Discectomy: Procedure, Recovery, Cost, Risk & Complication

Discectomy refers to a surgical procedure that involves the removal of a damaged part of a herniated disk (also known as ruptured, slipped, bulging disk or disk prolapse) in the spine. A herniated disk is a condition where a portion of the soft material present in the disk pushes out from a crack in the tough exterior. The herniated disk may cause irritation or compression of the nerves located nearby, resulting in numbness, weakness and pain. These symptoms may affect the neck or the back and even radiate down to the arms and legs.

A doctor generally suggests discectomy to a patient if the symptoms have gradually worsened or the non-surgical treatments have not been effective. Though there are several ways for performing a discectomy, surgeons prefer minimally invasive discectomy, where small incisions are made and a small video camera is used for viewing purpose.

A patient may be recommended to undergo discectomy in the following circumstances:

• If one has trouble in standing or walking due to a nerve weakness
• When other conservative treatments such as physical therapy or medication does not bring any improvement in your condition
• A disk fragment is lodged in the spinal canal, pressing on to a particular nerve
• Extensive pain in the legs, arms, buttocks or chest that becomes difficult to tolerate

Pre Procedure

It is important to follow the following pre-procedure instructions before undergoing a discectomy:

• There may be a few tests like an x-ray or EKG that you need to undergo before the surgery
• Stop smoking a few days before the surgery. Non-smokers are found to have lesser bleeding problems compared to smokers during a surgery
• Inform your doctor about the medications, supplements and vitamins that you take. You may have to stop taking medicines like aspirin, blood thinners and anti-inflammatory medicines for a few days before the surgery.
• You may have to stop drinking and eating anything for a few hours prior to the surgery. Your doctor will provide you with proper instructions. Ensure that you follow them correctly. If you have to take any medicine during that time, take it with very sips of water.

During Procedure

The surgery is performed by administering the patient with general anaesthesia. It can be done by one of the following methods or a combination of both:

• Sacral: The physician inserts an endoscopic fiber-optic scope through the help of a tiny incision into the sacrum, which is a natural opening at the base of your spine. With the help of direct visualization, the doctor examines the insides of the spinal canal and disc for identifying any ruptures, tears, bulges or other abnormalities. The damaged disc is then shrinked with the help of laser.
• Posterior lateral: The surgeon inserts a hollow needle through the back side of the lateral spine, directly into your disc tissue. A laser is then passed from into the disc through the needle for shrinking the bulging or herniated disc. Fluoroscopy is used for watching and guiding the progress of the whole procedure.

Post Procedure

After the surgery has been successfully completed, you will be shifted to a general bed where the doctors will monitor you and look for any complications related to the surgery or anaesthesia. You can go home the same day, or you may to stay in the hospital for a few days if you had a pre-existing health condition.

You can get back to work in 4-6 weeks after the surgery. In case your profession involves lifting heavy objects or operating heavy machinery, you may have to wait for 8 weeks before you resume working. Limit activities that involve bending, lifting or stooping for 3-4 weeks after the surgery. Also, avoid sitting down for long hours during this time.

Ensure to take your medications in time. A physical therapist will be able to teach you exercise for improving the flexibility and strength of your muscles around the spine.

Discectomy is generally considered to be a safe procedure. However, as with every surgery, there may be some risks that are associated with it. These complications also depend on your age, your general health condition, and how your body reacts to the surgery and the medications. Some of the complications that may occur are:

• Bleeding from the incision site
• Infection at the incision site
• Leaking of the spinal fluid
• Build-up of fluid in the lungs, leading to pneumonia
• Injury to the nerves or blood vessels in and around the spine while performing the surgery
• Injury in the protective layer that surrounds the spine
• Persistent pain even after the surgery

A discectomy reduces the symptoms of a herniated disc, but it does not cure the reason why the disc was actually herniated. To avoid injuring your spine once again, your doctor may recommend losing weight, go for low-impact exercises, and limit activities that involve repetitive or extensive twisting, bending or lifting. You can assume your normal diet, from the time you get back home. Fruits, vegetables and extra fluids must be added to avoid constipation.

Attending follow-up session with your doctor is important after undergoing a discectomy. You may also have to undergo an x-ray so that your doctor can analyse your progress.

The cost of discectomy would be approximately Rs. 2,25,000 – Rs. 2,75,000.