The lumbar disc is the cushioning tissue between each spinal segment. When an abnormal pressure is placed on the disc, the jelly-like center can push the outer edges into contact with a spinal nerve and cause pain. Most back pain resolves with conservative treatment, given enough time. In some instances, when conservative measures fail to reduce symptoms, lumbar disc surgery may be indicated.
Microdiskectomy
According to the American Academy of Orthopaedic Surgeons, surgery may be necessary if a fragment of the lumbar disc presses against a nerve, resulting in pain or loss of function. During a microdiskectomy, very small incisions are made and microscopic instruments are used to cut away the impinging portion of the disc. Surgeons try to preserve as much of the disc as possible to retain the integrity of the spinal anatomy. Microdiskectomy is often performed on an outpatient basis, and no hospital stay is required. Physical therapy is generally prescribed for four to six weeks; you can usually return to work during that time.
Laminectomy
The lamina make up part of the bony structure of the spine. In some cases it's necessary to not only remove part of the disc, but also part of the lamina, in order to create sufficient room for the spinal nerve. A laminectomy may be performed microscopically or through an open incision. You may be able to go home the same day following the surgery, or in some cases, stay in the hospital for two days. Following a laminectomy, you undergo physical therapy for six weeks and are instructed to avoid bending and prolonged sitting. According to the Mayo Clinic, it can take up to six weeks to feel a reduction in symptoms.
Lumbar Fusion
In more extreme cases, if there is continued re-injury to the disc, a lumbar spinal fusion is performed to stabilized and limit the movement of the involved area. Fusion surgery is performed through an open incision, and the fusing material can be a section of bone removed from your hip. Fusion surgery renders the involved segment immobile, although you won't notice this loss of motion during activities of daily living. Rehabilitation following lumbar fusion generally includes physical therapy and lifestyle modifications for up to three months. Most patients return to work six to eight weeks following surgery.
