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Overview

Discectomy: Procedure, Recovery, Cost, Risk & Complication

What is Discectomy?

Discectomy refers to a surgical procedure that involves the removal of a damaged part of a herniated disk (also known as ruptured, slipped, bulging disk or disk prolapse) in the spine. A herniated disk is a condition where a portion of the soft material present in the disk pushes out from a crack in the tough exterior. The herniated disk may cause irritation or compression of the nerves located nearby, resulting in numbness, weakness and pain. These symptoms may affect the neck or the back and even radiate down to the arms and legs.

A doctor generally suggests discectomy to a patient if the symptoms have gradually worsened or the non-surgical treatments have not been effective. Though there are several ways for performing a discectomy, surgeons prefer minimally invasive discectomy, where small incisions are made and a small video camera is used for viewing purpose.

Indication

A patient may be recommended to undergo discectomy in the following circumstances:

  • If one has trouble in standing or walking due to a nerve weakness
  • When other conservative treatments such as physical therapy or medication does not bring any improvement in your condition
  • A disk fragment is lodged in the spinal canal, pressing on to a particular nerve
  • Extensive pain in the legs, arms, buttocks or chest that becomes difficult to tolerate

What Procedure is followed :

Pre Procedure

It is important to follow the following pre-procedure instructions before undergoing a discectomy:

  • There may be a few tests like an x-ray or EKG that you need to undergo before the surgery
  • Stop smoking a few days before the surgery. Non-smokers are found to have lesser bleeding problems compared to smokers during a surgery
  • Inform your doctor about the medications, supplements and vitamins that you take. You may have to stop taking medicines like aspirin, blood thinners and anti-inflammatory medicines for a few days before the surgery.
  • You may have to stop drinking and eating anything for a few hours prior to the surgery. Your doctor will provide you with proper instructions. Ensure that you follow them correctly. If you have to take any medicine during that time, take it with very sips of water.

During Procedure

The surgery is performed by administering the patient with general anaesthesia. It can be done by one of the following methods or a combination of both:

  • Sacral: The physician inserts an endoscopic fiber-optic scope through the help of a tiny incision into the sacrum, which is a natural opening at the base of your spine. With the help of direct visualization, the doctor examines the insides of the spinal canal and disc for identifying any ruptures, tears, bulges or other abnormalities. The damaged disc is then shrinked with the help of laser.
  • Posterior lateral: The surgeon inserts a hollow needle through the back side of the lateral spine, directly into your disc tissue. A laser is then passed from into the disc through the needle for shrinking the bulging or herniated disc. Fluoroscopy is used for watching and guiding the progress of the whole procedure.

Post Procedure

After the surgery has been successfully completed, you will be shifted to a general bed where the doctors will monitor you and look for any complications related to the surgery or anaesthesia. You can go home the same day, or you may to stay in the hospital for a few days if you had a pre-existing health condition.

You can get back to work in 4-6 weeks after the surgery. In case your profession involves lifting heavy objects or operating heavy machinery, you may have to wait for 8 weeks before you resume working. Limit activities that involve bending, lifting or stooping for 3-4 weeks after the surgery. Also, avoid sitting down for long hours during this time.

Ensure to take your medications in time. A physical therapist will be able to teach you exercise for improving the flexibility and strength of your muscles around the spine.

Risk & Complication

Discectomy is generally considered to be a safe procedure. However, as with every surgery, there may be some risks that are associated with it. These complications also depend on your age, your general health condition, and how your body reacts to the surgery and the medications. Some of the complications that may occur are:

  • Bleeding from the incision site
  • Infection at the incision site
  • Leaking of the spinal fluid
  • Build-up of fluid in the lungs, leading to pneumonia
  • Injury to the nerves or blood vessels in and around the spine while performing the surgery
  • Injury in the protective layer that surrounds the spine
  • Persistent pain even after the surgery

More Info

A discectomy reduces the symptoms of a herniated disc, but it does not cure the reason why the disc was actually herniated. To avoid injuring your spine once again, your doctor may recommend losing weight, go for low-impact exercises, and limit activities that involve repetitive or extensive twisting, bending or lifting. You can assume your normal diet, from the time you get back home. Fruits, vegetables and extra fluids must be added to avoid constipation.

Attending follow-up session with your doctor is important after undergoing a discectomy. You may also have to undergo an x-ray so that your doctor can analyse your progress.

The cost of discectomy would be approximately Rs. 2,25,000 – Rs. 2,75,000.

