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Open discectomy is the most common surgical treatment for ruptured or herniated discs of the lumbar spine. This surgery is used to remove a part of the damaged disc which is relieving the pressure on the nerve tissue and alleviating the pain.



This operation can also now be performed arthroscopically. This means that it is being done through a smaller incision using specialized tools under local anesthesia. Microdiscectomy on the other hand is performed using a special microscope or magnifying instrument to view the disc and nerves. The magnified view makes it possible for the surgeon to remove herniated disc material through a smaller incision, thus causing less damage to surrounding tissue. 

MicroEndoscopic Discectomy (MED)

During this procedure a machine called fluoroscope which projects live x-ray pictures onto a screen is brought. The disc space is confirmed using the fluoroscope, and a long acting, local anesthetic is injected through the muscle and around the bone protecting the disc. A surgeon then makes a small incision through which the thin wire is placed and lowered until it touches the bone. Progressively larger dilators are brought down on top of one another following the wire. By the time the 4th or 5th dilator is placed, the muscles are stretched to an opening roughly the size of a nickel. The retractor is held in place by a mechanical arm attached to the table. Finally, the endoscope with a camera is attached to the edge of the working channel. This projects an image to the TV screen. This allows for microscopic manipulation and removal of the tissues which could be extremely helpful.

Discectomy with bone-grafting

Cervical discectomy is the most common surgical procedure to treat damaged cervical discs. When the damaged disc is localized in the neck the operation is called anterior because the cervical spine is reached through a small incision in the front of the neck. During the surgery, the soft tissues of the neck are separated and the disc is removed. In order to maintain the normal height of the disc space, the surgeon may choose to fill the space with a bone graft. A bone graft is a small piece of bone, either taken from the patient's body or from a donor or bone bank. This bone fills the disc space and ideally will join or fuse the vertebrae together.

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