Microdiscectomy

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Microdiscectomy

Microdiscectomy also sometimes termed as microdiskectomy or microdecompression, is a minimally invasive surgical procedure performed on patients suffering from a herniated lumbar disc.

Though years ago, removing a herniated disk required a rather large surgical incision; today surgeons are able to use a microscopic surgical approach using a small, minimally-invasive poke-hole incision for removing the disc herniation. This procedure allows a faster recovery as well.

Purpose

The procedure is generally performed for two main reasons:

  • A fragment of your intervertebral disc might be broken away from your disc and it is pressing on the spinal cord or your spinal nerves.
  • Though your disc might be intact, part of it is bulging or protruding and pressing on the spinal cord or your spinal nerves.

Preparation

It is important for you to stop taking certain medications for around two weeks before the surgery including blood thinners. You should discuss with your doctor which medications you should still continue with. Your doctor might also recommend certain tests.

Also, make sure you stop smoking at least two weeks prior to the surgery.

Procedure

You will need to lie face down on the surgery table. The procedure is generally done under general anesthesia, so during the entire procedure, you will be asleep and won’t feel anything.

First, an incision of around one inch will be made directly over the affected disc. With the help of a lighted microscope, your surgeon will be able to see the affected area.

Your surgeon might remove a small portion of bone protecting the root nerve. Using a scissor-like tool, he/she will next remove the damaged herniated tissue, relieving the pressure on the nerve. Then the incision is closed.

Since the spinal nerve now has the required space inside the spinal column, any pain that is caused by pinching on the nerve should now stop.

Recovery

The recovery time for this procedure is much less as compared to other invasive procedures. People are generally able to leave the hospital the same day or within twenty-four hours.

You will likely need to meet with a physical therapist as well as an occupational therapist before you leave the hospital. You will receive instructions on how you can reduce the bending, lifting and twisting done with your back. They will also tell you what kind of exercises you need to do to improve the strength and flexibility of the muscles around your spine.

Avoid driving, sitting for too long, lifting heavy objects as well as bending over immediately after the procedure. You may not be able to resume normal activities immediately, but it is likely that your lifestyle will not be impacted. It is best if you can take leave from work for a minimum of two weeks. Avoid lifting anything heavy for at least four weeks.

Slowly, you will make progress and will be able to resume your normal physical activities. A full recovery requires around six weeks.

A successful microdiscectomy will accomplish what a traditional open discectomy does, along with a faster and lesser painful recovery.

Risks

Although microdiscectomy generally is a safe procedure, with rare complications, some risks are definitely a possibility. Sometimes your pain can return or the disc can re-herniate.

Other risks are:

  • dural tear in 1 to 2 percent of surgeries
  • bowel/bladder incontinence (very rare)
  • nerve root damage
  • infection
  • bleeding

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