If a disc herniation in the low back results in significant nerve impingement, leg pain and sciatica may result. Lumbar discectomy (microdiscectomy) surgery is typically recommended for patients who have experienced leg pain for at least six weeks and have not found sufficient pain relief with conservative treatment (such as oral steroids, NSAID’s (non-steroidal anti-inflammatory drugs), and physical therapy). However, after three to six months, the results of surgery are not quite as favorable. If the pain is debilitating, it is not generally advisable to postpone surgery for a prolonged period of time (more than three to six months). If after an appropriate course of physical therapy and rehabilitation, the patient has continued disabling pain, a lumbar discectomy may be suggested . In a lumbar discectomy, 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. Importantly, since almost all of the joints, ligaments and muscles are left intact, the microdiscectomy procedure does not change the mechanical structure of the patient’s lower (lumbar) spine
How Is the Surgery Performed?
The goal of a microdiscectomy is to remove the disc material placing pressure on the nerves. The procedure is done under general anesthesia. You will be unconscious during the entire procedure and unable to feel anything. The procedure is performed with the patient lying face down. The process goes as follows:
- A 1- to 1 1/2-inch incision will be made directly over the affected disc.
- A lighted microscope is used to help your surgeon see the affected area.
- The surgeon may remove a small portion of bone that protects the root nerve.
- With a scissor-like tool, your surgeon will remove the damaged herniated tissue, relieving the pressure on the nerve.
- The incision is closed with sutures.
- The patient is usually discharged the same day or the next morning.
The recovery time is shorter than other, more invasive procedures. Most people can expect to leave the hospital that same day, or within 24 hours.
What Are the Risks?
Microdiscectomy is a safe procedure and complications are rare. However, like any surgery, there are some risks. These include:
- dural tear (cerebrospinal fluid leak) in 1 to 2 percent of surgeries
- nerve root damage
- recurrent disc herniation (5 percent of cases)
- bowel/bladder incontinence (very rare)