Overview

A lumbar discectomy is a surgical procedure performed to remove a portion of a herniated or damaged intervertebral disc in the lumbar spine (lower back). The decision to undergo a lumbar discectomy is typically made when conservative treatments have failed to provide sufficient relief from symptoms and the individual experiences persistent pain or neurological deficits.

The surgery is helpful for people suffering from prolonged back pain. The affected individual can walk, run, or bend easily after the minimally invasive surgical procedure. The procedure involves a small cut over the area to insert a small camera and tools to perform the surgery.

When to go for Lumbar Discectomy?

A backbone consists of a chain of bones known as vertebrae. These bones get support with cushion-like discs. These discs may wear and tear due to ageing. It leads to bulging out of the disc's inner part, leading to a herniated disc. The situation pressurises the spinal cord and makes the lower back extremely painful. The affected individual is unable to walk, jog, or sit comfortably. The surgical procedure helps remove the disc's damaged part and lower the back pain. Depending on the patient's vital stats, a surgeon may opt for other methods to remove a herniated disc.

Who needs a Lumbar Discectomy?

The decision to undergo a lumbar discectomy is typically made when conservative treatments have failed to provide sufficient relief from symptoms and the individual experiences persistent pain or neurological deficits. Here are some common indications for lumbar discectomy-

- Difficulty in standing and walking- The soft material pushing out from the cracks in the spinal bone discs may cause pain and not allow an individual to stand or walk for a more extended house. It disturbs the routine of an individual. A lumbar surgery may help lower the pain by removing the disc's damaged part. The affected individual can walk and stand properly after the surgery.
- Neurological deficits- Lumbar disc herniation can sometimes compress the spinal nerves, leading to neurological symptoms such as numbness, tingling, or weakness in the legs. If these deficits persist or worsen over time, indicating nerve damage or dysfunction, a lumbar discectomy may be recommended to relieve the compression and prevent further nerve damage.
- Failure of non-surgical options- A microdiscectomy may also be helpful for people who have tried to lower their back pain with the help of different medications, injections, or physical therapies. Failure of these methods may also affect the buttocks making the pain travel toward the lower body.
- Loss of bladder or bowel control- In rare cases, lumbar disc herniation can cause compression of the cauda equina, a bundle of nerves at the base of the spinal cord. This compression can lead to cauda equina syndrome, characterised by symptoms such as urinary or faecal incontinence, severe weakness or numbness in the legs, and sexual dysfunction. Cauda equina syndrome is considered a medical emergency, and immediate surgical intervention, including a lumbar discectomy, is necessary to decompress the nerves and prevent permanent damage.

How is a lumbar discectomy performed?

- Pre-Test Preparations- A doctor may advise a patient undergoing surgery to stop certain medications. The patient is asked to stop eating and drinking a few hours before the surgery. A few imaging tests may be recommended that are necessary for the surgery.
- Procedure- To begin the surgery, the patient is given local anaesthesia to avoid discomfort and let the patient sleep through the process. A small incision is made over the operative area at the lower back. A small wire attached to a tiny camera is inserted through the incision to see the surgical site. Small tools and instruments are also inserted through the wire. The damaged part of the disc pressuring the nerve roots is removed carefully. Doctors also do other required procedures. The surgery is completed by stitching the incision.
- Post-Surgery- The surgery is outpatient, allowing the patient to get discharged from the hospital the same day. The patient may be under observation for a few hours after the surgery. After a few weeks, one may be able to resume normal routine activities as suggested by doctors.

Complications of Lumbar Discectomy

Mentioned below are some of the possible risks that can occur during the surgery:

- Bleeding- Bleeding after spine surgery is a rare sight. It can happen due to damaged nerves and tissues around the surgical area. The condition is looked after to avoid other health issues.
- Infection- A vertebral infection can occur a few days or months after the surgery. The microorganisms can enter the patient through the surgical area. It can damage the vertebrae and worsen the situation. If the infection grows severely, an operation helps to cure it.
- Spinal Fluid Leak- A spinal fluid leak after back surgery happens often. It can occur due to intraoperative tears or postoperatively. The situation is resolved with the help of professional medical care.

Post-Surgery Care Guidelines

Mentioned below are the guidelines that need to be followed after the surgery to help the patient in speedy recovery:

- Light Activity- Doctors strictly advise avoiding heavy activities that might strain the back of the patient. One should avoid heavy workouts for at least 5 to 6 weeks after the surgery. If the patient avoids the instructions, it may slow the process.
- Medications- Pain and swelling after the surgery are expected conditions. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, muscle relaxants, and nerve pain medications may be recommended. Timely consumption, as instructed by the doctor, is vital.

When to Consult a Doctor

You can also get in touch with the expert Ortho doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Conclusion

A lumbar discectomy is a surgical procedure to eliminate prolonged pain in the lower back. The surgery is helpful for people suffering from herniated discs. It helps remove the painful lower back and allows the individual to perform routine activities like walking and standing for long hours.

Reference Links

- https://www.narayanahealth.org/blog/discectomy-procedure-risks-post-surgery-care/
- https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/minimally-invasive-lumbar-discectomy
- https://www.mayoclinic.org/tests-procedures/diskectomy/about/pac-20393837