discectomies

Discectomy refers to a surgical procedure that removes portion of an intervertebral disc that is pressing on a nerve root or the spinal cord, most commonly due to a herniated disc. The goal is to relieve radiating pain, weakness, numbness, and to restore normal nerve function.

Most commonly performed in the lumbar spine, but also in the cervical region. Indications include radiculopathy with imaging-confirmed herniation, failure of adequate conservative treatment after several weeks, and progressive neurologic deficit or signs of cauda equina syndrome in rare cases.

Techniques include open discectomy and microdiscectomy, endoscopic discectomy, and percutaneous discectomy. Microdiscectomy uses a small incision and a surgical microscope to remove the herniated fragment with minimal bone removal; endoscopic discectomy uses an endoscope; percutaneous methods use specialized instruments under imaging guidance.

Procedure overview: the operation is usually performed under general anesthesia. The surgeon exposes the affected segment, removes the herniated disc fragment, and may perform limited bone removal (laminotomy) to access the fragment. The goal is neural decompression with minimal disruption of surrounding tissue.

Risks include general surgical risks such as infection, bleeding, and anesthesia complications, as well as spine-specific risks such as nerve injury, dural tear with cerebrospinal fluid leak, recurrent herniation, scar tissue, and, rarely, adjacent segment disease or persistent pain.

Outcomes vary with location and pathology, but most patients experience substantial relief of radicular pain and improved function within weeks. Many procedures are performed on an outpatient basis, with gradual return to activities over several weeks.

Recovery may include physical therapy and activity modification; some patients may require additional procedures if symptoms recur. Discectomy is one option among nonoperative treatments, which may include medications and physical therapy, or epidural steroid injections, depending on severity and patient factors.