Discectomy

Small or ultra-small endoscopic discectomy (called Nano Endoscopic Discectomy) does not have internal cutting or bone removal and, due to the small size, is not called "open". These procedures do not cause post-laminectomy syndrome (failed back syndrome). ==Microdiscectomy==

Microdiscectomy is a spine operation with a smaller incision than traditional discectomy, in which a portion of a herniated nucleus pulposus is removed by way of a surgical instrument, while using an external operating microscope for lighting and magnification. They may be "open", i.e., with a larger incision, or minimally invasive, i.e., with a 1.5 to 2.0 cm surgical incision. Indications Microdiscectomy may be a surgical option for patients with a single-level disc herniation and evidence of nerve root compression with residual unremitting radicular symptoms after failed conservative treatment. Cauda equina syndrome and progressive or new motor deficits are among the urgent surgical indications for microdiscectomy. Contraindications Contraindications include additional pathologies, including infection, tumor, or segmental instability or vertebral fracture where fusion or instrumentation may be required. However, segmental instability and spondylolisthesis may be considered relative contraindications by some physicians. == Discectomy for athletes ==

Degeneration caused by years of repetitive mechanical stress can cause the disc of an athlete to be herniated. Lumbar disc herniation (LDH) is a critical injury for elite athletes that could cause extreme pain and significantly hinder performance. To relieve the pain, athletes usually go through microdiscectomy. However, the results of treatments in elite athletes differ due to the demand for optimal treatment, short recovery period, and high performance after the operation. Most athletes return to their pre-surgery level after a discectomy. A systematic review of 450 athletes shows that 75–100% of athletes return to play after surgery. The average recovery period ranged from 2.8 to 8.7 months. Athletes recovered an average of 64.4% to 103.6% of their preoperative performance and had reported career longevity of 2.6 to 4.8 years post-return. The removal of disc material due to discectomy meant that Woods eventually had to go through spinal fusion to recover. ==In the US==

In the U.S., it has been estimated that the Medicare system spends over $300 million annually on lumbar discectomies. ==See also==