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Are Patients Usually Awake during Microdiscectomies?


2.15 - Are-You-Awake-During-Microdiscectomy-Surgery

If physical therapy, lifestyle adjustments, and other nonsurgical treatments are not effective for your herniated spinal disc, your doctor may recommend microdiscectomy surgery. A microdiscectomy, which is a minimally invasive form of a traditional discectomy, is a way to remove protruding disc material that is compressing nearby nerves. As you prepare for this procedure, it helps to know what you can expect regarding your level of awareness and the role anesthesia plays during the procedure. This article discusses whether you will be awake during microdiscectomy surgery.

Local or Spinal Anesthesia

When a microdiscectomy is performed with localized or spinal anesthesia, you will be awake and aware during the entire procedure. However, you will not feel any pain, and you should not experience noticeable discomfort. With local anesthesia, only the area where the surgery will be performed is numbed. This type of anesthesia is more likely to be used with a minimally invasive
lumbar discectomy. Some patients prefer staying awake during a microdiscectomy for the following reasons:

• Lowering the potential risks of general anesthesia
• Being able to receive assurances or updates during the procedure
• Reducing blood loss, in some instances

The local anesthetic is administered in a way that allows it to last beyond the duration of the surgery to keep the area numbed longer, which means it will not suddenly wear off. You may still notice some post-surgery discomfort as it wears off afterward, but this is usually fairly minor and can be managed with medication.

General Anesthesia

If you have a microdiscectomy performed under general anesthesia, you will not be awake during the procedure. In this case, there is a temporary loss of consciousness that occurs due to a mix of medications that put you into a sleep-like state. Patients having microdiscectomies sometimes prefer general anesthesia even if it is not absolutely necessary. Possible reasons this option may be best for some patients include:

• Uneasiness about remaining awake during surgery
• Concerns about the ability to remain calm during the procedure
• Better control of breathing and circulation
• Sensitivity to local anesthetic agents

There is more preparation involved with general anesthesia, since you will be fully asleep. To safely and properly administer the mix of medications needed, many patient-specific factors also need to be considered, such as any underlying health issues and medications being taken for other reasons. The anesthesiologist will ask you about these details prior to your procedure.

Talking to Your Doctor/Surgeon about Anesthesia

It can be helpful to schedule a separate appointment with your doctor or surgeon to discuss anesthesia. This gives you a chance to be more focused as you ask questions and share your personal preferences and concerns about your
herniated disc surgery. This information can then be used to determine the most appropriate option for anesthesia. With any type of anesthesia, expect to remain at the surgery center or hospital until you are fully aware again and able to safely go home.

The type of anesthesia used during a microdiscectomy will vary according to each patient’s specific needs. Back surgery recovery time also varies among individuals and depends on factors such as whether the patient has a large hole in the outer ring of the disc after surgery. If the hole in the disc is larger than a standard pencil eraser, the patient has a significant risk of experiencing a reherniation. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. These reherniations often require additional surgery or even a larger spinal fusion operation. Barricaid is a bone-anchored device shown to reduce reherniations by closing the hole in the disc after a discectomy, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, you may ask your doctor or contact us at 844-288-7474.

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