In a Microdiscectomy or Microdecompression spine surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to relieve neural impingement and provide more room for the nerve to heal.
A Microdiscectomy is typically performed for a herniated lumbar disc and is actually more effective for treating leg pain (also known as radiculopathy) than lower back pain.
Microdiscectomy Spine Surgery Procedure
A microdiscectomy spine surgery is performed through a small (1 inch to 1 1/2 inch) incision in the midline of the low back.
- First, the back muscles (erector spinae) are lifted off the bony arch (lamina) of the spine. Since these back muscles run vertically, they can be moved out of the way rather than cut (see Figure 1).
- The surgeon is then able to enter the spine by removing a membrane over the nerve roots (ligamentum flavum), and uses either operating glasses (loupes) or an operating microscope to visualize the nerve root.Often, a small portion of the inside facet joint is removed both to facilitate access to the nerve root and to relieve pressure over the nerve.
- The nerve root is then gently moved to the side and the disc material is removed from under the nerve root.
Importantly, since almost all of the joints, ligaments and muscles are left intact, a microdiscectomy spine surgery does not change the mechanical structure of the patient's lower spine (lumbar spine).
What To Expect After Surgery ?
After a discectomy, you will be encouraged to get out of bed and walk as soon as the anesthetic wears off. You can use prescription medicines to control pain during the recovery period and will be advised to resume exercise and other activities gradually.
Other things to think about include the following:
- You can sit as long as you are comfortable, but most people avoid sitting for longer than 15 to 20 minutes. After surgery, sitting can be uncomfortable for a while.
- Use walking as your primary form of exercise for the first several weeks. Getting up frequently to walk around will help decrease the risk that excess scar tissue will form. Scar tissue can keep the nerve root from gliding freely as you move, and can press on the nerve root. Walking will also provide exercise for your heart and lungs without stress to your back or the incision line (scar).
- Avoid any activities that cause pain.
- You may begin bicycling and swimming about 2 weeks after surgery as directed by your doctor or physical therapist.
- If you work in an office, you may return to work within 2 to 4 weeks. If your job requires physical labor (such as lifting or operating machinery that vibrates) you may be able to return to work 4 to 8 weeks after surgery.
Many people are able to resume work and daily activities soon after surgery. In some cases, your doctor may recommend a rehabilitation program after surgery, which might include physical therapy and home exercises.
Microdiscectomy Surgery Risks And Complications
As with any form of spine surgery, there are several risks and complications that are associated with a microdiscectomy spine surgery procedure, including:
- Dural tear (cerebrospinal fluid leak). This occurs in 1% to 2% of these surgeries, does not change the results of surgery, but post-operatively the patient may be asked to lay recumbent for one to two days to allow the leak to seal.
- Nerve root damage
- Bowel/bladder incontinence
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