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Lumbar disc herniation on MRI | If all conservative means fail to give adequate relief a laminectomy and discectomy can be done. In this procedure a small opening can be made in the bony covering of the spine called the lamina. After identifying, protecting and mobilizing the nerve root, the disc fragment is removed. Additional loose pieces of the disc may be removed to prevent recurrence in the near future. Some surgeons choose to use the microscope, others use loupe (eyeglass) magnification. Some will use open technique and others will use minimally invasive or microdiscectomy techniques. All are adequate and it is more important to have the surgeon comfortable with his technique and make sure the nerve roots are safe and decompressed rather than having the surgery done one way or another. Long term results vary little in regards to approach.
Patients generally do quite well often going home from the hospital later that day or the next. Many are given a soft corset to wear to protect the muscles while healing. Patients are restricted in lifting for 2-3 weeks and generally can resume normal activities after that for the most part. One fact is important to note. Pain relief in the leg is usually good. Statistically 15 percent of individuals that undergo a discectomy will develop low back pain that eventually may require a fusion. This is due to continued disc degeneration and the pain mediators associated with that disease.
SEE ALSO LUMBAR DEGENERATIVE DISC DISEASE
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