Best Discectomy Clinics Abroad

What is a discectomy?

A discectomy is an operation during which a doctor removes part or all of an intervertebral disc. This surgical intervention is resorted to in case of ineffectiveness of conservative treatment and the presence of prolonged pain syndrome. In clinics abroad, operations to remove intervertebral discs are performed using a minimally invasive method. Thanks to the powerful microscope that the surgeon uses during the operation, there is less damage to the surrounding tissue, which affects the speed of rehabilitation. Microdiscectomy can be performed using an endoscope (through an opening about 1 cm in size) and through a classic small incision in the area of the damaged vertebra.

What are the indications and contraindications for surgery?

Discectomy is indicated for patients who suffer from herniated intervertebral discs. But surgical intervention is not recommended for all patients with a similar problem. Discectomy is prescribed for those who have undergone conservative treatment (anti-inflammatory drugs, physiotherapy, exercise) but have not received the desired effect and continue to feel pain, numbness, or muscle weakness. In addition, indications for surgery are:

• large hernia size;
• violation of urination;
• paralysis, paresis;
• spinal cord compression;
• a combination of hernia and stenosis of the spinal canal.

Contraindications to discectomy are a positive reaction to conservative treatment, a violation of the blood clotting process, pregnancy, inflammatory and infectious diseases in the active stage, heart or respiratory failure.

What types of surgery exist?

Abroad, the removal of intervertebral discs is performed using classical and minimally invasive methods. Lumbar discectomy can often be accompanied by other types of surgery:

• laminectomy - removal of a part of the bone to expand the spinal canal and eliminate compression of the spinal cord;
• laminotomy - removal of a part of the plate that infringes on the nerve root;
• foraminotomy - removal of a fragment of a disc or osteophyte (growth on bone tissue) that extend beyond the vertebrae, pinching the nerves;
• spinal fusion - the connection of several vertebrae to eliminate excessive mobility of the spine.
• Removal of a herniated disc of the cervical spine (anterior cervical discectomy) is often combined with laminectomy and foraminotomy.
• Microdiscectomy is a minimally invasive surgical procedure that is performed to eliminate compression of the nerve root in a herniated disc.
• The difference from open surgery is less trauma to the paravertebral tissues and faster recovery. For comparison, with a discectomy, the surgeon makes an incision of about 10 centimeters, and with a microdiscectomy, only 3 centimeters.
• The third method used in clinics abroad is endoscopic microdiscectomy.

Its difference from the classical operation is the use of an endoscope, which is inserted through an opening up to 1 cm in size and allows you to remove a hernia up to 0.6 mm in size and part of the intervertebral disc using microsurgical instruments. For example, in the case of intervertebral hernia of the thoracic region, the surgeon performs a transthoracic discectomy - this means that the instruments are inserted through punctures in the pleural cavity and the hernia is removed without classical tissue incisions.

Preparing for surgery

Before surgery, each patient undergoes a full examination, which includes a doctor's consultation, instrumental examination, tests (CT / MRI, echocardiography, blood and urine tests, etc.).

On the day of surgery, the patient is advised to stop eating eight hours before the surgery and stop drinking fluids two hours before the surgery. It is also imperative to warn doctors about what medications the patient is taking on an ongoing basis, to exclude drugs that affect blood clotting.

How is the discectomy done?

7 days before surgery, the patient must stop taking medications that affect blood clotting. Before the operation, itself, inform the medical staff about the medications that the patient takes systematically.

Classical Discectomy

Classical discectomy is performed in a hospital under general anesthesia. First, the surgeon makes an incision on the back in the region of the spine, displaces the muscle tissue to the side, opening access to the vertebrae of the cervical, thoracic or lumbar spine. Next, the surgeon removes the intervertebral disc and sutures the wound layer by layer.

If necessary, the discectomy is combined, for example, with a laminectomy, in which the doctor removes a fragment of the vertebral arch to reduce the compression of the spinal cord. In addition, during such an operation, the surgeon can reconstruct the disc with a graft. The surgical intervention lasts about two hours, and the next day after surgery, the patient spends in the supine position.

Microdiscectomy

Microdiscectomy differs from discectomy in that the incision of the case is found only in the area of the affected disc, and a special microscope and microsurgical instruments are used to remove it.

In terms of duration, this operation is not inferior to the classical method of removing intervertebral discs and is also performed under general anesthesia. With this method, most of the muscles and tissues are not affected, which reduces the patient's rehabilitation period.

Endoscopic method

The endoscopic method of removing intervertebral discs is to use a special endoscope, which allows the doctor to control the process. The procedure is performed under local anesthesia and lasts no more than 30 minutes. In the process, the surgeon makes a small puncture, where he places the endoscope and, using micro-instruments, removes the hernia. In the end, a suture is applied at the puncture site, and after a few days, the patient is discharged from the hospital.

Recovery after spinal surgery

Rehabilitation after lumbar, cervical, or thoracic discectomy requires strict adherence to the doctor's recommendations. The rehabilitation course is selected individually, taking into account the diagnosis and the type of surgery performed. In most cases, during the recovery period, the patient:

• in the first few weeks is not in a sitting position, does not do exercises where the spine is involved (for example, bends);
• wears an orthopedic corset or bandage (to distribute the load on the spine);
• makes therapeutic massage, goes to physiotherapy;
• is engaged in physiotherapy exercises (exercise therapy);
• avoids overwork and hypothermia;
• excludes lifting loads over 3-5 kg.

To avoid negative consequences after discectomy, all procedures are prescribed only under the supervision of a rehabilitation physician or physiotherapist, since rehabilitation is the key to the success of the surgical treatment of spinal problems.

Possible complications after discectomy

• relapse of the disease;
• bleeding due to vascular damage;
• the formation of scars and adhesions in the area of the removed disc;
• the formation of a hernia on the adjacent vertebra;
• chest pain while breathing;
• subcutaneous emphysema.

Where can I have the operation?

Surgical intervention on the spine is a rather complicated operation, so choosing a clinic should be approached responsibly. Each of the centers that you will see in the list below is equipped with quality equipment and has a staff of experienced specialists.

• Austria: Vienna Private Clinic, Rudolfinerhaus Clinics, Debling;
• Spain: Navarra Hospital, Quiron Clinics Barcelona and Torrevieja;
• Czech Republic: Motol Medical Center;
• Turkey: clinics Hisar, Koch, Liv;
• Israel: Assuta, Sheba, Ichilov hospitals;
• Germany: medical centers Rechts Der Isar, Vivantes, Helios;
• Korea: Severance Hospital, Anam Clinics, Samsung.

For a more individual selection of the clinic and the operating doctor, you can contact the ClinicsonCall coordinating doctor. The company's specialists will advise you on the treatment of intervertebral hernias abroad and organize a medical trip free of charge!