PROCEDURES

Discectomy

What are discectomies?

A discectomy is a surgical method of removing the injured portion of the spinal disc with its soft nucleus pushing out of the hard outer covering. One of the significant complications of a herniated disc is that it can increase pressure on the spinal nerves. Therefore, a discectomy is often performed to treat pain travelling from the arms to the legs as a result of nerve compression.
A discectomy is the surgical resection of a spinal disc that is too badly damaged to function. The following factors influence the need for a discectomy:

  • CT and MRI scan or a myelogram indicate a herniated disc
  • Muscle weakness and pain in the leg and foot
  • Sciatica
  • Pain does not improve after conservative treatments are put in place (medication and physical therapy)
  • Loss of bladder control (Cauda equina syndrome) due to disc herniation in the lower back

How do you perform a discectomy?

Based on the patient’s diagnostic results, Dr Bomela will decide on the most favourable surgical technique to use.

The length of the incision depends on the number of discectomies Dr Bomela decides to perform. For example, a single long incision ranges from one to two inches in length. Next, Dr Bomela reveals the back muscles to expose the spine. An x-ray taken beforehand can help pinpoint the affected disc.

A minimally invasive discectomy entails creating a one-inch incision over the side of the back to access and resect the damaged portion of the disc. A series of dilators separates the muscles and creates a tunnel to view the vertebrae. Using a drill, Dr Bomela creates a hole in the lamina to make a window for easy access to the herniated disc. In addition, a microscope can be used to locate and successfully remove the damaged disc. The ruptured portion of the disc is removed along with synovial cysts or bone spurs if present.

FAQ

1. What should I expect on the day of the procedure?

Dr Bomela will advise that you refrain from wearing jewellery on the day. You need to begin fasting the night before surgery after midnight. In addition, wear loose-fitting clothing, flat shoes and no makeup on the day. You should arrive two hours before the surgery so we can begin preparations and administer the anaesthetic. Bring a list of chronic medications as well as a list of all your allergies.

2. Does Dr Bomela perform spinal fusion after a discectomy?

Typically, spinal fusion can be performed after a discectomy to strengthen regions of the spine. The procedure involves using hardware (rods, screws and plates), bone grafts and an artificial matrix. However, spinal fusion is rarely needed for a one-level lumbar discectomy.

3. Are there any restrictions after a discectomy?

Dr Bomela will instruct you to avoid doing the following:

  • Twisting the back
  • Lifting heavy weights or carrying heavy loads
  • Avoid strenuous activities (Yard work, sex and other household chores)
  • Avoid driving for two to three days after the procedure
  • Avoid drinking alcohol