What Is a Microdiscectomy?
A discectomy is the removal of an intervertebral disc that has bulged or herniated, pressing on a nerve root and causing pain, numbness, tingling or muscle weakness. A microdiscectomy is a specific surgical technique to remove a disc. It involves the use of very small tools and/or a microscope that allows the surgeon to see the disc better and therefore be more precise with the incisions and removal of herniation.
Reasons for a Microdiscectomy
A microdiscectomy is performed in response to a herniated or bulging disc, in which the soft inner core of a disc protrudes through the hard outer shell and presses on a nerve root. This can cause pain, tingling, numbness or weakness in a limb. Herniated discs are often caused by degenerative disc disease, and can lead to sciatica, back pain, neck pain or pain radiating into the arms or legs, as well as other conditions.
Candidates for a Microdiscectomy
Candidates for a microdiscectomy are those who may have:
- An imaging study that shows evidence of a bulging or herniated disc
- Back or neck pain that radiates into the arms or legs
- Loss of bladder or bowel control
- Symptoms that persist through more conservative treatment—rest, ice, physical therapy or anti-inflammatories
While the microdiscectomy is the most commonly performed discectomy, there are different techniques available to achieve the goal, such as endoscopic, laser or open discectomy. The surgeon will discuss different options and recommend which technique is best for a particular patient’s case.
A microdiscectomy usually takes about one hour to complete and is usually done under general anesthesia. A small incision over the disc to be removed is made. The surgeon uses retractors to move tissue out of the way and a microscope or operating glasses called loupes to see the area without disturbing the surrounding tissue too much. The protruding portion is then removed, and the incision closed with sutures.
Sometimes a piece of vertebra called the lamina may need to be removed to give the surgeon access to the disc. This is called a laminectomy. Other times, if the entire disc must be removed, the surgeon will replace it with either an artificial disc or a fusion cage packed with bone material. This will allow the vertebra from which the disc was removed to fuse to the vertebra above it.
A microdiscectomy is generally an outpatient procedure, meaning no hospital stay is required, though a short hospital stay may be needed if the patient has other health conditions or complications.
Patients can usually return to work within two to six weeks, or a bit longer if their job involves lots of heavy lifting. Sitting and certain activities should be limited for up to four weeks after the surgery.
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