Lumbar Microdiscectomy

If you have been experiencing back or leg pain, the Desert Institute for Spine Care (DISC) has minimally invasive solutions, such as a lumbar (low back) microdiscectomy. See if you are a good candidate for microdiscectomy spine surgery below.

What Is a Lumbar Microdiscectomy?

Microdiscectomy is often referred to as a minimally invasive spine surgery because it involves a small incision and the use of a microscope or surgical glasses (loupes) to enlarge the view of the injury site. The surgeon employs smaller tools to navigate the confined space of the spine. This procedure is a form of spinal decompression surgery. While “microdecompression” can also describe the removal of any bone or ligament compressing a nerve, “microdiscectomy” specifically refers to the removal of the herniated disc fragment causing the patient’s symptoms.

You might be experiencing a herniated disc if you have back pain, shooting pain down your legs, muscle weakness or difficulty with repetitive movements. This procedure is often recommended after more conservative treatments, such as physical therapy and pain medication.

What Condition Does It Treat?

A lumbar Microdiscectomy is the gold standard procedure primarily used to treat specific conditions of the spine, particularly those affecting the lumbar (lower) region. The conditions it commonly addresses include: 

Lumbar Herniated Disc: When the inner gel-like core of a lumbar intervertebral disc (nucleus pulposus) protrudes through the outer fibrous ring (annulus fibrosus), it can compress nearby spinal nerves, causing pain, numbness, or weakness. This condition is often referred to as a slipped or ruptured disc.

Sciatica: This condition is characterized by pain that radiates along the sciatic nerve, which runs from the lower back through the hips and buttocks and down each leg. It is typically caused by a herniated disc compressing a nerve root.

Cauda Equina Syndrome: A rare but serious condition where a large disc herniation compresses the bundle of nerves at the end of the spinal cord (cauda equina). This can cause severe pain, numbness, and potential loss of bowel or bladder control, and is considered a medical emergency.

Radiculopathy: This term refers to pain, numbness, tingling, or weakness radiating from the spine into the extremities, usually due to nerve root compression. In the lumbar region, this often manifests as pain down the legs.

Recurrent Disc Herniation: In some cases, a previously herniated disc may herniate again after initial treatment. A lumbar microdiscectomy may be necessary if conservative treatments fail to relieve symptoms.

How Is a Microdiscectomy Performed?

While you are sedated, the DISC surgeon will make a ½ to 1 inch incision in the lower back. Using a tubular retractor, muscles are dilated instead of cut as such with open techniques. The surgeon will identify the lamina bone and the ligament which protects the spinal canal where the herniated disc is located. A small part of the lamina (a section of the vertebral bone) may be removed in a process called a laminotomy to provide access to the herniated disc and affected nerve root.   Then the surgeon decompresses the spinal nerve extracting the herniated disc and any boney stenosis that may compress the spinal cord and exiting nerves.  The surgeon ensures that no additional disc material is left that could potentially compress the nerve. The area is thoroughly inspected and cleaned. 

After herniated disc is removed, the surgeon will remove the tubular retractor, suture the incision and send you to a recovery area to be monitored while the anesthesia wears off. The procedure can take 30-60 minutes, depending on the severity of the herniated disc.

Microdiscectomy Preoperative and Postoperative Care

If you are considering a microdiscectomy, here is a closer look at what to expect before and after the procedure.

Preoperative

Before your procedure, you will come into our office to consult your surgeon. They will walk you through the upcoming procedure and provide a list of pre-care instructions that can make the procedure and recovery much smoother, including:

  • Showering or bathing before the procedure to ensure clean skin.
  • Preparing for someone to drive you home after the procedure.
  • Disclosing your medication list and health history.

Postoperative

Because minimally invasive procedures only require one to two small incisions, the recovery time following a microdiscectomy is much shorter than with open-back surgery.  During the first few weeks, avoid bending or slouching while sitting to allow your incision to heal properly. 

We also recommend physical therapy during this period for a quicker and safer recovery. You will learn exercises to improve your range of motion, strengthen your back and prevent further herniation.

As with most surgeries, the recovery period can vary from person to person. Generally, patients can begin moving normally after two to four weeks, with a full recovery after about eight weeks.

Why Is a Microscope Used During a Microdiscectomy?

A microscope is used during a microdiscectomy to enhance visualization, providing a highly magnified and illuminated view of the surgical area, which allows the surgeon to see intricate structures like the herniated disc, nerves, and surrounding tissues with great clarity. This magnification aids in performing precise movements in the confined and delicate space of the spine, reducing the risk of damaging nearby nerves and tissues. 

Additionally, the microscope facilitates a minimally invasive approach, enabling smaller incisions and the use of smaller instruments, which leads to less tissue damage, reduced postoperative pain, and faster recovery times. Overall, the improved visualization and precision contribute to better surgical outcomes, allowing the surgeon to accurately remove the herniated disc material while preserving the surrounding anatomy, resulting in a safer and more effective procedure with quicker recovery for the patient. 

Advantages of Using a Microdiscectomy vs. Open Spine Surgery

A microdiscectomy utlizing a microscope approach offers several benefits compared to open spine surgery. Using a microscope provides:

  • A safer technique: A microscope with tubular retractor is a safer and less invasive approach than open spine surgery, requiring only a ½ – to 1-inch incision.
  • A faster recovery: With a smaller incision and more precise approach, a microscope can speed up your healing process.
  • Higher patient satisfaction: Using a microscope for a microdiscectomy has a history of success and overall patient satisfaction following the procedure. 

Potential Complications of a Microdiscectomy

While a minimally invasive microdiscectomy offers minimal risks, you should still be aware of some potential complications:

  • Dural tear: A dural tear can occur if the surgeon accidentally nicks the outer spinal cord membrane, causing cerebrospinal fluid to leak.
  • Nerve injury: While uncommon, nerve injury can occur even after treating the herniated disc.
  • Blood vessel injury: A blood vessel injury is also rare but can occur if surrounding blood vessels are ripped or punctured.
  • Failed back surgery syndrome (FBSS): FBSS can happen if a herniated disc reoccurs even after treatment, requiring a revision surgery.
Dr Abrams explaining spine x-ray Dr. Abrams laughing

Contact DISC — the Microdiscectomy Experts You Can Trust

At DISC, we strive to help patients reach their pain-free potential. Our surgeons and our facility have a quality reputation for providing results. While we are based in Phoenix, AZ, we treat patients worldwide at our center. Contact us today to set up your microdiscectomy consultation with our experts.

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