When Back Pain Gets You Out of Step 


Your spine has 24 vertebrae, or bones, that are each cushioned by disks. About one-third of the spine is made up of intervertebral disks that compose the largest organ in the body without its own blood supply. These disks have a tough outer ring of tissue that surrounds a soft, jelly-like center. They are flat, round structures about one-fourth to three-fourths of an inch thick. Disks are held in place by ligaments and act like shock absorbers for the spine.

Disks can become thinner and more prone to problems through repetitive movement, injury or poor posture. When a disk herniates, or moves out of place, surgery may be necessary to relieve the resulting pain on the spinal column caused by the soft, inner gel pushing through the wall of the disk. This procedure is called a diskectomy.

Not everyone who has a herniated disk needs surgery. Approximately 90 percent of patients with this condition can be treated more conservatively through medication and physical therapy. But for the remaining 10 percent, diskectomy may be recommended:

  • When other forms of treatment fail to improve symptoms after six weeks
  • If a disk fragment lodges in the spinal column and presses on a nerve
  • You have difficulty standing or walking
  • If you have pain that radiates into your buttocks or legs

Diskectomy is usually performed in the hospital under general anesthesia. After the surgeon makes an incision a little longer than one inch over the herniated disk, muscles and tissue are moved aside to expose the spine. A small part of the bone that surrounds the spinal column and nerves, called the lamina, is removed to access the herniated disk. This part of the surgery is called a laminectomy or laminotomy.

Small instruments are then used to cut a small hole into the disk that is causing the problems to remove material from inside as well as any pieces that may have broken loose. This relieves pressure, and most of the disk remains intact. The procedure lasts approximately one hour depending on the extent of disk herniation, patient size and other factors. The incision is then closed using stitches or staples, and the patient typically spends one night in the hospital before going home to recuperate.

“Most patients experience a reduction in herniated disk symptoms following surgery. Exercise and other activities should be resumed gradually,” stated Al Geissele, MD, FACS, spine surgeon at Frye. Walking is the recommended form of physical activity for the first several weeks, followed by bicycling and swimming about two weeks after surgery. You could be allowed to return to work in two to four weeks if you work in an office. Physically demanding jobs that require lifting or operating machinery that vibrates may require a four to eight week recovery period.

 “While diskectomy can relieve symptoms, it will not stop the process that caused a herniated disk in the first place. To prevent re-injury, try to limit activities that require considerable or repetitive bending, as well as twisting and lifting,” added Dr. Geissele.

For more information about spinal diskectomy, talk with your doctor or call 1-828-315-3391 for a free referral to a spine surgeon near you.