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Diskectomy - Overview

Alternative Names

Spinal microdiskectomy; Microdecompression; Laminotomy; Disk removal; Spine surgery - diskectomy

Definition of Diskectomy:

Diskectomy is surgery to remove all or part of a cushion that helps protect your spinal column. These cushions, called disks, separate your spinal bones (vertebrae).

When one of your disks herniates (moves out of place), the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of your spinal column.

Description:

A surgeon may perform disk removal (diskectomy) in different ways.

Microdiskectomy: When you have a microdiskectomy, the surgeon does not need to do much surgery on the bones, joints, ligaments, or muscles of your spine.
Diskectomy in the lower part of your back (lumbar spine) may be part of a larger surgery that also includes a laminectomy, foraminotomy, or spinal fusion.
Diskectomy in your neck (cervical spine) is most often done along with laminectomy, foraminotomy, or fusion.

Microdiskectomy is done in a hospital or outpatient surgical center. You will be given spinal anesthesia or general anesthesia (asleep and pain-free).

The surgeon makes a small (1 to 1-1/2 inch) incision (cut) on your back and moves the back muscles away from the spine. The doctor uses a special microscope to see the problem disk or disks and nerves during surgery.
The surgeon finds the nerve root and moves it away. Then the surgeon removes the injured disk tissue and pieces. The surgeon puts the back muscles back in place, and closes the wound with stitches or staples.
The surgery takes about 1 to 2 hours.

Diskectomy and laminotomy is done in the hospital, using general anesthesia (asleep and pain-free).

The surgeon makes a larger cut on your back over the spine. Muscles and tissue are moved to expose your spine.
A small part of the lamina bone (part of the vertebrae that surrounds the spinal column and nerves) is cut away. The opening may be as large as the ligament that runs along your spine. The surgeon cuts a small hole in the disk that is causing your symptoms and removes material from inside. Other fragments of the disk may also be removed.

Herniated nucleus pulposis

Skeletal spine

Spine supporting structures

Cauda equina

Spinal stenosis

Microdiskectomy - series

Reviewed last on: 3/4/2009
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Chou R, Qaseem A, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478-491.

Gregory DS, Seto CK, Wortley GC, Shugart CM. Acute lumbar disk pain: Navigating evaluation and treatment choices. American Family Physician. Oct 2008;78(7).

Williams KD, Park AL. Lower back pain and disorders of intervertebral discs. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 39.

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