Southern DHB Neurosurgery Service
Public Service, Neurosurgery
Between the vertebrae in your spine are flat, round discs that act as shock absorbers for the spinal bones. Sometimes some of the gel-like substance in the center of the disc (nucleus) bulges out through the tough outer ring (annulus) and into the spinal canal. This is known as a herniated or ruptured disc and the pressure it puts on the spinal nerves often causes symptoms such as pain, numbness and tingling.
Initial treatment for a herniated disc may involve low level activity, nonsteroidal anti-inflammatory medication and physiotherapy. If these approaches fail to reduce or remove the pain, surgical treatment may be considered.
This surgery is performed to remove part or all of a herniated intervertebral disc.
Open discectomy – involves making an incision (cut) over the vertebra and stripping back the muscles to expose the herniated disc. The entire disc, or parts of it are removed, thus relieving pressure on the spinal nerves.
Microdiscectomy – this is a ‘minimally invasive’ surgical technique, meaning it requires smaller incisions and no muscle stripping is required. Tiny, specialised instruments are used to remove the disc or disc fragments.
Laminectomy or Laminotomy
These procedures involve making an incision down the centre of the back and removing some or all of the bony arch (lamina) of a vertebra.
In a laminectomy, all or most of the lamina is surgically removed while a laminotomy involves partial removal of the lamina.
By making more room in the spinal canal, these procedures reduce pressure on the spinal nerves. They also give the surgeon better access to the disc and other parts of the spine if further procedures e.g. discectomy, spinal fusion, are required.
In this procedure, individual vertebrae are fused together so that no movement can occur between the vertebrae and hence pain is reduced. Spinal fusion may be required for disc herniation in the cervical region of the spine as well as for some cases of vertebral fracture and to prevent pain-inducing movements.