Lumbar Microdiscectomy

The low back area is also called the lumbar spine. The discs are the shock absorbing cushions in between each of lumbar vertebrae. The disc can become injured or worn resulting in a herniation. Sometimes people refer to this as a slipped or ruptured disc. When this happens, it can become a cause of back and/or leg pain.
During a lumbar mcrodiscectomy the surgeon makes a 1- to 2-inch incision and uses a microscope or loupes along with micro-surgical techniques to remove the part of the disc that is putting pressure on the spinal nerve. This minimally invasive technique spares the bones, muscles, ligaments and surrounding soft tissue from trauma making recovery easier and faster.

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Who is a candidate for microdiscectomy?

Less than 10% of patients with disc herniations require surgery. Most of these conditions will resolve with basic care measures. However, in some cases, the back and leg symptoms become unmanageable. This occurs when the damaged disc puts pressure on the spinal nerve producing pain that goes to your leg. Pressure on the nerve may cause pain, numbness and/or weakness in the leg. This is sometimes called sciatica.

Sciatica is usually felt as a sharp, shooting pain through the buttock, down the back of the leg and may go into the foot. When leg pain does not resolve with basic care measures, and the ability to perform daily activities is severely restricted, the patient may be a good candidate for a microdiscectomy.

What are the alternatives to a microdiscectomy?

Most of the time conservative therapies will relieve the symptoms resulting from the herniated disc. Treatments such as medication, bed rest, steroid injections and physical therapy are effective and return the majority of patients to normal daily activities.

How are back problems evaluated?

Your doctor will use a number of approaches to evaluate and diagnose back problems such as a herniated disc. These include:

A Detailed History – Your role in providing a detailed history is very important. Your doctor will need to know where and when it hurts, if there was a recent injury or fall, and a description of the pain. Are there positions or activities that make it feel worse? What makes it feel better? All of these details can help your doctor pinpoint the problem.
A Physical Exam – Once your history is given, a thorough exam by a spine expert is another important step in getting a good diagnosis.
Diagnostic Imaging – X-rays can show the structure and alignment of the vertebrae, as well as the presence and size of bone spurs or other bony abnormalities.
Magnetic Resonance Imaging – MRI is probably the most utilized study for back pain evaluation. MRI uses a powerful magnet to send radio waves into the body. The images produced are very helpful in visualizing the soft tissues such as the spinal cord, as well as the discs and nerve roots.
Computerized Tomography – This is a special kind of X-ray machine. Rather than a single X-ray, a CT scanner sends out a number of beams at different angles. These images are then read by a computer, producing detailed cross-sections or “slices” that can show the shape and size of the spinal canal and the surrounding structures.
Bone Scans – These are useful in revealing certain abnormalities such as infections, fractures, tumors and arthritis. Because bone scans are unable to differentiate between these problems, they are usually performed in conjunction with other diagnostic tests.

How long is the hospital stay?

After surgery, you are encouraged to walk as soon as you recover from anesthesia. Once safe mobility is confirmed, you will be discharged to home. This usually occurs the same day of surgery or within 24 hours.

How long will it take to recover?

Recovery after a microdiscectomy varies depending on your particular situation. However, recovery from microdiscectomy surgery is faster because there is minimal soft tissue damage and the mechanics of the spine are not affected. You can quickly return to normal activity provided you use good body mechanics and regain adequate trunk strength.

During the early healing phase, you should avoid bending, lifting and twisting, and prolonged sitting. If you work in an office you should be able to return to work in 2 to 4 weeks. If your job requires heavy physical work, you may not be able to return for up to 3 months.