How Are Microdiscectomy Incisions Closed?

A microdiscectomy is a minimally invasive surgical procedure that involves removing a small portion of a herniated disc that is pressing on a nerve root in the spine. The surgery is often performed to relieve sciatica, which is a condition that causes pain, numbness, tingling, or weakness in the leg due to nerve compression. A microdiscectomy can provide significant relief for many patients, but it also requires some care during recovery after the surgery. This article explains how the microdiscectomy incision is closed and what to expect after the surgery.

Cleaning and Disinfecting

Before the incision is closed, the surgeon starts by meticulously cleaning and disinfecting the area around the incision. This step is crucial in preventing postoperative infections. Surgeons use a sterile solution and adhere to strict protocols to maintain a germ-free environment.

Methods for Closing the Microdiscectomy Incision

A microdiscectomy is performed through a small incision in the lower back, usually about 1 to 2 inches long. The surgeon uses a microscope and special instruments to access and remove the herniated disc material. After the disc material is removed and the incision site is cleaned and disinfected, the surgeon closes the incision with one of the following methods:

• Sutures or stitches – These are thin threads used to sew the edges of the incision together. They can be made of natural or synthetic materials, and they can be either absorbable or non-absorbable. Absorbable sutures dissolve over time and do not need to be removed, while non-absorbable sutures need to be removed by a doctor after a few weeks.
• Staples – These are metal clips used to hold the edges of the incision together. They are usually made of stainless steel or titanium and are applied with a special device. They need to be removed by a doctor after a few weeks.
• Glue or adhesive – This is a liquid or gel used to seal the edges of the incision together. As with sutures, it can be made of natural or synthetic materials and can be either absorbable or non-absorbable. Absorbable glue will dissolve over time without the need to be removed, while non-absorbable glue needs to be peeled off by a doctor after a few weeks.
• Layered closure – In some cases, especially when dealing with deeper incisions, surgeons opt for a layered closure approach. This involves closing different layers of tissue separately, ensuring proper alignment and minimizing tension on the outermost layer. Layered closure is particularly important in microdiscectomy surgeries, where precision is paramount.

The choice of the method depends on various factors, such as the size and location of the incision, the preference of the surgeon and the patient, and the availability and cost of the materials.

Dressing and Sterile Bandaging

After the incision is closed, the surgeon applies a sterile dressing and bandages to protect the wound from external contaminants and friction. This step is crucial in ensuring the incision heals properly and minimizes the risk of infection.

What to Expect After Surgery

After the surgery, you will be moved to a recovery room where you will be monitored for any complications or side effects. You may experience some pain, swelling, bruising, or bleeding at the incision site, which can be managed with medication and ice packs. You may also have some difficulty moving your back or leg, which can improve with physical therapy and exercises.

You will usually be able to go home on the same day or the next day after the surgery, depending on your condition and recovery. You will need someone to drive you home and help you with your daily activities for a few days. You will also need to follow some instructions and precautions for your wound care and microdiscectomy recovery, such as:

• Keep your incision clean and dry – You can shower after 24 hours, but avoid soaking your incision in water or applying any creams or lotions to it until it is fully healed.
• Change your dressing as instructed by your doctor – You may have a bandage or a gauze over your incision that needs to be changed every day or every few days.
• Watch for signs of infection or complications – You should contact your doctor if you notice any redness, swelling, pus, fever, increased pain, or numbness around your incision or in your leg.
• Be gentle with your spine – Avoid lifting heavy objects, bending or twisting your spine, sitting or standing for long periods of time, or driving until your doctor clears you. You should also avoid smoking or drinking alcohol, as they can interfere with your healing process.
• Follow your doctor's advice – Make sure to follow instructions on when to resume your normal activities and exercises. You should start with gentle walking and stretching exercises as soon as possible after the surgery and gradually increase your intensity and duration as you recover. You should also consult with your doctor or physical therapist before starting any new or strenuous exercises.

The closure of a microdiscectomy incision is a critical step in ensuring the success of the surgery and the patient’s overall wellbeing. Surgeons employ various techniques, from suturing to the use of tissue glue, to achieve the best possible outcome. A well-closed incision not only promotes healing but also contributes to a cosmetically pleasing result for the patient. As you consider the prospect of microdiscectomy surgery, remember the artistry of incision closure is just one aspect of the meticulous care provided by skilled surgeons in this field.

Although herniated disc treatment with microdiscectomy surgery is generally very successful, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc experience 70 percent of all reherniations after surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce reherniations, was specifically designed to close the large hole often left in the spinal disc after discectomy. In a large-scale study, Barricaid was proven 95 percent effective in a study of over 500 patients. This means 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us at 844-705-1081.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.