A disketomy is a surgery to remove all or part of a cushion that helps protect your spinal column. These cushions, called disks, separate your spinal bones (vertebrae). When one of your disks herniates (moves out of place), the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of your spinal column.
Diskectomy is done when a herniated disk makes you have:
Leg pain or numbness that is very bad or is not going away, making it hard to do daily tasks
Weakness in muscles of your lower leg or buttocks
An inability to control bowel movements or urination
If you are having problems with your bowels or bladder, or the pain is so bad that strong pain drugs do not help, you will probably have surgery right away.
Most other people with low back or neck pain, numbness, or even mild weakness are often first treated without surgery. Anti-inflammatory medications [such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn)], physical therapy, and exercise are often first treatments. Over time, many of the symptoms of low back pain caused by a herniated disc often get better or go away without surgery.
Should it be necessary for a disketomy, a surgeon may perform the disk removal in one of several ways.
Microdiskectomy - the surgeon does not need to do much surgery on the bones, joints, ligaments, or muscles of your spine.
Diskectomy in the lower part of your back (lumbar spine) may be part of a larger surgery that also includes a laminectomy, foraminotomy, or spinal fusion.
Diskectomy in your neck (cervical spine) is most often done along with laminectomy, foraminotomy, or fusion.
A microdiskectomy is done in a hospital or outpatient surgical center. To begin spinal anesthesia or general anesthesia (asleep and pain-free) is given. The surgeon then makes a small (1 to 1-1/2 inch) incision on your back and moves the back muscles away from the spine. The doctor uses a special microscope to see the problem disk or disks and nerves during surgery. Once the surgeon finds the nerve root and moves it away, the injured disk tissue and pieces are removed. The surgeon puts the back muscles back in place, and closes the wound with stitches or staples. This surgery can take about 1-2 hours.
Diskectomy and laminotomy is done in the hospital, using general anesthesia. The surgeon makes a larger cut on your back over the spine and muscles and tissue are moved to expose your spine. A small part of the lamina bone (part of the vertebrae that surrounds the spinal column and nerves) is cut away. The opening may be as large as the ligament that runs along your spine. The surgeon cuts a small hole in the disk that is causing your symptoms and removes material from inside. Other fragments of the disk may also be removed.
Most people have pain relief and can move better after surgery and numbness and tingling should get better or disappear. Your pain, numbness, or weakness may NOT get better or go away if your disk damaged your nerve before surgery.
As with any surgery there are certain risks involved. It is important to talk with your doctor about what treatment plan is right for you.
