Lumbar microdiscectomy, also known lumbar disc microsurgery, is performed to remove a piece of intervertebral disc that is pressing on a spinal nerve and causing severe pain, weakness or numbness in the lumbar, or lower, back. This pain may extend down the length of the leg, and is then referred to as radicular pain. The lumbar back is the largest moveable segment of the vertebral column and is especially vulnerable to painful disorders, both because it is the part of the spine most affected most by twisting and bending, and because it bears the most body weight.
Reasons for Lumbar Microdiscectomy
Typically, conservative treatments, such as rest, physical therapy and corticosteroid injections are tried first and, only if patients do not respond to these treatments after a period of 6 weeks, is surgery considered. While surgery is not needed in all cases, lumbar microdiscectomy is considered a highly effective option that can relieve pain quickly.
Lumbar microdiscectomy is most often performed to relieve pain caused by lumbar disc herniation. At times, it is also performed to treat a further complication, known as a lumbar disc rupture. A herniated disc is a common condition that occurs as a result of gradual wear and tear or an injury to one of the intervertebral discs, causing it to bulge beyond the parameters of the spinal column. If the pressure on the disc is great enough, the outer covering of the disc, the lamina, may fracture and break open. This condition is referred to as a ruptured disc.
The Lumbar Microdiscectomy Procedure
Lumbar microdiscectomy is a minimally-invasive procedure, performed laparoscopically, in which miniature surgical instruments and a tiny camera are inserted through several small incisions in the back. With this equipment, the surgeon has a magnified view of the affected area and can be extremely precise.
Once the surgeon pinpoints the location of the affected disc, the muscles are lifted away to access the spine. The impinged nerve root is identified and the targeted disc is removed to relieve compression. If necessary, a small portion of the facet joint, the joint connecting two vertebrae, may be removed as well. The muscles are then placed back in their original position and the incisions are closed with sutures. This procedure is performed under general anesthesia in a hospital setting. A hospital stay of a few days is usually required after surgery.
Risks of Lumbar Microdiscectomy
There are certain risks associated with any spinal surgery, although the chance of any of these complications occurring is extremely rare. Such risks include the possibility of postsurgical incontinence, nerve damage or leakage of cerebrospinal fluid. The risks of any surgical procedure also apply to a lumbar microdiscectomy. These include the risk of excessive bleeding, infection, breathing difficulties, blood clot formation, and adverse reaction to anesthesia or medication.
Recovery from Lumbar Microdiscectomy
After a lumbar microdiscectomy, the patient is encouraged to get up and walk as soon as possible. Postsurgical pain is managed through prescribed medication. Once the pain resulting from the surgery has waned, the patient usually feels much better than before the procedure since the underlying nerve pain has been eliminated.
Patients benefit from prescribed physical therapy during recovery to help restore their strength and flexibility and to reduce the chances that the back pain will recur. Patients are usually able return to work in 2 to 4 weeks, although for jobs that require physical labor twice as much recovery time may be required.