Lumbar discectomy is a type of decompression spine surgery that is performed to remove a damaged, or herniated, disc, or disc material under the nerve root. Discectomy is done in order to relieve spinal nerve root pressure. Relieving that pressure eases pain that can result from the damaged disc pressing on the spinal column or nerve.
Lumbar microdiscectomy is a type of discectomy in which the spine surgeon is able to use small, specialized surgical tools to perform the surgery using a tiny less-invasive incision. Typically, this procedure is performed when only a portion of the damaged disc is to be removed.
What Conditions Can Microdiscectomy Treat?
Microdiscectomy surgery is most often used to treat damaged, or herniated, discs of the spine.
Discs are soft cushion-like structures that sit between each bone (vertebrae) in the spine. They act as shock absorbers and facilitate movement between the bones in your lower back. Each disc has a strong outer ring of fibers, and a soft jelly-like central portion.
Most herniated discs are caused by wear and tear, called osteoarthritis. Discs may also rupture as a result of sudden force or pressure. In addition, prolonged bending or heavy lifting may contributed to herniated disc.
How Is Microdiscectomy Performed?
During microdiscectomy, one of our expert Denver spine surgeons makes a tiny, 1- to 1.5-inch incision in the back over the damaged disc. Special retractors and an operating microscope visually enlarge the surgical area, which allows the surgeon a clear view with minimal or no cutting of the adjacent muscle and soft tissue. After the retractor is in place, an X-ray is used to confirm that the appropriate disc is identified.
In some cases, a small portion of the inside facet joint is removed, both to facilitate access to the nerve root and to relieve any pressure or pinching on the nerve.
The surgeon uses micro instruments to go under the nerve root and remove the fragments of disc material that have extruded out of the disc.
The muscles are moved back into place, and the incision is closed. The procedure usually takes about one to two hours.
Most patients are able to go home the day of surgery.
If needed, the surgeon may make a small opening in the bony lamina, called a laminotomy, to access the site.
Who is a Candidate for Disectomy or Microdiscectomy?
Surgery for herniated disc generally is only considered when more conservative therapies such as steroid injections and physical therapy fail to provide adequate relief. Ideal candidates for microdiscectomy are those who experience:
- Leg pain caused by the damaged disc pressing on a nerve
- Numbness, weakness, or other symptoms in the leg and foot
- Back or buttock pain
- Bowel or bladder incontinence
In addition, at Neurosurgery One (formerly South Denver Neurosurgery), our spine surgeons believe that surgery should be performed only when patients have a diagnosis of herniated disc that is confirmed through imaging such as MRI.
Benefits of Microdiscectomy Surgery
Lumbar microdiscectomy is one of the most common surgeries performed to relieve back and leg pain, and is considered highly effective, with 90 to 95 percent of patients experiencing pain relief. Most patients feel immediate improvement in their leg pain, some as soon as they wake up from surgery.
Risks of Microdiscectomy Surgery
The risks associated with microdiscectomy are low, but can include surgical site infection. However, the small incision used in microdiscectomy means that risk is reduced.
An estimated 4 percent of microdiscectomy patients report a worsening of symptoms after surgery.
Every patient’s experience is unique. However, you may expect some or all of the following after microdiscectomy surgery:
- Most microdiscectomy patients go home the day of surgery or the following day.
- You may need help with bathing, dressing, and other activities in the first few days after surgery.
- Your spine surgeon will encourage you to gradually return to normal activities, including walking. Walking short distances at first and gradually increasing to one to two miles daily will help speed your recovery.
- You should expect to be fully recovered from surgery in four to six weeks.