When you are diagnosed with a herniated disc, and more conservative treatments have not solved the problem, your physician may suggest a discectomy. During the discectomy procedure, the physician relieves your lower back pain by removing any disc material that may be pressing on the nerve root or spinal cord. In most cases, this treatment option is delivered in one of two ways: microdiscectomy or endoscopic discectomy.
In a microdiscectomy, an orthopedic surgeon uses a microscope to view the disc and associated nerves during the procedure. The scope-enlarged view allows the surgeon to complete the process through a relatively small incision. Prior to removing the herniated disc material, the surgeon must remove a piece of bone from the vertebra in order to see the herniated disc. This is called a laminotomy, a process that, while generally safe, may lead to spinal instability long-term.
A microdiscectomy will require at least an overnight hospital stay. Recovery will involve some pain, and you can expect some tenderness as you move around after surgery. For the first few weeks after the operation, sitting or standing for longer than 15 or 20 minutes may be painful. Post-surgery recovery time is generally between two to eight weeks, depending on the nature of your work, before you can return to regular work or other activities.
Endoscopic discectomy is a minimally-invasive treatment option for resolving lower back pain caused by a herniated disc. While the procedure is much less invasive, the success rate is comparable to the more invasive procedure.
Using a specialized endoscope, the doctor begins with a “keyhole” needle insertion rather than a surgical incision. The detailed visual provided by the endoscope allows the doctor to remove the part of the disc creating the pain with the least possible distress to the patient. The relatively tiny access point protects the patient in several ways:
Thanks to the minimally-invasive nature of this option, the entire procedure only takes about 30 minutes. The patient is typically ready to go home in less than three hours.