Four Different Spinal Surgery Approaches For Herniated Discs
Herniated discs can cause debilitating pain, and while they sometimes heal with physical therapy and conservative treatments, it's common for them to require surgical repair. People often wonder how, exactly, their spinal surgeon will fix a herniated disc. The short answer is "it depends." The longer answer is that there are four different approaches they could take, as detailed below.
Laminectomy
If the primary effect of your herniated disc has been to narrow the spinal column, placing pressure on nerves, then your surgeon may recommend a laminectomy. An incision is made in the back, and all or part of the lamina — the bone that forms the arch of the vertebra — will be removed. With the lamina out of the way, there will be more space between the spinal cord and disc, so that the pressure will be alleviated, and your symptoms should subside.
Discectomy
This is the most common surgical procedure used to treat herniated discs. The herniated part of the disc is removed through an incision in the back. Sometimes this procedure is performed in conjunction with a laminectomy, depending on which structures, in particular, are pressing on your spinal nerves.
Disc Replacement
If your disc is badly herniated, or if you have re-herniated the same disc several times, then your surgeon may simply want to remove and replace that whole disc. This is a more invasive medical procedure than a laminectomy or discectomy, so it is only done when your surgeon is confident these other measures won't work. An incision will be made in your abdomen, and your organs will be temporarily moved out of the way so your surgeon can access your spine. The injured disc will be removed, and an artificial disc, made mostly from plastic and silicone, will be inserted in its place.
Fusion
Another option, and one that works well for badly herniated discs, is spinal fusion. In this case, your surgeon will simply fuse the two vertebrae on either side of the injured disc together, using bone from a cadaver. This will immobilize that joint in your spine, but in doing so, it will alleviate your pain. Fusion is a more straightforward procedure than disc replacement, which is why it is sometimes preferred even though it limits mobility.
If your doctor is recommending spinal surgery to fix a herniated disc, make sure you ask them to clarify which procedure they think is best. Each of these procedures has its benefits and drawbacks, which your doctor can discuss with you in more detail.
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