Discectomy

synonyms: microdiskectomy, microendoscopic diskectomy

CPT

• 22224 (anterior discectomy)
• 63030 (minilam / discectomy)
• 63055 (far lateral discectomy)

Anatomy

Indications

• Progressive neurologic deficit
• Cauda equina syndrome
• Unresolved pain

Contraindications

Alternatives

Planning / Special Considerations

Technique

• Sign operative site.
• Pre-operative antibiotics, +/- regional block.
• General endotracheal anesthesia
• position. All bony prominences well padded.
• Examination under anesthesia.
• Prep and drape in standard sterile fashion.
• Irrigate.
• Close in layers.

Complications

• Recurrent Herniation: 5%-10%

Follow-up care

• Post-op:
• 7-10 Days:
• 6 Weeks:
• 3 Months:
• 6 Months:
• 1Yr:
• Generally may return to activty at 6-12 weeks.

Outcomes

• (Weber H, Spine 1983;8:131),
• (Weinstein JN, JAMA 2006;296:2441),
• (Atlas SJ, Spine 2005;30:927)

Review References

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