Spinal Disc Excision Surgery in Türkiye

Spinal disc excision surgery is a surgical treatment for lower back pain associated with damage to the spinal discs.

What is Spinal Disc Excision Surgery?

The surgeon removes a portion of the disc to alleviate pressure on the adjacent nerves, reducing lower back pain and pain radiating down the legs (sciatica).

You should consider disc excision surgery only after trying non-surgical measures such as waiting for the disc to heal on its own, pain medications, back exercises, and physical therapy.

What is a Slipped Disc?

Spinal discs have a tough outer wall with a soft gel-like substance inside. Discs act as cushions and shock absorbers between the vertebrae. With age, they may bulge outwards like an uncovered car tire.

Sometimes the disc wall tears, allowing the soft gel-like material inside to protrude.

A slipped or herniated disc can compress bundles of nerves called nerve roots, which exit on the sides of each vertebra. This causes pain in the lower back as well as in one or both legs (sciatica) below the back of the thigh.

Symptoms of sciatica may include:

• Lower back pain
• Sharp or “electric shock” pain down the back of the leg
• Tingling in the foot
• Leg weakness

Disc excision can help alleviate sciatica and pain because during the procedure, a portion of the damaged or bulging disc is removed, relieving pressure on the nerves.

When Do You Need Spinal Disc Excision Surgery?

You may want to discuss surgery with your doctor if you have tried non-surgical treatments but still experience pain.

Despite following non-surgical treatments, lower back pain and sciatica can persist for months and become chronic. You may have difficulty walking or standing, performing normal daily activities, or going to work.

Some non-surgical methods your doctor may recommend before surgery include:

• Wait. For a new case of disc-related back pain, most people improve within a few weeks.
• Use over-the-counter pain relievers.
• Apply heat or cold packs to alleviate discomfort.
• Try physical therapy.
• Enroll in a comprehensive rehabilitation program available in the Turkish healthcare network.
• Try complementary and alternative treatments such as spinal manipulation (chiropractic treatment), massage therapy, acupuncture, or stress-relieving techniques.

How is Spinal Disc Excision Surgery Performed?

Most disc excision surgeries take about an hour and require general anesthesia, meaning you will be unconscious. During the surgery, you will lie on an operating table. There are different types of disc excision surgeries that can be performed by surgeons.

Standard or “open” Disc Excision:

During this type of surgery, the surgeon makes an incision to provide a clear view of the disc. Surgical tools are then used to remove a portion of the disc.

Open discectomy often involves a procedure called a laminectomy to remove part of the outer arch (lamina) of the vertebra. This can help relieve pressure on the nerves.

Microdiscectomy:

This is a minimally invasive version of disc excision and is the preferred technique for most surgeons. During microdiscectomy, the surgeon makes a small incision in your back and inserts instruments with video monitoring to visualize the disc. The surgeon also removes a small portion of the lamina to gain access to the disc. This is called a laminotomy.

After monitoring the disc, the surgeon removes a portion of the disc, similar to standard disc excision. The difference is that with microdiscectomy, they can work with a smaller incision.

Disc excision via endoscopy:

In endoscopic disc excision or “through the skin” disc excision, the surgeon makes a small incision. They then use a special X-ray imaging device called a fluoroscope to guide a thin tube through the incision to the herniated disc. The surgeon then inserts special tools through the tube to remove the disc material, relieving pressure on the adjacent nerves.

Different techniques are used to perform disc excision through the skin. These include removing disc material using laser instead of surgical tools, injecting a chemical substance to dissolve the disc material, or treating the inner part of the disc with heat or radio waves to shrink it.

Recovery from Spinal Disc Excision Surgery

After waking up from anesthesia, you will spend an hour or two in the recovery room. Many people are able to return home on the same day. You will need someone to drive you home.

Before returning home, make sure to receive instructions on how to keep the surgical incision clean. You will take antibiotics as a preventive measure against infection. The incision will be tender for several days, and fluid may leak from it.

If you notice any signs of infection at the incision site, contact the surgeon and seek immediate medical care. “Red flag” signs of infection include:

• Fever
• Swelling
• Redness
• Pain
• Warmth around the incision

The time it takes to return to your normal activities, including work, can range from two weeks to six weeks. During this time, the surgeon may advise you to avoid heavy lifting, bending, or sitting for prolonged periods. These activities put pressure on the spine.

Regular exercise can help prevent the recurrence of lower back pain and disc problems. If you are overweight, weight loss may also help. Consult your doctor or a physical therapist before starting an exercise program for back pain.

Risks of Lumbar Disc Surgery

Lumbar disc surgery is generally considered safe, but like any surgical procedure, there are risks of complications. Some of these risks include:

• Bleeding or blood clots
• Infection
• Cerebrospinal fluid leak
• Injury to blood vessels or spinal nerves
• Injury to the protective layer surrounding the spinal column

How Effective is Lumbar Disc Surgery?

Lumbar disc surgery can reduce pain and disability in the short term compared to non-surgical treatment. However, it does not guarantee the absence of symptoms in the future.

There is no definitive evidence that minimally invasive disc surgery is more effective or safer than open disc surgery, or vice versa. Minimally invasive disc surgery may potentially reduce complications and shorten the recovery time due to its smaller incision.

General Tips on Lumbar Disc Surgery

Lumbar disc surgery is a common procedure for individuals suffering from chronic back pain caused by aging or spinal injury.

Experts recommend trying non-surgical treatments first before considering surgery. Your doctor may suggest immediate surgery if you have symptoms of nerve damage such as tingling, burning, or “pins and needles” sensation, and loss of touch sensitivity.

Engaging in regular exercise to strengthen the muscles and support the spinal column can help prevent the recurrence of painful disc protrusions in the future.

Artificial disc replacements may someday offer an alternative to disc excision. Disc implants have been approved by the U.S. Food and Drug Administration as an alternative to spinal fusion.

Spinal Disc Excision Surgery in Türkiye

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