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When a nerve in the back or neck is irritated, the structure irritating the nerve has to be removed. This is often the case when a spinal disc herniates and pinches the neighboring nerve. This is how a lumbar discectomy is performed: A small incision is made directly over the herniated disc (using an x-ray during surgery helps to localize the disc and make a smaller skin incision). Next, the muscles are gently retracted to allow removal of a small ligament and sometimes a sliver of bone. This gives me the ability to visualized the pinched nerve and herniated disc that is pinching the nerve. The herniated piece of the disc is removed, leaving a majority of the disc (which you need for stability and shock absorption). When the nerve is free, it looks less inflamed and is mobile and happy.
Patients usually feel pain relief immediately after surgery and go home the same day!
Another common decompressive surgery is called a laminectomy. The name comes from two words: lamina (a small piece of each spinal bone) and ectomy (which means removal). During the procedure, the lamina will be removed, relieving the pinched nerve. The small ligaments connecting the lamina will also be removed because it contributes to the compression. The procedure is performed by making an incision on the back over the compressed nerves. After the muscles are gently retracted, the lamina is shaved down and the remains ligament is gently removed, freeing the nerve and giving it room to “breath.”
Patients usually appreciate leg pain relief during their first time standing and walking!