The human spine consists of the cervical, thoracic, and lumbar spine. The lumbar spine or the lower back consists of five vertebrae, each with an intervertebral disc connecting one vertebra to the other. Lower back pain due to injuries, herniated or degenerated discs can affect your daily life, making it harder for you to engage in various activities at home or work. Problems in the lumbar spine can be corrected with various procedures, one of them being lumbar discectomy. If you are dealing with back issues in Los Angeles, consult LAMIS Institute to establish whether a lumbar discectomy is a right procedure.
What is Lumbar Discectomy
Lumbar discectomy is a spine surgical procedure aiming to relieve pressure from the nerve roots of the lumbar nerves. This pain is often a result of a herniated or ruptured disc. Doctors often choose lumbar discectomy when other non-surgical treatments have failed, or you begin developing other worrisome symptoms such as numbness in the legs and loss of bladder and bowel control.
Today, patients can receive minimally invasive lumbar discectomy instead of open surgery. During the surgery, the surgeon reaches the herniated or ruptured disk from the back of the spine and removes the lamina (bone covering the spinal cord).
In an open procedure, the surgeon cuts through the skin and the back muscles to reach the spine and have a clearer view. This procedure takes time both at the operating table and for recovery. Doctors will often recommend the best procedure for you based on your case.
The Need for Lumbar Discectomy
A lumbar discectomy is a surgery used to correct a herniated disc. Discs function as shock absorbers in the spine, and when damaged or worn out, you experience sciatica, numbness in the legs, lower back pain, and muscle weakness or loss of muscle control.
These symptoms often worsen with time, depending on the herniation and your health. Your doctor will recommend medication and physical therapy to deal with the symptoms unless you are showing symptoms of numbness, significant lower leg pain, and loss of bladder or bowel function.
Not everyone with a herniated disc or lower back pain qualifies for a lumbar discectomy. The determination of the best candidates for the procedure depends on several factors such as:
- Diagnostic tests indicate that you have a herniated disc
- You are experiencing pain, weakness, or numbness in your limbs
- Your leg pain is getting worse
- Loss of feeling in the genitalia
- Loss of bladder and bowel control
- Non-surgical treatment has not worked so far
Preparing for a Lumbar Discectomy
As with all surgeries, you need to prepare for the surgery. Preparation involves signing consent forms at the hospital and providing your medical history, allergies, and medications you may currently be taking.
Discuss these medications with your doctor to ensure your doctor can provide the safest procedure possible – you may need to stop taking certain medicines before you go into surgery. Medications such as NSAIDs and blood thinners should not be taken for at least seven days before your procedure. Your doctor will order certain pre-surgical tests such as a chest x-ray, blood tests, and an electrocardiogram.
In preparation for the actual day of the surgery:
- Do not eat for at least 8 hours before the surgery. You can still take the allowed medication with a little water
- Shower with an antibacterial soap
- Wear clean, loose-fitting clothing and flat-heeled closed shoes
- Organize for someone to pick you up from the hospital as you may be unable to drive yourself
What to Expect During a Lumbar Discectomy
On the day of the surgery, you should arrive at the hospital earlier than the expected start to give you enough time to fill out any paperwork and prepare for the surgery. Once in the operating room, you will receive general or local anesthesia.
A team will constantly monitor your vital signs during the procedure. The surgery starts with the doctor making an incision on your back directly at the level of the damaged disc. At the same time, the doctor will use a special X-ray to ensure they operate in the right location.
Once the surgeon makes an incision at the right position, they will insert a wire into the intervertebral space, followed by a series of progressively larger tubes to push apart the tissue. The surgeon then removes the smaller tubes leaving the largest. This allows them to insert the tools and a camera required to complete the surgery.
The surgeon then removes the herniated discs and makes the necessary repairs before removing the tools and tubing and closing the incision. Since this is a minimally invasive surgery, you can go home on the same day if the doctor determines that your vital signs are stable and your surgery was successful.
Recovery and Aftercare
After the procedure, you will be moved to the postoperative recovery area to monitor your vital signs. Depending on the procedure, you can go home on the same day of the surgery or within a day or two.
Typical recovery for lumbar discectomy lasts between one and four weeks, depending on your health and the underlying condition that necessitated the surgery. You can return to work in two to four weeks, depending on your work. If your work requires heavy lifting or operating heavy machinery, you might be back to work in between eight to twelve weeks.
When being released, your surgeon will provide aftercare and recovery instructions that you should follow until the next follow-up appointment. Some of the Do’s and Don’ts to remember during your post-surgery recovery are:
- Do not bend or twist your back
- Avoid lifting anything heavier than 5 pounds
- Do not engage in any strenuous activity
- Avoid sex after your operation
- Do not drive for the first two or three days unless your pain is well-controlled
- Avoid taking alcohol after the procedure as it can cause blood thinning. Alcohol should also not be combined with pain medication.
- Do not take a shower in the first few days after surgery. Gently wash the incision with soap and water and pat dry.
- Cover the incision with gauze if you experience drainage. However, if the drainage at the incision point soaks through two or more gauze dressings in a day, visit your doctor.
- Do not use ointment or lotion on the incision.
- Keep your incision free from contamination by wearing clean clothes after bathing, using clean bed linens, and keeping pets off your bed until the incision heals.
