RANDALL F. DRYER, M.D.
TOP RATED U.S. SPINE SURGEON
Frequently Asked Questions
What is a lumbar discectomy for?
This procedure is normally recommended to resolve low back and leg pain resulting from a herniated disc.
A herniated disc may be referred to as one of the following by a variety of medical practitioners and/or laypersons:
- Pinched Nerve or Sciatica
- Ruptured Disc or Bulging (extruded) Disc
- Slipped Disc or Disc Disease
- Protruding Disc or Degenerative Disc Disease (DDD)
What diagnostic tools are used to decide whether I need a lumbar discectomy?
At Central Texas Spine Institute, your initial appointment will include a review of your patient history, we will perform a physical exam, and we will confirm our diagnosis by way of x-rays, Magnetic Resonance Image (MRI) or CT Scan
Are there any alternative treatments available?
As part of your diagnostic exam, we will discuss potential alternatives to a lumbar discectomy. Alternatives may include: Medications
continuing to live with the condition, physical therapy (exercises and stretching), chiropractic manipulation, epidural steroid injections (ESIs), the use of a TENS Unit
What is a lumbar discectomy?
The primary purpose of this procedure is to surgically remove a part of the disc that is pushing on the nerve and thus, causing the pain. The goal is to take pressure off the nerve but still retain as much of the disc as possible. The entire disc is not removed, only the herniated fragment.
You can view an animated video of a lumbar discectomy on our Orthopedic Surgery Animations page. The video provides further explanation of the procedure and its purpose.
Who will be involved in the procedure?
Surgeon – The orthopedic spine surgeon that you have been seeing in our office will be the primary surgeon in charge of your surgery.
Assistant Surgeon – Another orthopedic spine surgeon, usually from our office, will assist your surgeon with the procedure. This is done to minimize the length of time you are under general anesthesia and to provide the necessary assistance with the actual surgical procedure.
Anesthesiologist – The doctor who actually administers and monitors the anesthesia is a critical part of the surgical team. You will normally meet with the Anesthesiologist during your Pre-Op appointment at the hospital.
How long will the surgery take?
A typical lumbar discectomy takes approximately 1 hour.
What will my hospital stay be like?
With most spinal surgeries, patients are up and walking within hours after their procedure, although the walking is very limited. It is no longer necessary, or recommended, that you lie in bed for days or weeks after spine surgery. Nurses who are experienced in working with spinal surgery patients will assist you during your first few efforts at getting out of bed and walking.
Your doctor will tell you when it is safe to shower, usually 1-2 days after surgery. The nursing staff will show you how to keep the dressing dry and in place to protect the incision while showering. While you heal, soaking in a bathtub is not allowed. The wound should not be submerged in water (pool or tub) until it has healed and has been cleared by your doctor. The nurse will change the dressing after your shower, and again later if necessary.
What do I need to do to care for my incision?
You will be given directions on caring for your incision after the surgery. Your surgical incision will be checked during your first Post Op appointment. However, should your incision become red and tender or if drainage occurs prior to your first scheduled Post Op visit, you should contact our office for further instruction.
How soon after my surgery can I eat?
Liquids are allowed right after surgery. Solid foods are allowed shortly thereafter, as tolerated. Your doctor will give you specific instructions before and after your surgery.
How much pain should I expect and how is it treated?
Your doctor’s goal is to keep you as comfortable as possible. Almost all strong pain medications are narcotics that tend to make you sleepy and can depress your breathing. We must balance the side effects of these medications with our goal to relieve pain. In the hospital, patient controlled (IV) medications are given the first day. We will then switch you to oral medications. You will have pain pills for home use, once you leave the hospital. We continue home medications as needed, with the goal of weaning them as you recover.
It is important to tell your doctor of any allergies to medicines and all medications you are currently taking. Only use pain medications as directed, as mixing medications can be dangerous.
At Central Texas Spine Institute, we do not refill pain medications after hours or on weekends. You must ask ahead 1-2 days ahead of time if you are going to run out of pain pills. Refills of medications are at your doctor’s discretion.
How soon will I be back to my regular routine?
During the rehabilitation process, it is important to recondition the muscles with exercise, stretching, and aerobic conditioning. Your doctor will give more specific instructions during the course of your post-operative care during your office visits. Early return to normal activities is encouraged with three exceptions: Heavy lifting, bending from the waist and prolonged sitting are discouraged for the first 6 weeks after surgery. Driving is not allowed until after your first post-op visit (usually 1 – 2 weeks). Most patients are able to go up and down stairs when they go home from the hospital, though. Some patients may require additional assistance.
How soon will I be able to return to work?
The timeframe for returning to work will be determined for each patient individually and will be based on several factors. The doctor’s goal is to help you return to work as soon as you can do so safely. If you have a light or sedentary job or if light duty restrictions are available for your position, then return to work could occur in 10-14 days. If you are able to work from home by phone, fax, and computer, very early work may be realistic. If your job includes very heavy and strenuous physical labor, return to work can take several months. Other factors that play a role in return include your overall physical condition, tolerance of pain, and need for additional therapy.
Even the best results of surgery do not mean that you will necessarily be able to return to your prior type of job, depending on how strenuous it is. Some patients are advised to go through job re-education or find a lighter job for future back safety.
The risks and potential complications of this procedure include:
- Continued Pain
- Loss of Sexual Function
- Need for further surgery (The disc can re-rupture or go on to degenerate. The risk of re-rupture is less than 5%).
No guarantees can be made as to the success of this procedure.
Dr. Dyer is a trusted orthopedic surgeon with decades of specialized experience. To learn more about Dr. Dyer and the rest of Central Texas Spine Institute’s trusted spinal care staff, click here. If you have a referral from your primary care physician because you may need a lumbar discectomy, request an appointment with us today!
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