A herniated disc can make daily tasks difficult if it leads to severe pain. Most of the time, a herniated disc patient can receive nonsurgical care and see improvements, but there are those rare cases of severe pain or other symptoms that cease to fade away after extensive conservative treatment. Spine specialists might recommend discectomy surgery for both lumbar and cervical herniated discs in the event that conservative treatment fails, according to Spine Health.
For lumbar herniated discs, a patient with nerve compression might have the option of microdiscectomy, which is a minimally-invasive surgery. Microdiscectomy, or lumbar decompression surgery, removes the herniated part of a disc and gives the nerve root more space. With more space for the nerve root to heal, a patient might feel almost immediate relief from his or her pain. The procedure can be especially helpful in treating sciatica, which is severe leg pain caused by a herniated disc.
A microdiscectomy procedure is typically done in either a hospital or an outpatient surgical center and usually takes an hour or two while the patient is under general anesthesia. The procedure involves a small incision on the back, and a surgeon will use a microscope to locate the injured disc tissue. Normally, a surgeon will move the back muscles, remove the injured disc tissue and then reposition the back muscles to close the incision with either stitches or staples.
The other surgical option for both lumbar and cervical herniated discs is discectomy. According to MedLine Plus, discectomy on the lumbar or cervical spine may also include “a laminectomy, foraminotomy or spinal fusion.” For any combination of the procedures, a patient will receive general anesthesia in a hospital, and a large incision will be made near where the herniated disc is located to expose the spine.
During a discectomy procedure, a surgeon will typically cut away a small portion of the lamina bone, which is “part of the vertebrae that surrounds the spinal column and nerves,” according to MedLine Plus. Then, a small hole is cut in the herniated disc and material is removed from inside the disc. A surgeon may remove other parts of the disc as well.
Surgery is usually only considered after a patient has tried a wide variety of other treatments, such as medication, physical therapies, steroid injections and more for a few months with little to no results for pain, mobility and other symptoms caused by a herniated disc.