Complications after discectomy

What Is a Discectomy?

A discectomy, also known as a microdiscectomy, is a surgical procedure in which the surgeon performs decompression of the spinal nerve. To reach the herniated disc, the surgeon firstly performs a laminectomy. The procedure requires a microscope. The microscope helps the surgeon with the visualization of the operating field and it makes the operation easier. In general, a discectomy is performed under general anesthesia.

Discectomy is performed in patients in which a herniated disc has led to new loss of bladder or bowel control, weakness in the lower extremities (legs), or numbness or tingling sensations in the area of the buttocks and genital area. Furthermore, candidates for this surgical procedure include patients with a history of persistent pain in their legs and chronic weakness of the leg muscles, especially if these symptoms do not withdraw within 4 weeks after the initial treatment.

Complications of Discectomy

Fortunately, only one in 10 patients who has been operated on and who has undergone a discectomy develops complications.

One of the most serious complications is certainly the recurrence of the disc protrusion that required the procedure in the first place. It usually occurs within three months after the surgery. A recurrent protrusion is caused by remnant parts of the disc which have not been removed during the first surgery.

Nerve scarring is another possible complication of a discectomy procedure. Namely, scars regularly form after this surgery due to the process of healing. The scar usually does not cause any trouble. Only if the scar is huge can it potentially compress the nerve and limit its movements. In many patients this leads to painful sensations. The surgeon can successfully prevent this complication if he or she controls the bleeding during the surgery.

Pain in the back occurs due to cutting of the numerous structures including the skin, muscles and disc. The pain will eventually go away on its own in most cases, and only if it persists for a longer period of time should another surgery called a spinal fusion be performed in order to definitely reduce and eliminate back pain.

Nerve damage is a consequence of bruising and stretching. In some cases the nerve can restore its function. However, if the nerve is severed or damaged, its function is lost for good.

Paralysis is definitely the most severe complication of this type of surgery. In some cases, the exact cause of postoperative paralysis cannot be established. Still the most common cause of paralysis is epidural hematoma. By controlling the bleeding, the surgeon can prevent this terrible complication. To prevent permanent damage, hematoma must be urgently evacuated. The very hematoma can be one of the possible complications of discectomy.

Infection occurs in rather rare cases since the patients who undergo a discectomy prophylactically take certain antibiotics. The risk of infection is higher if a hematoma has developed. If the infection occurs in the disc, this condition is called discitis. Discitis can consequently lead to an epidural abscess. Such an abscess may compress the nerve and to prevent further damage of the nerve the surgeon has to perform urgent decompression.

A dural tear can occur if the dura is accidentally torn during the discectomy procedure. The spinal fluid may leak through the opening and the patients complaint about severe headaches. The tear most commonly heals on its own. If it does not heal spontaneously the doctors will treat it surgically.

And finally, there is a chance of clot formation in veins of the legs. The clots can detach and be transferred into the lungs which results in pulmonary embolism. This complication most commonly affects people who are already suffering from problems with coagulation.

Overall, this is a routine operation that has a very low rate of complications, especially when performed by a competent and experienced surgeon — and these surgeries are only performed in cases where the benefits outweigh the risks.