A lumbar herniated disc often means you are living with pain in the back, arms, or legs. Usually, a combination of physical therapy and pain medication can be an effective treatment. However, if noninvasive treatments have failed to provide significant relief after a few months, surgical procedures, such as microdiscectomy or discectomy may be considered.
Microdiscectomy and discectomy are surgical procedures that involve removing portions of the herniated disc to relieve pressure placed on the nerves of the spinal column. But what benefits does a microdiscectomy offer over an open discectomy, and how is a microdiscectomy performed? Read on to learn more.
What is a Microdiscectomy?
Microdiscectomy, also known as microdecompression, is a minimally invasive procedure used for treating a herniated disc in the lumbar section of the spine. This operation is designed to alleviate pressure placed on the spinal column by surgically removing a portion of a herniated disc, tissue, or bone spurs within the spine.
Microdiscectomy is an outpatient procedure and does involve the use of a local anesthetic during surgery. Surgery is performed at an outpatient center. Patients can typically expect to be released the same day as their operation. If your surgeon believes you need more observation time before being released, you may need to stay overnight before being cleared to leave.
People who undergo microdiscectomy usually report significant and immediate pain relief in the arms and legs. However, this procedure may not be as effective at relieving pain in the lower back. Physical therapy combined with pain medication can often be a better option for alleviating back pain.
Are You a Candidate for Minimally Invasive Surgery in Florida?
With any procedure, please remember to allow for six to twelve weeks of nonsurgical treatments before considering surgery, unless otherwise specified by your doctor. Surgery may be suggested sooner if you are experiencing pain so severe, you are unable to sleep or work. Or your mobility is inhibited to the point you can not move or perform daily tasks adequately.
If you have not seen significant relief with nonsurgical options, it may be time to consider surgery. Microdiscectomy is usually recommended for these reasons:
- MRI or other diagnostic tests have shown a herniated disc
- Patient has experienced leg pain for up to six weeks without any relief or change in symptoms
- Leg pain, also known as sciatica, is the patient’s main symptom rather than low back pain
- Nonsurgical treatments such as physical therapy, oral steroids, or NSAIDs have failed to provide significant relief
Ideal candidates for microdiscectomy should be seeking surgery to relieve pain, numbness, or weakness in the legs and arms caused by a herniated disc. Studies have shown microdiscectomy to be 95% effective at treating symptoms of sciatica.
If you believe you are a candidate for microdiscectomy and are considering surgery, you should note the longer you wait the less favorable your results could be. Microdiscectomy was shown to be less successful three to six months after symptoms were first experienced. Surgeons generally advise not putting off surgery after the first three to six months pain has persisted.
What Happens During a Microdiscectomy
Microdiscectomy does involve the use of a local anaesthetic during surgery. This means you will be unable to feel and not be conscious during your operation. In the weeks leading up to surgery, you will have the chance to meet with your anaesthesiologist and discuss the risks involved with anaesthesia, as well as your medical history and personal risk.
On the day of surgery, once you have been admitted to the outpatient center, you will be given a local anesthetic and moved into the operating room. You will be positioned face down on the table and your surgeon will begin the operation by making a 1 to 1 ½ inch incision in the back, directly above the damaged disc.
A miniature, lighted microscope, known as an arthroscope, is inserted through the incision and used to view the target area. With the use of tiny, scissor-like surgical instruments, your surgeon will begin to cut out and remove any damaged disc material and tissue. This frees up space within the spinal column, alleviating pressure on the nerve. In some cases, part of the bone protecting the root nerve may need to be removed as well.
Once all damaged tissue and disc material is removed, the surgical instruments are withdrawn and the incision is sealed using sutures. You will be taken to a postoperative care unit to be observed while you recover from the anesthetic. Most patients will be released from the outpatient center the same day as surgery.
How Does It Differ from a Discectomy?
Both a microdiscectomy and a discectomy are surgical procedures with the aim of cutting out and removing all or a portion of a herniated or bulging vertebral disc to relieve pressure on the spinal nerves. But how do these procedures differ? Microdiscectomy is a less invasive procedure than an open discectomy.
So, what exactly does this difference mean to the patient? An open discectomy would require:
- More anaesthesia
- Longer operation time
- A larger incision
- Muscle stripping
- Longer post operative recuperation in outpatient center
- Longer recovery time at home
On the other hand, a microdiscectomy utilizes small, advanced, surgical tools to perform a minimally invasive procedure. This procedure can be performed faster than a traditional discectomy and requires less anaesthetic for the patient. Another benefit of the smaller surgical tools is a faster recovery time on average.
How to Choose the Most Appropriate Procedure
For people suffering pain caused by a herniated or bulging disc, deciding when to get surgery and which procedure is the right one for their situation can be a difficult task. First, remember that microdiscectomy should only be considered if pain in your legs or arms are your main symptoms. Microdiscectomy has not been shown to provide significant pain relief in the lower back.
Next, be sure to discuss whether or not surgery might benefit you with your primary care physician before deciding on surgery. If you believe surgery is the right option, speak with your surgeon to determine what your surgery options are and which surgery would be appropriate for you.
Recovery Time and Post-Surgery Care
Being a minimally invasive procedure, microdiscectomy has a faster recovery time than an open discectomy. Most patients will be able to leave the outpatient center the same day as surgery, or the following if your surgeon believes more observation is required.
The average time it takes most patients to fully recover is around six weeks. However, there are many steps you can take to help make sure your recovery is smooth and no complications arise.
Before being discharged from the outpatient center, you will likely meet with a physical therapist. Your physical therapist will give you exercises to improve strength and flexibility of the spine as you recover. Your therapist will also instruct you on how you can avoid bending, lifting, or twisting your back as much while at home or at work.
Some other tips for a speedier recovery include:
- Avoid sitting for prolonged periods of time (including driving)
- Do not lift objects heavier than 5 pounds
- Avoid physical exercise until cleared by your doctor and physical therapist
When you have been cleared by your doctor, you can begin easing yourself back into exercise by taking moderate walks. This will help improve strength in the spine and aid your recovery time.
