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.
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.
What is a herniated disc? What are the risk factors for getting one? What are its symptoms? Melvin Makhni, MD, Spine Surgeon and Director of Complex Spine Surgery at Brigham and Women's Hospital, explains the causes of disc herniations and how to treat them.
Discectomy and other services at Brigham and Women's Hospital
The Orthopaedic Spine Service at Brigham and Women's Hospital provides a wide variety of medical and surgical treatments to effectively treat patients with spine disorders, including rheumatoid arthritis treatment and osteoarthritis therapy. Our spine surgeons work closely with our spine physiatrists who specialize in non-surgical interventions. They also collaborate with the physicians in our Pain Management Center to diagnose and treat patients with a complete range of non-operative and operative care options.
The Department of Neurosurgery's Spine Surgery Service also provides comprehensive patient care for the full spectrum of spinal disorders, ranging from herniated discs to complex spinal reconstruction for tumors and deformity.
Our spine surgeons at Brigham and Women's Hospital can offer a wide array of innovative techniques for the full range of spinal problems. While not all conditions can be effectively treated with minimally invasive surgery, it may be an option for many patients needing a discectomy for herniated disks. The benefits of minimally invasive spine surgery include smaller incisions, lower risk of infection, less blood loss and faster recovery times. We also offer minimally invasive procedures for a wide range of orthopaedic conditions, including knee replacement surgery.