The intervertebral disc is an elastic structure that absorbs the pressure applied to the spine, allowing its mobility by separating the vertebrae from one another.

The deterioration of the disc contents, for any reason (degenerative, traumatic or otherwise), can cause a part of the disk to migrate into the spinal canal, compressing the spinal cord or nerve roots and causing pain (sciatica), paralysis or loss of sensation.

The operation consists in approaching the spinal canal to remove the fragments compressing the nerve structures.

Benefits of intervention

Decompressing the nerve root relieves pain immediately, but other symptoms like weakness or numbness may take time to recover or, rarely, remain as sequelae, depending on the degree of damage already caused.

The purpose of the simple disc surgery is only to decompress the neural structures, not to restore the integrity of the spine, so it is important to compensate the loss of a disk by muscle strengthening after surgery.

Medical-technical description

For the simple discectomy it is necessary to approach the vertebral canal, for visualizing both the aggressor element (hernia) and the attacked element (bone or nerve).

There are several ways for approaching, depending on the type of hernia, surgical site, age and condition of the patient.

• MICRODISCECTOMY, open approach to small size (2-4 cm). Always effective, but can lead to fibrosis or instability
• PERCUTANEOUS FORAMINOSCOPY: percutaneous approach of 1 cm, is the least aggressive, but not in all cases is effective due to the restriction of movement of the instruments used
• COSTOTRANSVERSECTOMY APPROACH: specific approach to the dorsal canal. More aggressive and associated with long-term instability
• RETROPLEURAL APPROACH: specific approach to the thoracic region, minimally invasive and may be associated with instrumented stabilization

The Procedure

The excision of a disc is performed in the operating room. The intervention usually takes between 15 min. and 2h, depending on the type of approach and the surgery site, while the patient remains in the operating room and in the recovery area for 2 to 5 hours.

Patients will be hospitalized for 1-3 days

Preoperative Measures

• Assessment prior consultation, deciding and stating the specific aspects of the intervention and giving informed consent
• Conduct a comprehensive preoperative blood test, ECG and X-ray studies
• Do not drink alcohol or smoke 48 hours before surgery
• If surgery is scheduled in the morning, the patient should go to hospital without breakfast. If it is afternoon, an early breakfast and must not take any food or drink from 9 am
• Do not wear any metal object during operation (rings, bracelets, earrings, piercing, etc.)

Postoperative cares

• Must change position in bed and avoid constantly lying on your back
• Drains (if any) will be removed 24 hours after surgery
• Does not require cervical collar, as the mobility of the neck must be respected. Yes you should avoid sudden movements (sports) for 6 weeks
• Can and should walk during the days following surgery, avoiding tiring your back. Notice that you can gradually increase the distance
• Use straight-back chairs to sit on for the first 2 weeks
• Once discharged, you must contact us if you have any weakness in the extremities, fever and chills, or drainage from the wound
• Once discharged, likewise, you must avoid the following movements and postures for 2 weeks:

1. Lifting weights
2. Spinal postures
3. Housework
4. Driving

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