Discectomy Surgery

spinal stenosis

Discectomy is one of the most widely used surgical procedures for treating bulging, herniated, ruptured and extruded discs anywhere in the spine. This surgical technique involves removing some of the disc in the hope of relieving any pressure that the bulge or rupture is enacting on delicate and sensitive neurological tissue, such as the spinal cord or a spinal nerve root.

Although traditionally a fully open surgical procedure, disc removal is now almost always performed using minimally invasive methods. This is great for patients, since the less damage incurred during the procedure, the faster the recovery, the less the chance for complications and the better the possibility for providing marked pain relief. Most procedures are referred to as microdiscectomies or microendoscopic discectomies, since they utilize the smallest of incisions and the least degree of anatomical injury to the patient. These newer operations allow a number of small incisions to replace one large surgical cut and also facilitate reaching the spine through the front or side of the body, preventing the need for muscular dissection and the messy rehabilitation needed to correct this devastating damage.

The partial disc removal procedure is case specific, meaning that it is custom tailored to the exact needs of each patient. In some cases, a small amount of disc material is removed, while in others, a sizeable percentage of the overall disc is excised. Typically, the surgery will be performed to treat one of two diagnosed conditions. Spinal stenosis is when the implicated disc is thought to be applying pressure to the spinal canal and possibly the spinal cord itself. In these cases, the disc will be trimmed at the center line or the areas of posterolateral herniation, depending on where the impingement occurs. In cases of foraminal stenosis leading to a suspected pinched nerve, the posterolateral and far lateral aspect of the disc will be trimmed to relieve pressure on the compressed nerve.

One of the problems with discectomy is the incredibly common recurrence of herniations, often worse than the originally treated condition. This occurs in a large percentage of treated patients. This can make the entire procedure worthless and even land the patient in a worse state than before the surgery. I see this often in the patients who write too me on my various websites each week. However, the real catastrophe of the surgery is the fact that most are not needed at all. This is because the condition has been misdiagnosed in what is actually occurring, wherein the disc is taking the blame for sourcing pain, when all along it is innocent of any symptomatic expression. This is an epidemic concern and explains why so many back pain treatments fail...

Avoiding back surgery is always advised whenever possible. Remember that many spinal operations are not needed, nor are they proven to be effective in most cases. In fact, statistics clearly show that the majority of patients will have a recurrence of symptoms either immediately or within a matter of weeks or months after the procedure. Very few patients enjoy symptomatic resolution for the 10 years necessary to deem an operation a complete success. Unfortunately, almost none of the patients operated on each year have any idea of this until after they themselves endure the misery of failed back surgery syndrome and their doctor stops taking their calls.

There are many alternatives to surgery and most will work better, even in cases of misdiagnosis. At least no new damage will be done when avoiding invasive anatomical injury. Spinal decompression is a great option for contained symptomatic bulges and herniations, while simply allowing time to pass can work wonders for even the most acute discs. Never forget that in the great number of cases where disc herniations exist, but ARE NOT the actual source of pain, NO treatment is needed at all. This comes as a shock to patients, such as myself, who spent years of their lives and more money than can be easily counted pursuing worthless and unnecessary treatment which provided no relief, but certainly did wonders to make their physicians, chiropractors and therapists wealthy.