Microdiscectomy has revolutionized the treatment of herniated discs, offering patients a minimally invasive alternative to traditional open back surgery. This surgical technique has gained popularity due to its precision, effectiveness, and shorter recovery times. In this comprehensive guide, you will learn about the surgical approach in microdiscectomy, including details about the procedure, its benefits, and what patients can expect.
A microdiscectomy is a type of spine surgery aimed at removing part of a herniated disc that is pressing on a spinal nerve. This compression causes pain, weakness, and numbness, often radiating down the leg (a condition known as sciatica). Microdiscectomy offers a faster recovery and smaller incisions compared to traditional open discectomy.
This minimally invasive technique uses specialized instruments and a microscope or magnifying lens to remove the portion of the disc that is compressing the nerve, alleviating pain and other symptoms associated with nerve compression. The procedure is typically performed under general anesthesia and is commonly recommended when nonsurgical treatments fail to provide relief.
Microdiscectomy is typically recommended when conservative treatments such as physical therapy, medications, or spinal injections have failed to provide adequate relief from symptoms caused by a herniated disc. Common indications include:
It is important to note that not all patients with herniated discs require surgery. A thorough evaluation by a spine specialist is necessary to determine if microdiscectomy is the appropriate treatment option.
Before having microdiscectomy surgery, patients typically undergo several steps to ensure they are suitable candidates for the procedure and to optimize surgical outcomes:
The procedure is usually performed under general anesthesia. Once anesthetized, the patient is positioned prone (face down) on the operating table, often with specialized supports to reduce pressure on the abdomen and chest. Proper positioning is crucial to ensure access to the spine while minimizing complications such as nerve injury or pressure ulcers.
The surgeon makes a small incision, usually around 1 to 1.5 inches, directly over the affected vertebrae. Then the surgeon uses a special retractor to gently move aside muscles and soft tissues, creating a corridor to the spine.
One of the hallmarks of microdiscectomy is the use of a surgical microscope, which provides a magnified view of the affected area. This allows the surgeon to operate with great precision, minimizing damage to the surrounding tissues. The small incision and microscope guidance are key aspects that differentiate microdiscectomy from open discectomy.
Once access to the spine is achieved, the surgeon carefully removes the portion of the disc that is pressing on the nerve root. Only the herniated portion is removed, leaving the rest of the disc intact. In some cases, a small portion of the lamina (a part of the vertebral bone) may also be removed to create more space for the nerve.
After removing the herniated disc material, the surgeon ensures there is no remaining compression on the nerve. The incision is then closed with sutures or staples. The entire procedure typically takes about one to two hours, depending on the complexity of the case.
Recent years have seen several advancements in microdiscectomy techniques aimed at further improving outcomes and reducing invasiveness.
This technique uses an endoscope (a thin, flexible tube with a camera) inserted through an even smaller incision. It allows for exceptional visualization while further minimizing tissue disruption.
A series of progressively larger dilators are used to create a surgical corridor through which a tubular retractor is placed. This technique potentially reduces muscle damage compared to traditional approaches.
After microdiscectomy surgery, patients are monitored in recovery rooms and are usually discharged the same day or after one night in the hospital. Most patients are encouraged to walk within a few hours of the procedure, which can prevent complications like blood clots. Pain management typically includes over-the-counter medications or short-term prescription pain relief.
Physical therapy is often recommended a few weeks after surgery to strengthen the muscles around the spine and increase flexibility. Patients are advised to avoid heavy lifting, twisting, or bending for several weeks, as these movements can put strain on the healing spine.
The majority of patients experience significant improvement in symptoms such as leg pain, numbness, and weakness. However, some may continue to experience residual back pain, especially if there was preexisting degeneration of the spine. The microdiscectomy recovery process is generally faster than traditional open spine surgery, and full recovery typically occurs within three months.
As with any surgical procedure, microdiscectomy carries potential risks, though complications are uncommon. Some possible risks include:
Microdiscectomy represents a significant advancement in the treatment of herniated discs, offering a minimally invasive approach that balances effectiveness with reduced tissue trauma. The surgical approach in microdiscectomy, characterized by its use of magnification and specialized instruments, allows for precise decompression of affected nerve roots while preserving spinal stability.
As with any surgical procedure, the decision to undergo microdiscectomy should be made after careful consideration of all treatment options and in consultation with a qualified spine specialist. For many patients suffering from persistent symptoms due to herniated discs, microdiscectomy offers a path to relief and improved quality of life.
Although microdiscectomy surgery is a common and generally quite successful procedure, patients with a larger hole in the outer ring of the disc have a significantly higher risk of herniation following surgery. This risk is doubled if there is a large hole in the outer ring of the disc. Fortunately, there is a new treatment specifically designed to close the large holes that are often left in spinal discs after discectomy surgery. Barricaid is a bone-anchored device proven to reduce reherniations, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study timeframe. This treatment is performed 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, ask your doctor or contact us directly.
For full benefit/risk information, please visit: https://www.barricaid.com/instructions.