Those studying degenerative disc disease surgery are likely to be familiar with herniated discs or bulging discs and the painful symptoms they can cause. There is also a high probability that they have also already attempted a wide range of conservative treatment methods aimed at relieving symptoms. The conservative approach to treatment is symptomatic treatment. In other words, their goal is symptom suppression. The surgical approach to treatment is correction of the cause(s) of symptom creation. In other words, correction is used instead of suppression.
Surgery for degenerated discs is not aimed at stopping the degenerative process or repairing those discs that have already sustained damage. Rather, its goal is to relieve any neural compression that is being caused by a degenerative disc abnormality, such as a bulging disc or herniated disc. There are different surgical techniques that can decompress spinal nerves. They all involve different levels of invasiveness.
Comparing disc surgeries
Patients who choose to undergo surgery for neural compression related to a herniated or bulging disc will need to choose the type of procedure that will offer them the best possible outcome with the least possible risk and side-effects. You should always speak with several spine specialists about the risks and benefits associated with the different surgeries before making a decision.
In general, two types of degenerative disc procedures exist: an endoscopic discectomy and a discectomy with spinal fusion. An endoscopic discectomy is, by far, the less invasive of the two. Not all patients are good candidates for this type of minimally invasive surgical procedure. Characteristics of a minimally invasive approach include:
- Only a small incision is required (less than one inch in length)
- It is an outpatient procedure (no overnight hospitalization is necessary)
- Most patients recover to the point of leaving the surgery center within an hour or two of surgery
- The surgeon removes only the portion of the disc that is directly causing nerve compression
- A discectomy with spinal fusion involves several steps. First, one or more large incisions are created in various locations. Second, the underlying muscles, tendons, ligaments and investing fascia are severed and distracted while approaching the site of actual area to be fused. Third, intervertebral disc or discs are completely removed, including the periosteum (bone covering tissue) of the endplates of the vertebra to be fused. Fourth, bone fragments from the patient’s own body or another source are packed into the void once occupied by disc. Fifth, metallic hardware devices are affixed to the vertebra and connected or linked together to securely immobilize the vertebra being fused. Sixth, the major disrupted muscles, tendons, etc., are sutured back into approximately their original position. (Minor structures are ignored.) And seventh, the skin incisions are closed. Spinal fusion surgery requires hours to complete and involves many significant risks. After the surgery, the patient may look forward to a long (many months) and often difficult recovery period.
Taking the next step
To learn more about endoscopic degenerative disc disease surgery and to find out if you are a candidate, contact Laser Spine Institute. We successfully perform more minimally invasive spine procedures each month than any other spine surgery center in the world, and we may be able to help you.