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Discectomy​ Surgery

Discectomy in Hyderabad, India – Best Hospital for Diskectomy Surgery

Suffering from debilitating back or leg pain caused by a herniated disc? Discectomy surgery may offer significant relief. Our team of experienced spine surgeons specialize in performing advanced discectomy procedures, a minimally invasive techniques to ensure quicker recovery, reduced pain, and better surgical results.


As the Best Hospital for Discectomy in Hyderabad, India, we utilize minimally invasive techniques to minimize discomfort, accelerate recovery, and achieve optimal outcomes. Our state-of-the-art facilities and patient-centered approach ensure you receive the highest quality care. Choose PACE Hospitals to effectively address your herniated disc and regain your mobility and quality of life. Schedule your appointment today for Diskectomy Surgery!

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    Discectomy

    Discectomy is the surgical removal of the herniated or damaged disc, and it is the most commonly performed surgical procedure by a neurosurgeon or an orthopaedic surgeon to alleviate pain due to herniated discs. Usually, surgeons recommend this spine surgery only when non-surgical (conservative) treatments have failed to relieve painful symptoms or for persons experiencing specific issues or who develop progressive neurological signs and symptoms such as weakness and numbness.


    This procedure helps remove the part or complete disc irritating the nerve root of the spinal cord.

    Discectomy surgery​ meaning | Discectomy surgery in Hyderabad | best Discectomy surgery hospitals in Hyderabad India

    Intervertebral discs are the flat and round cushions between the vertebrae (bones) in the spine and act as shock absorbers. Each disc has a soft, inner gel-like center called nucleus pulposus surrounded by a flexible outer ring called an annulus.


    In some cases, a disc may tear due to constant pressure, allowing some of the inner gel substance to leak out. This condition is called a slipped disc (herniated disc), commonly seen in the lumbar spine (lower back region) and less commonly in the cervical spine (neck region). However, it is rare to have a herniated disc in the middle back (thoracic spine). Lumbar discectomies are more common than the cervical and thoracic discectomies.

    Discectomy meaning


    Discectomy meaning explains the surgical removal of a disc, where the word "disk" comes from the Latin “quoit, discus, disk," and the Greek words “disk, quoit, platter," which means “round, approximately flat surface. The word “ectomy” comes from the Greek “ektomia,” which means surgical removal, “a cutting out of.”

    Indications of Discectomy surgery​ or procedure

    Discectomy indications

    A comprehensive understanding of the expected surgical outcomes is essential for the surgeon before proceeding. The discectomy procedure may be indicated in the following conditions: 


    • Severe radiating pain (unresponsive to conservative treatment for more than six weeks)
    • Constant (persistent) muscle weakness 
    • Difficulty walking
    • Cauda equine syndrome (absolute emergency): It involves compression of the spinal nerve bundle leading to potential paralysis and loss of bowel or bladder control.
    • Morphine–resistant hyperalgic sciatica: Severe and constant sciatic nerve pain that is resistant to morphine-based pain management (does not respond effectively).
    • Paralysing sciatica: A severe form of sciatic nerve pain causing paralysis or significant loss of motor function in the affected leg.

    Discectomy contraindications

    Discectomy is contraindicated in the following medical problems or history:


    • Lumbar canal stenosis: Spinal canal narrowing in the lower back
    • Concurrent segmental instability: It indicates a significant movement (hypermobility) in the spine.
    Contraindications of Discectomy surgery​ or procedure

    Types of discectomy

    There are various types of discectomies depending on the location and surgical approach, which includes:


    • Open or traditional discectomy
    • Anterior cervical discectomy and fusion (ACDF)
    • Minimally invasive surgery (MIS) discectomy (keyhole discectomy)
    • Microdiscectomy
    • Micro-endoscopic discectomy (MED)
    • Laser discectomy
    • Percutaneous endoscopic lumbar discectomy (PELD)
    • Transforaminal endoscopic discectomy 
    • Full endoscopic discectomy


    • Open or traditional discectomy: It is also called standard discectomy (SD), where in this procedure, the surgeon makes a large incision (cut) on the back of the patient and moves the muscles to the side to easily access the targeted area to view the area and operate on the disc.


    • Anterior cervical discectomy and fusion (ACDF): ACDF mainly indicated in the cervical disc herniation. The surgeon approaches the damaged disc from the anterior (front) of the neck and removes the disc with spinal fusion. Fusion involves placing implants or bone grafts in the place of the actual disc to provide stability and strength to the neck. Depending on the condition, the orthopaedic or neurosurgeon may remove part or all of the damaged discs and one or more discs.


