Lumbar discectomy at Exeter Hospital

What is lumbar discectomy?

Your back is made up of 24 hollow bones held together by fibrous plates called discs. Your discs can become worn or be injured causing the soft centre of the disc to push out of its normal space. This is called a herniated disc.

Lumbar discectomy is a surgical procedure to remove herniated discs in your lower back. Sometimes herniated discs put pressure on the nerves in your spine. This may make you feel pain running over your hip and down your leg called sciatic pain. You may also feel “pins and needles” or numbness in your leg and lower back pain.

Alternatives to lumbar discectomy

When your symptoms first develop your GP may prescribe anti-inflammatory medication and/or physiotherapy. If the pain remains or increases you may be offered an epidural injection.

If your symptoms persist or get worse you may be referred to a spinal consultant. They may order x-rays or an MRI scan. Based on the results of these procedures your consultant may recommend a lumbar discectomy.

Before your lumbar discectomy

Before you come into hospital for your operation, you will be asked questions about your health by one of our nurses. Further "pre-assessment" questions may be asked over the phone, or you might be asked to come into the hospital for some simple tests, such as a blood test, a urine sample or swabs to check for MRSA.

What happens during lumbar discectomy surgery?

Lumbar discectomy is usually performed under general anaesthetic. Your surgeon will make an incision in your lower back near the affected area. They will move the muscles to expose the bones. A very small piece of the bony cover of your spinal cord will be removed so the surgeon can access the herniated disc. They will remove only the herniated portion of the disc relieving the pressure on nearby nerves. The muscles will be moved back in place and both muscle and skin incisions will be closed using stitches. A dressing will be applied to the wound.

What happens during microdiscectomy surgery?

A microdiscectomy is usually performed under general anaesthetic. Your surgeon will make a small incision in your back near the herniated disc. They will insert small surgical instruments into these incisions. A microscope will be used to view the disc and the surrounding area. Only the herniated part of the disc will be removed, relieving the pressure on nearby nerves. The incisions will be closed using stitches or steri-strips. A dressing will be applied to the wound.

After your lumbar discectomy

Immediately after your surgery you will be taken to the recovery area. Staff will monitor your blood pressure, heart rate and breathing. If you are in any pain be sure and tell the recovery room staff. When you are stable a nurse will take you to your room.

Back in your room

Once back in your room, our nursing team will continue to check on you to make sure you are recovering well. After you’ve recovered from any effects of the anaesthetic, you can have something to eat and drink.

In order to prevent blood clots (DVT) you may need to wear support (compression) stockings.

Sometimes patients experience difficulty in passing urine and emptying their bladder following this procedure. Be sure and tell staff if you are in any discomfort. You may need a catheter to help you pass urine in the first few hours following your operation.

A physiotherapist will visit you to teach you some exercises and show you how to move about for the first few weeks. You may be asked to walk up and down stairs prior to discharge.

Going home following lumbar discectomy

Depending on the extent of your surgery you may stay in hospital overnight. You will not be able to drive so please arrange for someone to drive you home. You will be very tired and you may need help with daily activities at first. You should avoid heavy lifting, bending, twisting and sitting for long periods until your followup visit with your surgeon. In addition you should not drive until your followup visit.

You stitches will need to be removed 10-14 days following surgery.

Be sure a discuss your return to work with your surgeon.

If you have any questions or concerns about your restrictions be sure and ask a member of the Healthcare Team or the Physiotherapist.

Most people make a good recovery and return to normal activities following lumbar discectomy. As with any surgery there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
• Difficulty passing urine
  

Specific complications of lumbar discectomy:

• Continued pain or numbness down your leg
• Numbness between your legs, loss of normal bowel and bladder control and, in men, problems with having an erection
• Tear of the thin membrane that covers the nerves in your spine
• Infection of the intervertebral disc

Why not print this treatment page so you can discuss any concerns you have with your surgeon?