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The highly skilled surgeons at Cedars-Sinai Marina del Rey Hospital can perform intervertebral disc excisions for a wide range of conditions, including herniated discs, spinal tumors, fractures, and infections. Our well-trained physical therapists will advise you on postoperative care and precautions, and provide you with effective treatment regimens to help speed up your recovery and alleviate any discomfort you might experience after your procedure.
Intervertebral disc excision, also called discectomy, is one of the most common spinal surgeries performed. Intervertebral discs sit in between the vertebrae and act as shock absorbers for the spine. Intervertebral disc excision is commonly performed to treat herniated or ruptured discs in the lumbar section of the spine. Cervical and thoracic herniated discs can also be treated using this technique. During the procedure, a surgeon will remove the portion of the intervertebral disc that protrudes from the wall of the disc, along with any fragments that impinge on the spinal cord or nerve root. This procedure can be performed through open or microscopic surgery (microdiscectomy).
Microdiscectomy makes use of a specialized microscope or a magnifying tool to visualize the spinal disc and nerves. In a microdiscectomy, a smaller incision is sufficient to remove the disc. Another method called arthroscopic microdiscectomy, or percutaneous endoscopic discectomy, serves as an alternative to both open surgical and microdiscectomy procedures. Laser discectomy is a technique in which a laser is used to vaporize a portion of the disc, and may be done percutaneously (using fluoroscopic guidance), or laparoscopically.
Intervertebral disc excision is performed when conservative treatment methods are unsuccessful in relieving back pain that persists for more than six weeks. If a herniated disc causes nerve impingement leading to myelopathy symptoms, such as severe muscle weakness and/or bowel and urinary incontinence, then disk removal may be recommended. Other conditions for which intervertebral disc excision is used include:
Your spine surgeon will advise you of certain pre-operative precautions that should be strictly followed. Prescription drugs and over-the-counter medications that are used as blood thinners, such as coumadin and aspirin, should be stopped at least a week prior to your procedure. You will also need to follow instructions regarding eating and drinking on the day leading up to your surgery. If you take any type of regular medications, like blood pressure or diabetes pills, you will need to inform your surgeon.
Intervertebral disc excision is performed under general anesthesia and usually takes about an hour. Your surgeon will make a 1-2 cm long incision in the middle portion of your lower back, exactly where your disc is displaced. Specialized tools, such as operating microscopes, are used to view the spinal region so that there is little or no disruption of the surrounding soft tissues and muscles. The nerve roots are also carefully retracted when the herniated disc is removed, using small grasping tools. Then, the area is cleansed with an antibiotic solution and the incision is closed using sutures.
Minimally invasive intervertebral disc excision offers the following benefits:
All surgical procedures carry a risk associated with the administration of general anesthesia, although these complications are very rare. The other most common risk is infection, which may occur in 1-2% of patients. There is also a small risk of damage to the major blood vessels in the front of the spinal disc and the nerves in the lower back region.
Patients undergoing intervertebral disc excision will be allowed to return to home on the same day or the day following their procedure. Before leaving the hospital, a physical therapist will explain the proper ways of getting in and out of bed and walking. A follow-up visit will be scheduled for eight to 10 days after the surgery.
During the first two to four weeks of the postoperative period, patients should refrain from bending, lifting, and twisting movements in order to avoid strain and recurrent injury to the disc. Patients should not remain in the same seated position for more than one hour, and should avoid any long travel in a car. The area where sutures are placed should be kept dry, clean, and covered during showers. Patients can return to activities like driving once their pain is reduced, usually within 10 days after surgery. Patients should never drive while on pain medications, especially narcotics. Most patients can return to work within two weeks of surgery. If a patient's job requires heavy manual labor, they may require four to six weeks of postoperative rest.
Do you have symptoms related to a herniated disc or other spinal disorder? You can learn more about intervertebral disc excision and other services at Cedars-Sinai Marina del Rey Hospital by calling 310.823.8911.
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