Popular Health Tips

Endoscopic Discectomy - Pin Hole Stitchless Techniques

Fellowship in Interventional Pain management , Diploma in Anesthesia, DA, MBBS
Pain Management Specialist, Jaipur
Endoscopic Discectomy - Pin Hole Stitchless Techniques

What's pivd?
Also called as slipdisc pain or sciatica may affect your lumbar or cervical or throracic spine. But most common is l4 5and l5-s1 level or c5-6 level.
Most of painful condition of pertaining to your spine due to bulge, prolapse (protrusion), extrusion, sequestration. In with all condition nucleus pulposus come out from it originally site. Causing pressure over traversing or exiting nerve roots. Most of time patient getting treatment for of slipdisc or sciatica etc without any radiological evidence.

What causes pivd?
*unwanted prolonged exposure to sitting posture
*acute forward flexion
*unwanted weight lifting
*trauma or accident
*overweight body
*undesirable exercise
*keep on exercise for chronic pain condition

What is symptoms?
Paresthesia, numbness, tingling sensation, burning sensation, spasms in thigh's and calf muscles, radiating pain upto knee or foot. Unable to sitting or standing for long hours, bowl or bladder incontinence, motor power affected

What are basic investigation?
X-rays only show alignment and fracture and displacement of vertebrae,
Mri scan shows all soft and hard structure of spine-all disc, nerve, ligaments, joint, vessel and muscles etc can be seen in perfect way
Emg, ncv, neurometry etc

Treatment options?
There's two types of options for your spine pain, one is conservative treatment with bed rest, exercises and medicine. But upto certain duration 6week to 6month you can try with. If no red flag sign like loss of motor power. Or bowl bladder involvement should take opinion from surgeon.
Second way is surgical procedure-like conventional open surgery or endoscopic minimal invasive techniques choice of your surgeon. As common man had reservation about spine surgery as thoughts to be risky, chance of bowl and bladder incontinence, or power loss of limbs, because in conventional surgery a small percentage of cases use to face failed back surgery syndrome. Where such complaint were invitable. Big skin incision. Long bed rest. Long hospital stays. Even with expert surgeon these complications were enviably there.
Secondly there is minimal invasive like pin hole stitchless techniques are now choice for spine disc pain problem. Day care surgery with out any blood loss. 24hrs hospital stay, no incision like conventional surgery. Done under local anaesthesia and sedation. Patient can resume daily activities same day. Can go to work with safety measures after 2weeks. And safety precautions to be followed for strengthening your back spine. Now like day care surgery endoscopic discectomy for slipdisc pain can be managed in our hands. All surgery can be seen even by patients on screen, what exactly happened to your spine and disc material.

Post procedure- follow up-
Regular physiotherapy and rehabilitation services is mandatory for strengthening of your spine.
Prognosis-success of procedure is 95%with all precautions and safety measures.

Sciatica

MBBS ,MD
Pain Management Specialist, Hyderabad
Sciatica

Disc prolapse can be easily treated by nerve root injection or removal of disc fragment by endoscopic discectomy under local anesthesia
www.endospinedoctors.com

1 person found this helpful

Disc Bulge And Treatment

MBBS ,MD
Pain Management Specialist, Hyderabad
Disc Bulge And Treatment

Lumbar disc prolapse is common
The mri images and symptoms of the patient need not necessarily match.
Here comes the role of pain management specialist
He examines the patient thoroughly and offers treatment options like root injections or endoscopic discectomy under local anesthesia
These are simple safe and scientific

www.endospinedoctors.com

1 person found this helpful

Disc Prolapse And Effective Cure

MBBS ,MD
Pain Management Specialist, Hyderabad
Disc Prolapse And Effective Cure

Lumbar disc prolapse causes severe back pain and radiates down to one or both legs below the knee. MRI shows exact problem. After basic pain killers - rest for a week, do some physiotherapy if pain persists, a pain management specialist is needed. He will see the possibility of a root block at the nerve affected by disc prolapse. If severe degree of prolapse, endoscopic discectomy under local anesthesia is best as a day care and minimally invasive procedure.The patient usually is discharged in 12-24 hrs.

11 people found this helpful

Ozone Therapy For Back Pain

MBBS, MD, FIPP
Pain Management Specialist, Delhi
Ozone Therapy For Back Pain

Ozone in pivd/slipped disc

In case of prolapsed inter-vertebral disc (or, slipped disc) different other mechanism acts. Inter-vertebral disc is filled with nucleus pulposus which is a jelly like material which holds water (90% of disc material is water). When ozone is injected into the disc the proteo-glycan bridges in the jelly-like material are broken down and they no longer capable of holding water. As a result disc shrinks and mummified which is equivalent to surgical discectomy and so the procedure is called ozone discectomy or ozonucleolysis. It has been published in anesthesia and pain journals that up to 85% of disc operation can be avoided with these non-surgical interventions. Success rate is about 88% which is comparable to surgical discectomy (50% to 90%). Complications are remarkably low and much less than surgery.