- Do not remove any staples, stitches, or glue used to hold the incision closed.
- Avoid sitting or lying in one position for long as it can cause stiffness and more pain. Walk around for about five to ten minutes every 3-4 hours, gradually increasing the walking duration as your body allows
- Take your pain medications as directed by a physician. If your pain subsides, reduce the frequency of this medication to prevent dependency.
- Drink plenty of water and eat fiber-rich foods to prevent constipation
You can expect some pain and soreness during the recovery period, but it should generally improve as you recover. That said, you should be aware of warning signs that something could be wrong. Here are some signs you should visit the doctor:
- You have a fever of over 101.5° that does not respond to medication
- Nausea and vomiting that won’t let up
- Your incision looks infected
- Itching at the incision site
- Swelling and tenderness in the calf of the leg
- Your limbs start tingling or becoming numb
- Excessive sleepiness
Once you have recovered from the surgery, it’s a good idea to keep caring for your back to prevent a recurrence of the issue. Some prevention techniques include:
- Work in an ergonomic area
- Maintain a good posture when sitting, standing, walking, or sleeping
- Engage in an appropriate exercise program
- Manage your stress
- Employ the right lifting techniques to avoid straining your back
Risks of Lumbar Discectomy
Although lumbar discectomy can effectively deal with a herniated or ruptured disc, it carries several risks, as with all surgeries. Some of the risks you should be aware of include:
- No relief for the symptoms you had
- Some patients experience the same pain, discomfort, or symptoms they had before the surgery. In other patients, the relief may be short-lived. Recurring symptoms could arise due to another slipped disc, thickening ligament, scarring around the nerves, or a weakened spine. These symptoms can be alleviated with physiotherapy or further surgery if they persist.
- Infection at the site of the incision. Post-surgical infections are usually easy to treat with antibiotics.
- You could develop blood clots in your leg. Staying active during the post-recovery period can help reduce the risk of blood clots. Alternatively, you can wear compression stockings to improve blood flow to the legs.
- Lumbar discectomy risks causing a Dural tear which could lead to leakage of cerebral-spinal fluid post-surgery.
- Some patients end up with nerve injury and, in severe cases, paralysis. These outcomes could occur due to bleeding in the spinal column, leakage of spinal fluid, accidental damage to the spinal blood supply, or accidental nerve damage during the surgery.
- A patient could develop a life-threatening reaction to anesthesia or die due to a blood loss. Blood clots during and after surgery could also be fatal.
Lumbar Discectomy Frequently Asked Questions
1. What are the alternatives to lumbar discectomy?
Normally, surgeons don't rush to get patients a lumbar discectomy unless other non-surgical options have failed. These non-surgical options include medications, pain management, and physical therapy. If these fail or you develop worrying symptoms like difficulty walking and losing bladder and bowel control, your doctor will discuss surgery with you.
2. Are there any limitations after surgery?
While a lumbar discectomy is an outpatient procedure, you need to allow time for healing and recovery. You are encouraged to remain mobile after the surgery to help your healing. However, you should not engage in strenuous physical activity or lifting heavy items as this hurts your recovery. Once you have fully recovered, you can return to your normal activities.
3. Should you feel pain after the surgery?
You will experience pain and slight discomfort in the first few days after your surgery. You may also experience muscle spasms in your thighs, lower back, and buttocks for the first few days. Your doctor will give you pain medication to manage the pain after surgery.
You can help alleviate some pain by maintaining a good posture when you walk, stand, or sit. Being mobile also helps in healing by preventing excessive scarring in the recently operated area.
4. How long does the surgery take?
Lumbar discectomy takes about 2 hours to complete. Other factors such as your overall health and possible issues could affect the duration of the surgery. For the most part, however, this is an outpatient procedure.
5. How long is the recovery?
Every patient's healing time varies based on their health. Most patients can walk around within a few hours of the surgery. Within two to four weeks, you can return to light activities, but it may take at least three months to resume activities such as heavy lifting.
Your doctor will schedule follow-up appointments to check on your progress. The first appointment is two weeks post-surgery with further follow-up scheduled after six weeks and three months after the surgery.
6. When Can I Drive After Surgery?
Following the surgery, it's advisable to have someone drive you back home. Most patients receive narcotic pain medication, meaning it is illegal to drive while on these medications. You need to wait until you are off the narcotic pain medication before you can drive safely.
7. Will I need physical therapy after a lumbar discectomy?
In the hours and days after your surgery, you are encouraged to engage in light walking to prevent blood clots, deconditioning, and other complications. It is not recommended to start physical therapy in the immediate postoperative period. Your doctor will advise whether you need physical therapy in the follow-up appointments to assess your recovery.
Find a Lumbar Discectomy Specialist Near Me
Having a herniated disc can cause multiple issues, including problems walking, numbness in the arms, and loss of bladder function. If you have taken medication or physical therapy but are still experiencing the same or worsening symptoms, surgery could help. Lumbar discectomies are minimally invasive procedures that can help alleviate herniated disc symptoms and allow you to resume your activities. LAMIS Institute offers minimally invasive lumbar discectomy for patients who need it in Los Angeles. We start with a consultation and an evaluation of your medical history to provide the best care possible. Contact our lumbar discectomy specialists at 310-734-6088 to schedule a consultation.