A discectomy is surgery performed most commonly to relieve pain in patients with a herniated disc (also called a slipped or ruptured disc). Discs are cushions that separate the vertebrae (spinal bones) and help protect the spinal column. Each disc has a tough outer layer surrounding a jellylike substance called the nucleus. A herniated disc occurs when all or part of the nucleus is forced through a weakened part of the disc's outer layer. The ruptured disc fragments may place pressure on nearby nerves, causing symptoms such as low back or neck pain, leg pain, and tingling or weakness in leg or arm muscles. Most patients with a herniated disc improve with conservative treatment such as medications, steroid injections, physical therapy, and exercise. However, some patients may require surgery such as a discectomy or spinal fusion to relieve severe or worsening symptoms.
A discectomy may also be performed as part of spondylitis treatment if the disease leads to spinal deformity or in patients requiring stabilization procedures as part of scoliosis treatment.
In a discectomy, a surgeon removes all or part of a disc. Depending on the type of disc problem, the surgeon may recommend either of two procedures:
- Open discectomy is done under general anesthesia. Through an incision in the back, the surgeon first performs a laminectomy, which removes a small amount of bone and ligament from the back of the spine in order to see the spinal nerves. Once the herniated disc is found, the disc fragment is removed along with other fragments that may cause future problems.
- Minimally invasive discectomy may be an option for some patients. In this procedure, the surgeon uses special instruments and a camera to remove the herniated disc through very small incisions. A minimally invasive discectomy has similar outcomes to open discectomy with reduced pain and improved recovery time.
Patients who are considering a discectomy can find comprehensive care at the Orthopaedic Spine Service or the Department of Neurosurgery's Spine Surgery Service at Brigham and Women's Hospital.
Learn more about discectomy at Brigham and Women's Hospital.
