Lumbar Discectomy

This procedure is generally performed to treat ruptured discs in the lower back that are causing leg pain. The goal of the procedure is to decompress the nerve and thus eliminate the leg pain. Many different procedures (laser discectomy, endoscopic discectomy, and percutaneous discectomy) have also been developed over the years, but the minimally invasive discectomy has been shown to have the best results with few complications.

How it's done:
If surgery is undertaken, it is usually performed as a minimally invasive procedure. The procedure can be performed as a day stay surgery, but most patients stay in hospital overnight. General anaesthesia is utilized and the surgery is performed through an incision of approximately 3cm.

Through gentle dissection under illumination and magnification, the interface between the nerve root and disc bulge is identified and the compressing fragment is removed. Only a small portion of disc is removed. The whole disc is not removed.

After the nerve is freed completely the operation is completed. Typically this takes about 1 hour to perform.

Outcomes:
The likelihood of good/excellent relief of leg pain is 80-90%. Numbness is slow to recover and may persist for long periods. Weakness also may take up to 6 months to return to normal. Pins and needles usually starts to improve immediately. Sensory changes and leg weakness re caused by compression of the nerve root and are signs of internal damage to the nerve itself. When the pressure is relieved from the nerve, although the pain may improve immediately, these signs of internal nerve damage may persist for a long time as the nerve fibres slowly recover over many months.

Convalescence:
Patients who have a lumbar discectomy are typically in hospital for 1-2 nights. They are advised not to work for 4-6 weeks and recommendations on back and wound care are the same as in lumbar laminectomy.