What Is a Discectomy?

• In simple terms: A standard discectomy is performed through a larger incision in the back, giving the surgeon direct access to the herniated disc and nerves.
  
  

• Scientifically: Standard open discectomy involves posterior midline incision, muscle detachment, laminectomy or laminotomy, and direct removal of herniated nucleus pulposus fragments. This approach provides wide exposure for visualization and decompression.
  
  

Conditions Treated

• Large or complex herniated discs not suitable for MIS
  
  

• Radiculopathy from nerve root compression
  
  

• Spinal stenosis with significant bony overgrowth
  
  

• Sciatica due to severe disc herniation
  
  

• Failed prior MIS attempts or need for revision surgery
  
  

The Standard Discectomy Procedure: Step by Step

Plain-English Overview

1. Anesthesia & positioning: You’re asleep under general anesthesia, lying face down.
   
   

2. Incision: A midline incision (2–4 inches) is made over the affected level.
   
   

3. Muscle exposure: Back muscles are gently moved aside to expose the spine.
   
   

4. Bone removal: Part of the lamina is removed to access the disc and nerve.
   
   

5. Disc removal: The herniated disc material pressing on the nerve is removed.
   
   

6. Nerve decompression: The nerve is freed and confirmed to move normally.
   
   

7. Closure: The incision is closed; patients usually walk the next day.
   
   

Surgeon-Level Detail

• Exposure: Posterior midline incision; paraspinal muscles dissected subperiosteally to expose lamina and facets.
  
  

• Bony access: Hemilaminectomy or laminotomy performed; ligamentum flavum removed.
  
  

• Nerve root mobilization: Dural sac and traversing root exposed and gently retracted.
  
  

• Discectomy: Annulotomy performed; herniated nucleus pulposus fragments excised with pituitaries; annular defect inspected.
  
  

• Final check: Ensure nerve root pulsation and decompression.
  
  

• Closure: Layered closure with drains if needed; sterile dressing.
  
  

Benefits

• Direct, wide exposure for complex or large herniations
  
  

• Allows thorough decompression under direct vision
  
  

• Reliable outcomes for nerve-related pain
  
  

• Preferred in certain revision or complex cases
  
  

Risks & Limitations

• Larger incision = more muscle disruption compared to MIS
  
  

• Longer recovery time
  
  

• Blood loss, infection, dural tear/CSF leak, or nerve injury (rare)
  
  

• Risk of recurrent disc herniation (similar to MIS techniques)
  
  

• Less cosmetic compared to minimally invasive methods
  
  

Recovery Timeline

• Hospital stay: 1–2 days
  
  

• Weeks 1–2: Wound healing; walking encouraged
  
  

• Weeks 2–6: Gradual return to light work and activities
  
  

• 6–12 weeks: Structured PT; increased activity allowed
  
  

• 3–6 months: Most patients resume full activity; nerve healing continues
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon: Dr. Greenwald is skilled in both traditional and minimally invasive approaches
  
  

• Tailored care: We choose standard discectomy only when MIS isn’t the best option
  
  

• Comprehensive support: From diagnostics to rehab, all under one roof
  
  

• Conservative-first philosophy: Surgery only when it’s truly needed
  
  

Frequently Asked Questions

Why would I need a standard discectomy instead of a microdiscectomy?

Standard discectomy provides wider exposure, which may be necessary for large herniations, severe stenosis, or revision cases.

Is recovery longer than minimally invasive surgery?

Yes. Incision size and muscle disruption are greater, so recovery usually takes longer.

Will I still get pain relief?

Yes. Nerve pain often improves quickly, but recovery may be slower compared to MIS.

Can the disc herniate again?

Yes, recurrence is possible with any discectomy. If instability develops, fusion may be recommended.

How does Desert Spine and Pain perform standard discectomy differently?

We use meticulous technique, neurosurgical precision, and thorough aftercare to maximize safety and outcomes.