Ozone therapy

Minimally invasive procedure using small needle and probe to remove disc material of prolapsed disc, releasing pressure on nerves and relieving pain in most of the patients of prolapsed / bulging / slipped disc.

Rotating probe is inserted through needle into the disc under x-ray/ fluoroscopic guidance

Rotating tip removes small portion of disc material. Because only enough of the disc is removed to reduce pressure inside the disc, the spine remains stable

Insertion site covered with bandage. Recovery is fast as unlike surgical decompression no bone or muscle is cut. 2-3 days of bed rest and may return to normal activity within one week.

Ipsc india has been pioneer in ozone discectomy or ozonucleolysis for slipped disc or prolapsed disc. We have treated thousands of patients not only from across india but also international patients from usa, uk, nigeria, afghanistan, iraq, bangladesh, nepal and saudi arabia. We have the original, closed circuit-self calibration ozone machine, imported from italy.

2 people found this helpful

Popular Questions & Answers

Hello sir, I am 43 years old and have back pain for the last 2 days. Please help me. I underwent a discectomy 10 years back.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Patient needs to be examined in detail & be investigated. Anyway you may try- sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5 days then inform me.

Slipped disc L4-L5 Dr. Suggest me epidural treatment, can you tell me best alternative way to heal my disc as like before. I had took PT but It works only for some days but after some days pain comes back

MBBS ,MD
Pain Management Specialist, Hyderabad
Root block is better if severe, do endoscopic discectomy under local anesthesia for permanent relief Hyderabad.
1 person found this helpful

I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
If it's small disc bulge then it's treated with medication, exercises, physiotherapy. If no much relief then needs epidural steroid injection. Last resort with no improvement then needs discectomy.

Table of Content

What is Discectomy?

Indication

What Procedure is followed :

Risk & Complication

More Info

Play video
Tips on Lower Back Pain
Tips on Lower Back Pain
Hello, I am Dr G.P. Dureja, senior consultant and director at the Delhi pain management centre, in New Delhi.

Today, I am going to discuss a very important topic, Back pain. As we all know, the prevalence of back pain in India is rising tremendously. Not only in younger people, but middle-aged and older people are also suffering from persistent back pain may it be lower back pain or upper back pain.

The causes of back pain are tremendous and numerous. But the most important cause is absolutely you have a back posture and because of our back posture which results in disk collapse which causes pressure on the nerves and results in excruciating lower back pain which radiate to the leg. This is very commonly seen nowadays in younger people who are always having bad postures and are always working beyond their scheduled time, working very hard with no emphasis on their back care.
When we talk about emphasis, I mean that they do not do any exercises, they do not walk, their muscles are all weak and when they sit for a long time in front of their computers, it results in severe back pain. In older people, of course, the common causes are lumber canal stenosis where because of the degenerative changes happening in the spine because of osteoporosis it results in pressing of the nerves or impingement of the nerves and that results in very severe back pain which is relating to the leg and the old people are generally not able to walk because of this.
So as I said, prevention is very important. Once you have been able to find out the cause of the pain which is causing the excruciating pain in the back, we should always look towards treating this and preventing this.
Preventing, we always emphasise on good posture. We always tell the patients how to sit properly, not to bend forward, not to lift weight and please take care of your both upper back and lower back. That means the cervical spine and the lumbar spine. That is why we tell the patients to continuously exercise. There is a set of exercises which you have to do it for 5 minutes a day and that is sufficient for strengthening your back muscles and preventing this severe pain to occur in you and your friends if you can guide them to.
There are various types of treatment available. We call it as a conservative management when a patient can take medicines or just be on rest. And after adequate rest and medicine, when the pain is relieved, he does continuously exercises takes care of his posture, sits properly at his job place and does not do any forward bending or weight-lifting activities. Most of the patients will get relief at this manoeuvre or this conservative treatment and get relief in pain. Of course, there are people who do not get relief in pain because they have a bulging disc which is irritating the nerve and therein the role of a pain physician comes in. A pain physician can help a patient by injecting into the spinal column or in the spinal cord, giving drugs or even doing discectomy by needles and getting rid of the pain, avoiding a certain surgery.
In younger people, we generally tend to avoid surgery and that is the reason interventions in the spine done by pain clinicians are becoming very popular and can help a large number of patients.
After the pain has gone down, we rehabilitate the patient, give them the advice as in how to sit/ how to stand and how to exercise and takes care of the pain completely and patient just has to follow the simple instruction throughout the life.
If you want to consult us at Delhi pain management centre you can contact us through Lybrate and also we can give you an appointment if you want to show any of our consultants here and they will tell you all about how to look after your spine and how to do the exercises.

Thank You.
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