Disc Surgery

There are general standards that must be met before one can be a candidate for disc surgery, a procedure that is usually done when a disc is herniated (protrudes from its normal spot) and causing severe discomfort.

• An MIR or CT scan reveals that a disc is pressing against the root of a nerve.
• Persistent pain is experienced despite the use of more conservative measures, such as weight loss, exercise, and ergonomic measures.
• Severe pain is radiating down the leg or into the buttock, despite conservative interventions of physical therapy or medications.
• Neurological warning signs are observed, such as the loss of reflexes or bodily control. These may be indicators of a surgical emergency.
  

Once the need for disc surgery has been established there are a number of approaches available:

• Discectomy: This is the most frequently performed back operation. In general, an incision is made over the disc and a part, or all of it, is removed in order to relieve pressure on the nerve.
• Microdiscectomy: The procedure is much the same as for a discectomy. The difference is that a smaller incision is made because magnification is used to enlarge the view of the target space.
• Laser Decompression: A needle is inserted into the disc and a portion of it is destroyed with a laser. This relieves pressure on the nerve. The advantage of the procedure is that it is less invasive than traditional surgeries and can be performed on an outpatient basis.
• Percutaneous Removal: A small tube called an endoscope is inserted into the back and used to remove portions of the disc. This allows the surgeon to pinpoint the problem and leave the surrounding area intact. This, too, can be performed on an outpatient basis.
• Chemonucleolysis: This is an alternative to taking out part or all of a disc. A preparation from papaya plants, called chymopapain, is injected and has the effect of decreasing the size of a disc, with the intention of relieving nerve pressure.