     

    • Minimally invasive surgery (MIS) discectomy (keyhole discectomy): In this procedure, the neuro or orthosurgeon makes a tiny incision on the skin and then uses progressively larger tubes (called dilators) to pass through the muscles. The surgeon may use an endoscope (special instrument) to see and operate in a smaller space. This minimally invasive surgery has some versions that include micro-endoscopic discectomy (MED), microdiscectomy, laser discectomy, percutaneous endoscopic lumbar discectomy (PELD), transforaminal endoscopic discectomy and full endoscopic discectomy. 


    • Microdiscectomy: . The neurosurgeon or orthopaedic surgeon uses the microscope to see through the smaller incision. A tiny incision is made in the back just above the site where the disc is herniated. The rest of the surgery is executed precisely like the traditional laminotomy and discectomy.
    • Endoscopic discectomy: It is a less invasive procedure that uses an endoscope for visualisation to treat the herniated discs. Endoscopic lumbar discectomy is the most commonly performed surgery.
    • Micro-endoscopic discectomy (MED): Utilizes a micro-endoscope for visualization and disc removal through a small incision.
    • Laser discectomy: Employs a laser to vaporize disc material through a small incision or cannula.
    • Percutaneous endoscopic lumbar discectomy (PELD): Involves a percutaneous approach with an endoscope to remove disc material through a tiny incision.
    • Transforaminal endoscopic discectomy: Accesses the disc through the foramen with an endoscope for targeted removal of disc material.
    • Full endoscopic discectomy: Uses an endoscope for a comprehensive view and removal of disc material through a small incision.

     

    • Discectomy neck surgery address the herniated discs in the neck to improve nerve function and relieve pain. In the neck region (cervical spine), discectomy may often perform along with foraminotomy or fusion. 


    • In the lower back region (lumbar spine), discectomy is a part of a larger surgery that also includes laminectomy, foraminotomy (discectomy and foraminotomy) or spinal fusion. As per the studies, it was found that more than 95% of disc herniations in the lumbar region may occur at the L4-L5 level. L4-L5 discectomy is used to alleviate pressure on spinal nerves in the lower back area by removing the disc between the L4 and L5 vertebrae. L5-S1 discectomy targets the fifth lumbar vertebrae and the first sacral vertebrae.

    Advantages of discectomy

    Discectomy may be preferred over other spine surgeries for herniated discs and degenerative disc disease because it has more invasive options and the ability to directly address the source of pain. However, surgeons choose discectomy by considering the patient's condition, age, and overall health. The following are the typical advantages of discectomy:


    • Reduces the leg or arm pain
    • Severe weakness
    • Improved functionality
    • Quick recovery
    • Minimal scarring (In case of minimally invasive procedure)

    Considerations of neurosurgeons and orthopaedic surgeons before performing discectomy procedure

    The decision to proceed with discectomy is carefully considered based on the individual patient's overall health and lifestyle and the severity of the symptoms.


    The majority of people (60% - 90%) may recover well from conservative treatments such as NSAIDs, epidural steroid injections, and physical therapy. However, the pain and other symptoms may not get better in some people. The surgeon may choose discectomy to give relief from the following symptoms that are not getting better with non-surgical treatments. The choice of the technique type may depend on patient selection and especially on disc morphology.


    The surgeon may consider the following before performing surgery:

    • Detailed neurological examination and history
    • Ideal patient selection (e.g., active and younger patients)
    • The natural evolution of disc hernia and the risk of recurrence.
    • Surgery is the only remaining option after all other possible treatments have been tried and are no longer viable or effective.
    • The benefit/risk ratio for surgery, with benefits particularly in terms of nerve root pain, and risk of paralysis, large vessel wounds, and nosocomial infection.
    • Surgical approach and technique


    Surgeons may discuss the following factors with the patient to know the patient's expectations and goals:

    • Natural history of the disease process
    • Different management strategies
    • Different surgical strategies
    • Risks and benefits of surgical management.

    Discectomy procedure

    Before the procedure


    • Before performing a discectomy, anaesthetics or surgeons review the patient's medical history to decide the best type of anaesthesia.
    • The surgeon asks about any medications the patient has been taking, such as drugs, supplements, or herbs, and the surgeon will ask to stop taking any medicines that make it hard for the patient's blood to clot two weeks before the surgery.
    • The patient will also be asked about the asthma or allergic reaction to stop the symptoms such as itchiness, difficulty breathing, and hives.
    • It is recommended that the patient should avoid consuming any food at least 6 hours before the procedure. Small amounts of clear liquids will be suggested to take up to two hours before the procedure. Pre-procedure, the medical team will place an intravenous (IV) line to give antibiotics and fluids to the patient.
    • The patient will be connected to the monitoring equipment to monitor the patient's vitals during the procedure.



