A discectomy is a surgery performed to relieve the compression of a nerve root by a herniated disc. This procedure can be performed as an open surgery or as a minimally invasive procedure. A new type of minimally invasive procedure, known as a decompression discectomy, has proven highly successful. This procedure, also known as a percutaneous discectomy, is performed using a device known as the Stryker Dekompressor®. The Stryker Dekompressor is a probe intended for single use. It can be used effectively in discectomies performed on any region of the spine: cervical, thoracic or lumbar.
Discs are the cushions between the vertebrae of the spine. Each is composed of an exterior shell of tough cartilage and a center of softer, more gelatinous material. Through aging, normal wear and tear, or injury, the disc may bulge between the vertebrae. If it herniates, or ruptures, it can cause severe pain by putting pressure on adjacent nerves. If this occurs, it decompression surgery may be required.
Candidates for a Decompression Discectomy
Patients for whom decompression discectomy may be a good option are patients with ongoing back or neck pain, sciatica, which involves radicular pain (traveling down the leg), or spinal stenosis, a condition in which the spinal canal has narrowed to the point that it is pressing on the spinal cord.
Typically, patients become candidates for decompression surgery when more conservative methods have failed to resolve symptoms after a period of 6 weeks to 3 months. Treatments normally tried before surgery is considered include:
- Lifestyle changes, such as diet or exercise
- Medications, such as analgesics and NSAIDs
- Physical therapy
- Chiropractic treatment
- Epidural injections of corticosteroids
Certain neurological symptoms, such as extreme weakness, numbness, or bladder or bowel dysfunction, especially if they occur suddenly, may necessitate emergency surgery.
Benefits of a Decompression Discectomy
There are many advantages to having a decompression discectomy. This procedure is a relatively simple one and provides rapid relief from pain for the great majority of patients. It is only minimally invasive and so involves little scarring or pain. In addition, it:
- Provides tissue for biopsy
- Does no thermal (heat) damage to the nerve root
- Controls the amount of material aspirated
- May be used in all three sections of the spine
- Allows for customization of the individual procedure
Carrying less risk than some other types of spinal surgery, a decompression discectomy also allows for more rapid recovery.
The Decompression Discectomy Procedure
During a decompression discectomy, the surgeon uses the Stryker Dekompressor, in combination with fluoroscopic imaging and a pump, to remove targeted matter from herniated discs. With the removal of this material, pressure on the nerves in the area, and the pain caused by that pressure, are both relieved.
During the procedure, fluoroscopic guidance helps the surgeon to direct a small needle to the herniated disc. Once the Stryker Dekompressor is turned on, the tip of the probe wears away part of the center (nucleus) of the disc. This provides more space, relieving pressure on the nerve and restoring neurological function. In the course of a decompression discectomy, the surgeon is also able to:
- Remove bone spurs
- Remove fibrous tissues contributing to stenosis
- Remove parts of vertebrae (laminectomy)
- Fuse affected vertebrae (spinal fusion)
When necessary, each one of these procedures helps to relieve pain by reducing or eliminating pressure on nerve roots or by stabilizing spinal segments.
Risks of a Decompression Discectomy
This procedure is considered a safe one, but any surgical procedure involves certain risks. In this case, risks during or after the procedure may include:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Postsurgical infection
- Respiratory difficulty
While 90 to 95 percent of discectomies are successful, there is a possibility that a disc can reherniate.
Recovery From a Decompression Discectomy
A simple decompression discectomy usually requires only half an hour to perform and, in most cases, does not require inpatient hospitalization. Although recovery times are variable, most patients can return to work within a week to 10 days. Sometimes physical therapy is necessary after this procedure in order for the patient to develop greater strength in the back or legs to prevent a reocurrence of the problem.