is accompanied by spinal fusion to stabilise and strengthen the spine. Spinal fusion is mostly recommended for athletes or for patients who suffer from spinal instability. Unstable vertebrae are fused through the use of bone (synthetic or natural), plates and screws. Both ends of the vertebrae are left to merge into one component of bone. Although some patients do require spinal fusion, it is rarely necessary for a herniated lumbar disc. Also, in the case of recurrent disc herniation, spinal fusion is needed.
Typically, patients return home on the day of the procedure but, in some instances, may have to stay overnight in the hospital. It is while in the recovery room that the doctor and his team monitor the patient's blood pressure, breathing and heart rate.
“Once you choose hope, anything is possible”.
CHRISTOPHER REEVE