    During the procedure


    It involves the removal of the greater part or portion of the inner gel-like center (nucleus pulposus) while keeping the majority of the outer layer (annulus fibrosus). It may be performed as an open or an endoscopic procedure.


    • This procedure is performed on an outpatient basis and takes about 60 minutes. It will be performed in a special room equipped with a fluoroscope (X-ray).
    • The patient will be positioned on his stomach, and his back will be cleansed with an antiseptic solution. Afterward, general anaesthesia is used to perform this surgery. 
    • An X-ray will detect the correct lower back area. After detecting the correct location, the surgeon will make a small cut. Muscles will be separated from the spine, and a small amount of ligament and bone covering the nerves will be removed. The nerves will be inspected and gently moved to the side to access the disc prolapse. 
    • The prolapsed disc is removed by making a small incision in the back of the disc. The rest of the disc is left behind. At the end of the procedure, the wound (incision site) is closed using dissolvable stitches and covered with dressing. This can relieve the pressure and reduce the disc bulge. 
    • Surgeons performs discectomy and decompression, together to remove disc material and to create more space around spinal cord or nerve roots.


    Discectomy post operative care (after the procedure)


    • After the procedure, the patient is shifted to the recovery area. Most patients can have prompt relief following the process; however, some soreness may rarely occur at the procedure site and may reduce within 2-3 days.
    • The patient has to stay at the hospital if needed. Before leaving the hospital, the medical team will explain how to look after the wound.
    • A physiotherapist will see the patient before discharge. During the first six weeks of recovery, the patient should avoid heavy lifting and prolonged sitting or standing. The patient has to limit the activity to gentle stretches and walking.
    • After six weeks, the patient can increase the activity as comfort allows. The patient can return to a normal activity level after 12 weeks.
    • The pain may take a couple of weeks to settle down. The patient needs to follow the instructions given by the surgeon.


    Patients will get instructions from the surgeon that include:


    • What foods have to take
    • How to care for the (wound) incision site
    • What side effects to look out for
    • What exercises and activities are safe to do


    Healthcare physician consultation must be sought at once if the patient is experiencing any of the following:


    • Difficulty breathing
    • Sudden numbness 
    • Sudden muscle weakness
    • Severe pain or worsening pain
    • Difficulty peeing
    • Signs of an infection at the incision, such as fever, swelling, and skin discoloration.

    Discectomy recovery time

    Recovery after surgery depends on the patient's overall health, age, and the type of approach that the surgeon performed. Usually, patients may go home on the same day the procedure performed or after a short hospital stay. 


    • Post-operative pain: Post-operative pain will be managed with pain medications.
    • Returning to work: People with non-physical jobs may generally be able to return to work after 2-4 weeks, although often with some restriction of physical activity. It may take three months to return to manual work completely.
    • Flying: It is advised not to fly for two weeks after the surgery. 
    • Exercise: Exercising aims to improve and maintain aerobic fitness, so surgeons may recommend some physical therapies or post discectomy exercises to strengthen and improve the muscles and range of motion.
    • Smoking: Surgeons may recommend avoiding tobacco because it is associated with increased pain and poorer results from spinal surgery.
    • Avoid heavy lifting: Patients might be advised to avoid heavy lifting and prolonged manual work, which may cause a repeat disc prolapse or further injury.
    • Follow-up: The patient has to visit the hospital a few weeks after the surgery to see the progress. Follow-up appointments might be scheduled to monitor progress and to ensure that there are no further complications.

    Discectomy success rate

    Lumbar discectomies have a high success rate, with 60% - 90%, respectively. However, individual factors may be considered for the surgery's success. 


    Patients showed high satisfaction after discectomy, and over 80% return to work; compared to this, reoperation rates are very low, which accounts for only 15%. However, as per the studies, revision discectomies effectively relieve pain and numbness.

