Lumbar discectomy is a broad term that includes microdiscectomy, laminectomy and discetomy. Those who undergo lumbar discetomy are patients who suffer from pain that extends from the buttock, down one leg to just below the knee. Usually, the pain is present either to the calf’s back and to the foot’s sole or to the outside of a shin and the top of a foot.
Problems in the lumbar disc are quite common and sufferers must realize that in the great majority of incidences non-surgical treatments are very effective including medications, activity avoidance, physiotherapy, hydrotherapy, steroid injections or acupuncture.
Generally, if the patient continues to experience symptoms after 6 to 12 weeks of conservative treatments in a way that affects the quality of life, then the doctor may recommend lumbar discectomy.
The procedure for lumbar discectocmy is minimally invasive. It involves the use of general anesthesia and performed through small incisions about 3 to 5 centimeters. Typically, a small cut is made on the affected side through which some ligament and bones are removed to allow the surgeon to see the bulging disc and affected root.
The surgeon then gently removes the offending disc fragment, not the entire disc, and any other debris. Lumbar discectocmy does not involve the repair of the annulus tear. The operation is complete once the nerve is free. The procedure usually takes 30 minutes to 1 ½ hours to perform.
As with other surgical procedures, there are certain risks to lumbar discectomy including nerve injury but this occurs in less than 1 percent of the cases. There is also a risk of infection and bleeding. There may also be a recurrence of disc protrusion in 10 to 15 percent of cases, either at the same location or at the other side or disc level. This risk is greatest during the first six weeks after lumbar discectomy.
What to Expect
Lumbar discectomy can provide excellent pain relief in the leg eighty to ninety percent of the time although there may still be numbness. There is immediate improvement of tingling sensation or what is known as pins and needles.
Typically, patients who undergo a lumbar discectomy stay in the hospital during the entire day of the surgery or overnight. They are advised to stay home for two weeks and avoid certain activities and movements such as lifting, bending and twisting because these may lead to a recurrence. Basically, walking is the only exercise that is allowed. The doctor will recommend methods for caring for the back and wound.
The patient can start to return to his normal activities after six weeks but it is important to take care of the back at all times because it does not go back to being normal even after surgery. For the entire life of the patient, the governing rule is proper back care.