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Intervertebral Diskectomy
What is it? Overview Usage Side Effects and Warnings
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Intervertebral Diskectomy Overview

Written by FoundHealth.

Definition

Intervertebral discs are located between each backbone (vertebra). When damaged, these discs can put pressure on nerves as they leave the spinal cord. An intervertebral diskectomy is a back surgery that removes all or part of these discs. The procedure is most often done on lumbar discs (located in the lower back). It may also be done on cervical discs in the neck. There are two methods for this surgery:

  • Open procedure—A large incision is made.
  • Microdiskectomy—Small incisions are made, and the doctor inserts tiny instruments through these incisions.

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Ask about the pain and when it started
  • Obtain an MRI scan —a test that uses magnetic waves to make pictures of structures inside the back
  • Discography —an imaging test used to detect a herniated disk; involves injecting dye into a disc in the spine and taking an x-ray to determine if there are any leaks

Leading up to your procedure:

  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
  • Anti-inflammatory drugs (eg, aspirin )
  • Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
  • Arrange to have someone drive you home. Also, arrange for someone to help you at home.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
  • Wear comfortable clothing to the hospital.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep during surgery.

Description of the Procedure

There are different types of surgical procedures, including:

Anterior Cervical Diskectomy

A cut will be made in the skin on the left or right side of the neck. The doctor will go through a muscle to reach the spine. The disc material will be removed after the doctor uses an x-ray to confirm that it is the correct disc. A portion of the bone may be removed to give the nerve more space. A bone graft may be placed to fuse the vertebrae.

Posterior Cervical Diskectomy

A cut will be made in the skin at the back of the neck. The muscles will be pushed aside. A small piece of bone will be removed to get to the disc space ( laminectomy ). Next, the doctor will gently push the nerve aside and remove the disc material.

Lumbar Diskectomy

The doctor will make a 1-1½ inch cut in the skin on the lower back. The muscles will be moved out of the way. A small part of the bone may need to be removed to gain access to the nerve and disc. The disc or disc fragments will then be removed.

Diskectomy
Diskectomy
© 2009 Nucleus Medical Media, Inc.

How Long Will It Take?

This depends on:

  • Which method your doctor uses (open or minimally invasive)
  • Which procedure you need

For example, the minimally invasive surgery may take longer, but the recovery is faster.

How Much Will It Hurt?

You will have pain while recovering. Your doctor will give you pain medicine.

Average Hospital Stay

This surgery is most commonly done in a hospital setting. It may be possible to go home on the same day of the surgery. If you have a cervical diskectomy, you may have to stay in the hospital for a few days.

Post-procedure Care

Follow your doctor’s instructions . Bending, lifting, or twisting may be limited for six weeks. You will work with a physical therapist to stretch and strengthen your muscles. This will help to decrease the risk of future back problems.

References

RESOURCES:

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/

North American Spine Society
http://www.spine.org/

CANADIAN RESOURCES:

Canadian/American Spinal Research Organization
http://www.csro.com/

Spinal Injury Foundation
http://www.spinalinjuryfoundation.org/

References:

Bach HG, Lim RD. Minimally invasive spine surgery for low back pain. Dis Mon. 2005;51:34-57.

Canale S. Campbell's Operative Orthopaedics. 10th ed. St. Louis, MO: Mosby; 2003.

Lavelle W, Carl A, Lavelle ED. Invasive and minimally invasive surgical techniques for back pain conditions. Anesthesiol Clin. 2007;25:899-911.

Treatment options: low back (lumbar). University of Southern California, Department of Neurological Surgery website. Available at: http://www.usc.edu/schools/medicine/departments/neurological_surgery/clinical/spina/treatmentoptions-lumbar.htm . Accessed September 8, 2009.

Treatment options: neck (cervical). University of Southern California website. Available at: http://www.usc.edu/schools/medicine/departments/neurological_surgery/clinical/spina/treatmentoptions-cervical.htm . Accessed September 8, 2009.

6/7/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.

 
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