Discectomy


Related Terms

  • Excision of Intervertebral Disc

Specialists

  • Neurologist
  • Neurosurgeon
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist
  • Physical Therapist

Comorbid Conditions

  • Alcohol abuse
  • Degenerative spine conditions (arthritis, ankylosing spondylitis)
  • Infection
  • Inflammatory disease
  • Malnutrition
  • Nerve root damage
  • Obesity
  • Poor physical conditioning
  • Tobacco abuse

Factors Influencing Duration

The individual’s general health, age, access to rehabilitation, extent of surgical procedure, number and location of discs involved, concurrent procedures performed such as laminectomy or spinal fusion, and whether surgery successfully treated an underlying disc disease all influence duration. Prior back surgery and the length of time individual had experienced radicular pain prior to discectomy can also influence recovery time.

Medical Codes

ICD-9-CM:
80.5 - Excision or Destruction of Intervertebral Disc
80.50 - Excision or Destruction of Intervertebral Disc, Unspecified; Unspecified as to Excision or Destruction
80.51 - Excision of Intervertebral Disc; Discectomy; Level: Cervical, Thoracic, Lumbar (Lumbosacral); Removal of Herniated Nucleus Pulposus; That by Laminotomy or Hemilaminectomy; That with Decompression or Spinal Nerve Root at the Same Level
80.59 - Other Destruction of Intervertebral Disc; Destruction NEC; That by Laser

Rehabilitation

Note on research and authorship

Rehabilitation for discectomy will vary significantly based on the location of the disc and the surgical procedure used. The primary focus of rehabilitation following discectomy is to promote independence in all functional activities.

Early ambulation should be encouraged, and assistive devices may be used as needed. Proper transfer techniques should be taught to maximize independence and minimize discomfort. These techniques may include log rolling for bed mobility and use of the upper extremities to assist with transfers. Gentle isometric exercises of the trunk stabilizing muscles may be initiated unless contraindicated.

When indicated by the treating physician, usually around 4 to 6 weeks postoperatively, patients may be progressed to a more aggressive exercise program (Danielsen, Ostelo). Rehabilitation should emphasize stretching, strengthening, stabilization and aerobic exercises as well as instruction of proper body mechanics. Stretching, strengthening and stabilization exercises should focus on the muscles around the trunk, hips, and thighs. Improved general aerobic conditioning has been shown to yield better postoperative outcome (Dolan). Low impact activities, such as walking and swimming, may be beneficial after discectomy to improve general fitness.

FREQUENCY OF REHABILITATION VISITS
Surgical
SpecialistDiscectomy
Physical TherapistInpatient: daily
Physical TherapistOutpatient (lumbar spine): up to 6 visits within 6 weeks
Physical TherapistOutpatient (cervical spine): up to 12 visits within 4 weeks
The table above represents a range of the usual acceptable number of visits for uncomplicated cases. It provides a framework based on the duration of tissue healing time and standard clinical practice.

Source: Medical Disability Advisor






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