A lumbar decompression procedure may be an option for pain relief from a herniated or bulging disc. This is a nonsurgical treatment that lasts between four and six weeks. Microdiscectomy, also known as microdecompression, is a type of lumbar surgery that treats nerve compression caused by a herniated or bulging disc.
One option is to remove a part of the facet joint to improve access to the nerve root and relieve nerve pressure. The herniated area of the disc beneath the nerve root can be removed during a minimally-invasive microdiscectomy procedure. This allows nerve roots to breathe and relieves pressure. Nerve root healing can then begin.
A microdiscectomy procedure is highly successful in relieving leg pain caused by a herniated or bulging disc. The nerve root may take several months or even years to heal fully, but patients often experience immediate relief from leg pain.
What is microdiscectomy and how can it help?
Microdiscectomy can be used to relieve pain and other symptoms caused by a herniated spine disc pressing on a nearby nerve root. The surgeon removes small portions of bone and disc from the nerve to release it.
Microdiscectomy is often described as a minimally-invasive spine surgery. This is because it only requires a small incision. A microscope or surgical glasses (called loupes) are used to magnify where the injury has occurred. In order to reach the restricted area of the spine, the surgeon may use smaller tools and instrumentation.
Microdiscectomy is a form of spinal decompression. It may also be called microdecompression. This refers to the surgical procedure of removing any bone or ligament which is compressing a nervous system. Microdiscectomy refers to the removal or resection of a fragment of herniated disc tissue that is causing symptoms.
A majority of patients can heal from a herniated spine without surgery. Microdiscectomy is only recommended after conservative treatment such as physical therapy and cortisone injections have been attempted for at least 6 to 12 week without any relief.
Sometimes, motor weakness can be a reason for this surgery to be performed sooner. Cauda Equina syndrome patients need immediate surgical intervention. This condition is caused by pressure on the nerves at the lower part of the spine. It affects bladder function and bowel function in less than 1%.
How is a surgeon able to perform a microdiscectomy procedure?
One of three minimally-invasive options for microdiscectomy is available to access the herniated disc and nerve. These are a midline, tubular, or endoscopic microdiscectomy.
A traditional discectomy was performed using a large incision that involved the removal of the entire disc. With the advancement of equipment and techniques, nearly all spine surgeons now perform microdiscectomies. The procedure is usually quick and can sometimes provide pain relief immediately.
Microdiscectomy techniques
A midline microdiscectomy involves the surgeon making a one- to two-inch vertical incision through the back. He or she then lifts the surrounding muscles from the vertebrae and uses instruments to keep the tissue layers apart.
A tubular microdiscectomy: In this procedure, the surgeon inserts a series of small tubes or dilators into a small opening to create a channel through the muscle to allow for operation. It causes less tissue damage. Endoscopic microdiscectomy (also known as microendoscopic discectomy) is an incision that is smaller and where the surgeon uses miniaturized cameras and instruments to perform the procedure. This approach causes less damage to surrounding tissues.
What are the benefits to microdiscectomy
No matter what microdiscectomy technique you choose, the surgical goal remains the same: remove the disc fragment along with any bone and ligament that may have been compressing the nerve root. To accomplish this, the surgeon makes a small incision in the vertebra and then pulls out the ligamentum flavum (the underlying tissue) to expose the dura (the covering over the spine) and the root. The nerve decompression is completed by removing the herniated portion of the disc.
Imaging techniques include X-rays and other imaging tools are used to locate the exact surgical site. While herniated discs can occur at almost any level of your spine, lumbar Microdiscectomy – which is performed in the lower part of the back – is the most common.
How long does it take to perform a microdiscectomy procedure?
The average time to perform microdiscectomy surgery is between 30-60 minutes. Patients are usually given general anesthesia after surgery and required to spend some time in the recovery area for monitoring. This can take up to two hours.
Most people who have undergone microdiscectomy will be able to return home the next day. Patients usually receive a small amount (either acetaminophen, or a small dose of opioid medication) and instructions about post-operative care.
The most important symptoms are those that indicate the need to seek immediate medical attention such as muscle weakness or changes in bladder or intestinal function and severe and unexpected leg or back pain.
