Discectomy

Discectomy is a surgical procedure to remove herniated or damaged disc material that compresses a spinal nerve root or the spinal cord. It is most commonly performed in the lumbar spine but can also be done in the cervical region. The operation is typically considered after nonoperative treatments such as medications, physical therapy, or injections have failed to relieve symptoms of radiculopathy or when there is progressive neurologic deficit.

Indications include persistent leg or arm pain due to nerve compression, weakness or numbness in the affected limb, and, in rare cases, signs of cauda equina compression which require urgent evaluation.

During the procedure, the patient is placed under anesthesia. The surgeon makes a small incision near the affected level and removes part of the disc or the herniated fragment that compresses the nerve. The aim is to relieve pressure while preserving as much healthy disc tissue as possible. Open discectomy and microdiscectomy are common approaches; microdiscectomy uses an operating microscope or endoscope to minimize tissue disruption. Additional steps such as foraminotomy or laminotomy may be used to widen the nerve opening.

Recovery varies but many patients go home within 24 hours and gradually resume activity over several weeks. Physical therapy is sometimes advised. Overall outcomes are usually favorable for appropriately selected patients, though some may experience persistent pain or require further treatment. Risks include infection, bleeding, nerve or dural injury, recurrent herniation, and, less commonly, spinal instability.