    Discectomy side effects

    Discectomy is a safe surgery; however, as with any other surgery, some side effects and risks occur during or after the surgery. Side effects and risks of surgery and anaesthesia in general are:


    • Reactions to medicines
    • Breathing problems
    • Bleeding, blood clots and infection


    The risks are rare for this procedure. However, the possible dangers might include as follows:


    • Allergic reaction to medication or dye
    • Discitis (Infection in the spinal discs)
    • Bleeding and bruising at the injection site
    • Nerve damage (nerve roots and spinal cord)
    • Infection
    • No improvement in symptoms (worsening of pain in some cases).
    complications of Discectomy surgery​ or procedure

    Discectomy complications

    Every surgical procedure has benefits and complications. Like every surgery, discectomy also has some complications, that includes:


    • Large vessel wounds: Haemorrhage (bleeding)
    • Dural tear: Cerebrospinal fluid leak
    • Epidural bleeding: Hematoma (a collection of blood that forms between the skull and the dura mater, the outermost protective membrane covering the brain).
    • Recurrence of discal herniation: Reherniation
    • Durotomy: Tear
    • Recurrent discopathy: Degenerative disc disease
    • Revision surgery: Reoperation 
    • Nerve root injury
    • Neurologic complications
    • Wound complications

    Questions that the patients can ask the healthcare team about discectomy surgery?

    • What are the wound care instructions for my incision site?
    • How soon should I contact the healthcare team if I notice any unusual symptoms or issues after the procedure?
    • What signs of complications or infections should I watch for at the surgical site?
    • When can I go back to my normal activities?
    • Are there any specific activities I should avoid during my recovery period?
    • What dietary restrictions should I follow for recovery?
    • What should I expect during the recovery period?
    • When should I schedule follow-up appointments?
    • Will any tests or evaluations be required after the surgery?

    Differences between Laminectomy and Discectomy

    Laminectomy vs Discectomy

    Laminectomy and discectomy are both two spinal surgical procedures that may be performed to relieve pressure on the spinal cord and the nerves. Although these are similar, they have some differences, and they address different structures, that includes:

    Elements Laminectomy Discectomy
    Procedure It is a surgical incision into the backbone of the patient to obtain access to the spinal cord. It is a surgical procedure mainly performed to remove the herniated or damaged disc material to relieve nerve compression.
    Targeted areas Problems with the back of the vertebrae. Problems related to vertebral discs.
    Mainly focuses To remove a partial or complete vertebral bone) to create space for nerves. To remove the herniated or damaged disc material to relieve nerve compression.
    Purpose To relieve pressure on the spinal cord or spinal nerves, remove herniated discs, narrow the canal, or remove tumours. To treat the herniated, bulging, or prolapsed discs causing constant radicular pain, weakness, or numbness.
    Indications Nerve root compression, tumors, Severe persistent neck pain, low back pain, arthritis of the spine, and spinal stenosis. Severe radiating pain, constant (persistent) muscle weakness, difficulty walking, loss of bladder or bowel control.
    Possible complications Paraplegia or quadriplegia, delayed instability, and breakdown of the wound. Large vessel wounds, epidural bleeding, recurrence of discal herniation, and neurologic complications.

    Differences between spinal fusion and discectomy

    Spinal Fusion vs Discectomy

    Spinal fusion and discectomy are both surgical procedures performed to treat back pain and radiating leg pain due to disease processes in the lower back. Although these are similar, they have some differences, which include:

    Elements Fusion Discectomy
    Procedure It is a surgical technique that involves joining two or more vertebrae together. It is a surgical procedure mainly performed to remove the herniated or damaged disc material to relieve nerve compression without spinal fusion.
    Indications Tumor, infection or fracture in the spinal column, scoliosis, spinal stenosis, degenerative disc disease, spondylolisthesis, fractured vertebrae, and herniated disc. Severe radiating pain, constant (persistent) muscle weakness, difficulty walking, loss of bladder or bowel control.
    Mainly focuses To correct problems with small bones in the vertebrae of the spine. To remove the herniated or damaged disc material to relieve nerve compression.
    Purpose To fuse together two or more vertebrae to heal them into a solid bone and eliminate painful motion or restore spine stability. To treat the herniated, bulging, or prolapsed discs causing constant radicular pain, weakness, or numbness.
    Complications Recurring symptoms infection, pseudarthrosis, pain at the graft site, and blood clots Large vessel wounds, epidural bleeding, recurrence of discal herniation, and neurologic complications.

