The spinal cord is a linear arrangement of many small bones known as vertebrae. These vertebrae consist of spaces between them known as intervertebral spaces. They are filled with cartilaginous structures that provide a cushioning effect to the vertebrae and support the movement of the spine. These cartilaginous structures are called Intervertebral discs.

Any pathology of the intervertebral discs such as disc herniation (slipping of the disc from between the vertebrae), ruptured disc, or degenerative disc disease may cause severe back pain due to nerve impingement, indicating the need for either partial or total disc replacement. In partial disc replacement surgery, only a portion of the cartilaginous disc is replaced by the artificial disc, while the total disc is replaced in the total disc replacement surgery.

Cervical disc degeneration and disc rupture may cause chronic neck pain radiating towards the arm.  Thoracic disc degeneration may cause chronic upper/ mid back pain while lumbar disc degeneration may cause chronic lower back pain.

Conditions that indicate the need for a disc replacement surgery:

• Discitis (Inflammation of the intervertebral disc)
• Scoliosis (abnormal spinal curve laterally)
• Herniated disc in back (slipping of the cartilaginous disc into surrounding tissue)
• Disc degeneration and disc rupture (infection of the intervertebral disc causing its degeneration.

Laminectomy is also known as decompression surgery. In this surgical procedure, a part of the vertebral bone called lamina is removed to create additional space. The lamina is the back part of the vertebrae that covers the spinal canal. Removing the lamina enlarges the spinal canal and thus, helps relieve pressure on the nerves and the spinal cord. Bony growths, especially in people with spinal arthritis, may put an additional pressure on the spinal cord. It may cause severe back pain and in some severe cases, can even cause paralysis. Narrowing of the space between the vertebrae is also known as spinal stenosis.

Laminectomy surgery, which is a form of spinal stenosis treatment, helps relieve pressure on the spinal cord and the nerves by creating a room between the vertebrae and the cord. When the pressure on the spinal cord in the case of lumbar spinal stenosis is relieved by creating a space between the lumbar vertebrae, the procedure is known as lumbar laminectomy. During a lumbar laminectomy, the surgeon may even remove the ligaments or bone spurs pressing the spinal cord.

Microdiscectomy is also known as microdecompression or cervical microdiscectomy. It is one of the most commonly performed spine surgery procedures.

Microdiscectomy or cervical microdiscectomy is preferred for patients with a lumbar herniated disc. The main goal of a discectomy is to relieve the pressure on a spinal nerve root by removing the material causing the pain. Traditionally, this purpose was solved by an open technique called lumbar discectomy surgery, which involves making a large incision to cut some of the back muscles, leading to a slow and painful recovery. Nowadays, an advanced form of surgery called microdiscectomy can achieve the same goal that too with the help of a small incision and fewer injury to back muscles. As a result, the recovery takes less time and is less painful.  A special microscope is used in microdiscectomy to view the disc and nerves. The larger view allows the surgeon to make a smaller incision, causing less damage to the surrounding tissues.

When is microdiscectomy needed?

Sciatica is a condition caused by compression of the spinal nerve, which generally results in chronic pain in the legs of the patients. This compression of the spinal nerve is frequently the result of a herniated lumbar disc.  As a herniagrows, the damaged tissue extends into the spinal column and pushes on the nerves. This condition causes the nerves to send pain signals to the brain and the brain interprets the pain source to be coming from the legs.

Most commonly, sciatica heals naturally or with the help of medication in a few weeks. But, if sciatica lasts more than 12 weeks after taking oral medicines, patients may benefit from discectomy. Discectomy is also used for the treatment of spondylosis and lumbar spinal stenosis. While spondylosis occurs due to degenerative osteoarthritis of the vertebrae, lumbar spinal stenosis occurs due to narrowing of the spinal canal leading to nerve compression. The latter may also warrant the need for a spinal stenosis surgery.

Spinal fusion surgery is a type of a spinal procedure used to join two or more bones permanently in the spine and to prevent movement between them. The bones that are joined are called as vertebrae. Spinal fusion surgery is performed along with other surgical procedures such as foraminotomy or laminectomy and after diskectomy in the neck. It is required if the patient has an injury or a fracture of the vertebrae. The spine will become weak due to an infection or tumors. Spinal fusion is also performed in abnormal curvatures that result from scoliosis or kyphosis.