What is Lumbar Discectomy

Lumbar Discectomy is a surgery to treat a damaged disk in the lower back. Disks are oval-shaped layers of connective tissue (cartilage) between the bones in the spinal column (vertebrae).

Disks prevent the vertebrae from rubbing together. A disk can tear and bulge outward (become herniated). This puts pressure on nerves that are near the spine and may cause pain, numbness, weakness, or other symptoms.

You may need this surgery if your symptoms are severe, get worse, or have not been helped by other treatments. In this procedure, a surgeon will remove the part of the disk that is causing problems.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reactions to medicines.
• Damage to other structures or organs, such as nerves or the spinal cord. The damage may cause:
  • Loss of bladder or bowel control (incontinence).
  • Worsening pain.
  • Numbness and weakness in your lower body.
• Failure to relieve your symptoms.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given antibiotic medicine to help prevent an infection.

General instructions

• You may have an imaging study of your spine, such as an MRI or CT scan, to help plan the procedure.
• Do not drink alcohol.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• You will be positioned face-down on the operating table.
• Your surgeon will make an incision over your spine.
• Your surgeon may move muscles and nerves so the injured disk can be seen easily.
• Your surgeon may need to remove some connective tissue (ligaments) or pieces of bone to get to your disk.
• Your surgeon will remove the part of the disk that is causing problems.
• The muscles and nerves will be put back in their normal position.
• The incision will be closed with stitches (sutures) or staples.
• A bandage (dressing) will be placed over the incision.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Your IV may be removed when you are able to drink fluids on your own.
• You will be encouraged to get up and walk around as soon as you can.
• You may meet with a physical therapist to talk about recovering at home.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• Lumbar diskectomy is a surgery to treat a damaged disk in the lower back. You may need this procedure if you have pain, numbness, weakness, or other severe symptoms that have not been helped by other treatments.
• Generally, this is a safe procedure, but problems may occur, including damage to nerves or the spinal cord or failure to relieve your symptoms.
• Before the procedure, tell your health care provider about your complete medical history, including all medicines you are taking, any allergies to medicines, medical conditions, previous surgeries, and problems you have had with anesthetic medicines.
• Before the procedure, follow instructions from your health care provider about eating and drinking and about changing or stopping your regular medicines.
• Follow instructions from your health care provider about doing physical therapy after the procedure.

Lumbar Diskectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain in the lower back, in the area of the incision.
• Numbness in the legs or in the lower back.
• Weakness in the legs.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider. You may need to have someone change your dressing for you.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. If you cannot see your incision, have someone check it for you. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Keep the dressing dry until your health care provider says it can be removed.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Rest as told by your health care provider.
• Avoid sitting or lying for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Do not climb stairs more than one time each day until your health care provider approves.
• Do not bend or twist at the waist until your health care provider approves. To lower yourself to pick things up, bend your knees instead of tipping your upper body forward.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe. Avoid lifting anything above the level of your head.
• Avoid pushing and pulling motions.
• Ask your health care provider or physical therapist what kinds of exercises you can do to help with healing. Do these exercises only as directed.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.

Driving

• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• If you have a back brace, wear it as told by your health care provider. Remove it only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• Your pain is not controlled with medicine.
• You have pain, numbness, or weakness that lasts longer than 3 weeks after surgery.
• You become constipated.
• You have more redness, swelling, or pain in your incision area.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.

Get help right away if:

• You have increasing pain, numbness, or weakness.
• You lose control of when you urinate or have a bowel movement (incontinence).
• You have chest pain.
• You have trouble breathing.
• You have swelling in your legs.
• You have confusion or are difficult to wake up.

Summary

• After a lumbar diskectomy, it is common to have pain in the lower back and numbness or weakness in the legs. These should improve in a short amount of time.
• Be sure to check your incision every day for signs of infection. Change dressings and bathe as told by your health care provider.
• Return to your normal activities as told by your health care provider and physical therapist. Avoid twisting, bending, or lifting until your health care provider approves.
• Make sure you know which symptoms should cause you to contact your health care provider or to get help right away.