What complications are possible with microdiscectomy
Multiple safety measures are used during surgery to avoid bleeding, infection, or injury to the surrounding tissues. Rarely, a tear of the dura (the surrounding tissue for the spinal nerves), may occur. This is repaired by the surgeon with a suture, or a patch of collagen.
What is the average recovery time from microdiscectomy?
After a two-week rest period to allow the soft tissue to heal, most patients are able to return to work. Microdiscectomy recovery requires six weeks of modified activities. The course of physical therapy begins at week two.
Physical therapists work with patients to strengthen core muscles, loosen stiff joints and create home exercises that protect the spine. All patients should gradually ease back into their routines, especially those who work with physical labor. Sitting in a chair with your back forward puts pressure on the spine. People who work more sedentary positions should be aware of their posture and walk or do gentle exercise about every hour.
Patients who wish to resume driving after surgery need to wait until they feel free from pain and are no longer taking any medication that makes them drowsy. A practice drive in a garage or another safe area is recommended to test your comfort before you return to regular driving.
Is a microdiscectomy painful for you?
Patients will tolerate some non-opioid pain medication, as well as a medication to relax the muscles. There is some discomfort after surgery, but many patients report feeling relief quickly from the herniated disc pain.
Pain relief can take longer for patients who have had nerve compression and other symptoms over a long period. If leg pain is the primary symptom, the pain usually subsides over time. Some patients may feel mild numbness or cramping, as well as muscle cramping. This usually resolves over time.
Who is eligible for microdiscectomy
A microdiscectomy is an option for most patients who have herniated discs and are unable to respond to both medication and physical therapy. The condition is most common in those between the ages of 30 and 50, but it can also be seen in others.
In children and young adults, herniated discs are uncommon. They are often more manageable without surgery. For adults over 90, microdiscectomy might be an option. However, this age group is more susceptible to medical and surgical complications.
How successful is microdiscectomy
The success rate of microdiscectomy is high. Many patients are very happy with the result. Presurgical screening and evaluation are important factors in the success of microdiscectomy. Patients should also be committed to maintaining good spine health after the operation.
Some people with herniated discs may also have nerve-related pain or disability due to other problems in their spines. Additional procedures, such as a laminectomy, which involves the removal of the lamina (bony roof above the spinal canal) from one or more vertebrae in these cases, may be necessary if the issues are causing the disability.
What Can I Expect during Recovery?
Herniated disc surgery can often be very effective and works much faster than other treatment options. After a few weeks, you will begin to feel a difference in your symptoms, including pain, weakness and numbness.
Rehab or physical therapy can speed up your recovery. You can visit a rehabilitation center or exercise at home. Walking can be a great way to get your spine back in motion.
For the first few weeks after surgery, you should be cautious not to:
- Lift heavy objects
- You should sit for long periods of uninterrupted time
- Don’t stretch or bend too much
Your doctor will inform you when you can drive again, return to work, or do any other activities you normally do. Within 2 to 4 week, you should be able go back to your desk job. It is possible to take 6 to 8 weeks to get back to your desk job if you need to lift heavy objects or use large machines.
What are the potential risks? What’s my outlook?
It is usually safe to have herniated disc surgery. While risks are not common, there may be:
- Infection
- Damage to blood vessels or nerves
- Problems with the new drive
- Leakage of spinal fluid
- Bleeding
There’s a possibility that your symptoms won’t be improved by surgery. Sometimes, the pain will get better but may return later.
Most people who have a herniated or bulging disc can find relief from their symptoms and pain through surgery. It doesn’t work for everyone. About 5% of the time, the disc will again herniate.
Surgery may offer faster relief than some other treatments but it’s not always the best choice. Before you decide to undergo surgery, make sure you talk with your doctor about the risks as well as the benefits.
Conclusion: Successful Treatment of a Herniated Disc
The individual nature of each patient’s symptoms and pain makes it difficult to treat a herniated spine. The best treatment for one patient may not be the best for another. Working with several spine specialists can help patients find the right combination of treatments for their pain. Patients can also avoid needing surgery too soon.