What is disc surgery? The answer to this question is best approached by first discussing what an intervertebral disc is, and then describing what can happen to a disc that would prompt a doctor to recommend surgical treatment.
Intervertebral discs are round cushions that are made up of mostly water, protein, and cartilage. These discs are sandwiched in between the bony vertebrae of the spine. Each disc is like a spongy pad that allows the hard vertebrae in the spine to move comfortably as you walk, bend, sit, and perform other tasks throughout the day.
Discs, however, are not indestructible. An intervertebral disc can be injured or damaged in a number of ways such as during a car accident, while you exercise, or when you bend down to lift a heavy box. Discs also can experience gradual, age-related damage which can limit the disc’s ability to bounce back from normal activities.
Eventually (or sometimes suddenly), a disc’s tough, thick outer wall can break down. Instead of remaining firmly in place between the vertebrae, a disc will flatten and press out of its normal position. This is often referred to as a bulging disc. A disc’s outer wall also can break open, allowing the jelly-like, inner core material to seep out. This is known as a herniated disc.
If bulging disc or herniated disc material presses upon, or “pinches,” nerves in the spinal column, it can cause extreme pain and weakness. In many cases, discs can heal over time and the symptoms will subside. For a small percentage of people, however, damaged discs do not heal and disc surgery becomes the next logical step.
There are several approaches to disc surgery. For instance, a surgeon may propose that an entire disc or discs be removed. Then, to compensate for missing discs, a surgeon may recommend spinal fusion, which means the vertebrae are permanently joined with hardware and bone grafts. Another approach is artificial disc surgery or artificial disc replacement (ADR), during which a surgeon implants a prosthetic disc where the damaged disc used to be. And finally, a surgeon may be able to remove only the disc material that is impinging on a nerve (sometimes called micro disc surgery). This releases the nerve from painful pressure and also allows the spine to stay intact, eliminating the need for fusion or disc replacement surgery.
A successful disc surgery is easier than ever before thanks to advancements in laser technology. Historically, an individual suffering from a herniated disc or other disc disorder was faced with the prospect of open back surgery, hospitalization, and a lengthy rehabilitation. Now, with the emerging field of endoscopic orthopedic spine procedures, disc surgery can be minimally invasive and is regularly performed as an outpatient procedure with exceptional results.