    Differences between endoscopic discectomy and microdiscectomy

    Endoscopic discectomy vs microdiscectomy

    Endoscopic discectomy surgery and microdiscectomy methods are less invasive spinal procedures that allow spine surgeons to easily access and treat spinal problems, offering small incisions, less tissue disruption, and acting as alternatives for traditional open discectomies. Although these are similar, they have some differences, which include:

    Elements Endoscopic discectomy Microdiscectomy
    Definition It is a minimally invasive procedure that uses an endoscope to visualize the disc and nerves to treat herniated material of the intervertebral discs. It is a surgical procedure that uses a microscope for visualisation to remove the herniated disc to relieve pain and symptoms.
    Technique It is considered the safe, efficient, and less invasive alternative technique of microdiscectomy. It is considered a gold-standard surgical option for treating lumbar disc herniations.
    Duration Takes on an average of an hour to complete. Usually, this operation takes between 1 to 2 hours.
    Benefits Smaller incisions, less muscular retraction, less bone removal, minimal manipulation of nervous tissue, less blood loss, shorter operative time, minimal tissue damage, and better patient satisfaction. Less traumatic approach, better visualization and smaller incision.
    Intensity of pain Post-operative lumbar pain is less intense. Post-operative lumbar pain is more intense than endoscopic discectomy.

    Frequently Asked Questions (FAQs) on Discectomy

    • Is a discectomy a major surgery?

      Yes, a discectomy can be a major surgery. However, a few minimally invasive surgical approaches are less major than open surgery in terms of hospital stay, recovery, and incision size. Due to the delicate nature of the spine and spinal cord, the patient must strictly follow the instructions given by the surgeons to heal quickly.

    • When one can return to my normal activities?

      It may take up to 8 weeks to 3 months to get back to complete normal activities. Recovery after discectomy may depend on the patient's age, overall health, and the type of approach that the surgeon has performed. However, after discectomy, the patient may feel relief from the symptoms or get better over days or weeks.

      Initially, the patient may struggle to sit or stand in one position. Surgeons will prescribe pain medication to relieve the patient from post-operative pain.

    • How long does the back hurt after discectomy?

      After a discectomy, back pain may vary and depend on the patient's age, overall condition, and how effectively patient followed the surgeon's instructions. However, after a discectomy, the patient can feel relief from symptoms such as lower back pain, leg pain, or numbness, or the patient may get better over days or weeks. It is normal to experience discomfort or soreness for a few weeks to months. Surgeons will prescribe pain medication to relieve the patient from post-operative pain.

    • Can I run after the discectomy?

      No, running is not recommended after a discectomy. Slowly, activities can be resumed one by one. Driving and light activities may be resumed after about two weeks. Surgeons may restrict excess activity for the first six weeks. Routine activities such as hobbies, work, and school may be resumed within six weeks. Strenuous physical activity or sports may be recommended after 12 weeks or more. However please consult the surgeon (Neuro or ortho surgeon) before proceeding with physical activities or any sport.

    What is a lumbar discectomy?

    Lumbar discectomy is a type of spinal surgery that is performed to fix a disc in the lower back or to remove a herniated or degenerative disc in the lower spine. The cut may be made posterior (lower back side) through the back muscles to remove the pressing disc on the nerve. 


    Elective lumbar discectomy may be indicated in cases of constant radicular symptoms such as back or leg pain that correspond to radiographic evidence of nerve root compression by a herniated disc in patients who have failed conservative treatment techniques or physical therapy. The lumbar discectomy will be performed either using open or minimally invasive technique.

    Why the discectomy procedure is performed?

    Discectomy will be performed when one of the intervertebral discs moves out of place (herniation) and the soft gel inside pushes through the wall of the disc. These bulged discs may pressure the nerves and spinal cord from the spinal column.


    Many symptoms may get better or worse over time with non-surgical treatments (anti-inflammatory medicines, pain medications, physical therapy, and exercise). Surgery (discectomy) will be recommended if the person displays persistent symptoms such as leg or arm pain or numbness (not going away), severe weakness in the muscles of the arm, lower leg, or buttocks, and pain that spreads into the legs.

    Can discectomy cure sciatica?

    Yes, discectomy procedure can cure sciatica caused by a lumbar disc herniation. The research showed that 86% of patients may experience sciatica pain relief after a microdiscectomy surgery. It is a common surgical approach used to treat sciatica, which involves removing a small part of the disc material under the nerve root or bone over the nerve root. However, outcomes may vary for patients.

    What is anterior cervical discectomy and fusion?

    Anterior cervical discectomy surgery and fusion are the procedures to relieve pressure by removing the herniated disc. This procedure helps remove the problematic disc and avoids future nerve compression by fusing the injured spinal bones. For a fusion, a bone is inserted into the empty disc space; an artificial disc (made of plastic and metal) is placed into the disc space for a disc replacement. Generally, anterior cervical discectomy and fusion risks commonly include bleeding, infection, and blood clots.

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