discectomie

Discectomie, or discectomy, is a surgical procedure aimed at removing part or all of a herniated intervertebral disc that compresses a nerve root or the spinal cord. The term discectomie is used in French medical literature, while the English term is discectomy. The goal is to relieve nerve irritation and associated pain or neurological symptoms.

Indications typically include persistent radicular pain in the leg or arm due to lumbar or cervical disc herniation after a period of nonoperative treatment, or a progressive neurological deficit. In cases of cauda equina syndrome or myelopathy, surgery is usually urgent. Candidates are selected based on clinical exam and imaging confirming nerve compression.

Techniques range from open discectomy to less invasive variants such as microdiscectomy and endoscopic discectomy. The surgeon may perform the procedure through a small posterior incision, sometimes with a limited laminectomy to access the disc. The herniated fragment is removed, with care to preserve surrounding bone and ligamentous structures when possible. The goal is adequate decompression with minimal tissue disruption.

Outcomes are generally favorable for relief of radicular pain and improvement in function, though back or neck pain may persist and symptoms can recur. The risk of reherniation exists and overall complication rates are low but can include infection, dural tears with cerebrospinal fluid leaks, nerve or vascular injury, and hematoma.

Recovery typically involves early mobilization and activity modification, with gradual return to work and physical therapy to restore flexibility and core strength.