Microdiscectomy is a surgical procedure employed to relieve the pressure over the thecal sac and/or nerve roots, caused by a ruptured (herniated) intervertebral disc. A herniated disc, common in the lower back (lumbar spine) occurs when the inner gelatinous substance of the disc escapes through a tear in the outer, fibrous ring (annulus fibrosis). This may compress the spinal cord or the surrounding nerves, resulting in pain, sensory changes, or weakness in the lower extremities.
It is usually indicated in patients with herniated lumbar disc, who have not found adequate pain relief with conservative treatment. This procedure involves the use of microsurgical techniques to gain access to the lumbar spine. Only a small portion of the herniated disc that compresses the spinal nerve is removed.
Lumbar Microdiscectomy Procedure
A microdiscectomy is performed under general anaesthesia. Your surgeon will make a small 2.5 cm incision in the midline over your lower back. Larger patients may require a slightly bigger incision. Through this incision, and using micro-retractors the area is accessed with the help of a microscope. The affected nerve root is then identified. Your surgeon removes a small portion of the bony structure or disc material that is pressing on the spinal nerve using microsurgical techniques. The incisions are closed with absorbable sutures and covered with a dressing.
Post-operative Care for Lumbar Microdiscectomy
Following the surgery, patients will be discharged on the same day or the next day. Post-operatively, patients are advised to walk normally. they may find it difficult to sit for 2 weeks. Most patients get back to work in 2-3 weeks. It is advisable to avoid Bending, Lifting and Twisting (BLT) for the first 6 weeks. Driving can usually be commenced at 2 weeks if there is no weakness or numbness in the legs. It is advisable to avoid sitting in a low chair, avoid sex, to take laxatives for constipation and cough syrups if you get a cough for 3-4 weeks atleast. This helps avoid a recurrence and also a late pseudomeningocele or CSF leak. If required, physical therapy is started after four to six weeks of the surgery to improve strength and range of motion.
Benefits of microdiscectomy include:
- Less muscle and soft tissue disruption
- Shorter recovery time
- inimal post-operative pain and discomfort
- Fewer risks of complications
Bleeding, infection, anaesthetic risks such as chest infections, Clots in your legs or Lungs which can cause stroke or heartattacks or PE. Specific risks to the spinal procedure are bleeding, clot formation which requires evacuation, Spinal Fluid leak, recurrence, worsening of back pain, weakness in legs or numbness and bowel or bladder dysfunction. The risks are low but known to exist.