Lumbar Microdiscectomy Spine Surgery 

Candidates for a Lumbar Microdiscectomy

You may be a candidate for a Lumbar Microdiscectomy procedure if test results from an MRI, CT or myelogram reveal a damaged disc in your lower spine. When a disc herniates or becomes degenerative, it presses on the nerve and can cause symptoms such as leg or back pain, muscle weakness and loss of feeling in your legs. These symptoms, or variations of them including numbness in your feet, loss of feeling in your genital area or bladder and bowel control issues, are typically the direct result of either a bulging or herniated disc, or degenerative disc disease.

A bulging or herniated disc is when the annulus, or wall that surrounds the disc, weakens and allows the nucleus pulposus, or gel-like substance within the disc, to escape. As the nucleus pulposus squeezes through the weak area of the annulus, it presses on the nerve and causes swelling and irritation.

Degenerative disc disease is a naturally-occuring deterioration of the disc resulting in bone spurs and inflammation of the facet joints. The shape of the disc will change as it dries out and shrinks, losing its mobility and insulation and causing spacing issues within the spine.

Nonsurgical treatments are usually attempted prior to the recommendation for surgery. The majority of herniated discs can be healed in the months following the herniation without the need for surgical treatment. Physical therapy or medication may provide relief from back and leg pain and are suitable if no nerve damage is present. However, if these treatments fail and symptoms worsen, you may become a candidate for a Lumbar Microdiscectomy procedure to remove the disc causing pain.

What is a Lumbar Microdiscectomy?

A Lumbar Microdiscectomy is a minimally invasive surgery to remove a herniated or degenerative disc from the lower back. A discectomy is the removal of the disc and can be performed anywhere along the spine, from the neck area, or cervical, to the lower back area, or lumbar. The procedure can be performed either minimally invasive or open. A Lumbar Microdiscectomy is specific to the lumbar, or lower back, region and is a minimally invasive method performed through a small incision and with a series of thin dilator tubes used to tunnel through the muscles.

A small, one-inch incision is made posterior in the lower back and the back muscles are separated to reach the damaged disc by first removing the lamina, or “bone roof.” Once the lamina is removed, the spinal nerve is moved to the side. Then, a special tool is used to remove the piece of the disc that is compressing or “pinching” the nerve causing pain. Depending on the condition of the patient, one disc (single-level) or multiple discs (multi-level) may be removed.

This minimally invasive approach causes less disruption to the back muscles, typically resulting in a much shorter recovery time.

Results of a Lumbar Microdiscectomy Procedure

Positive outcomes from a Lumbar Microdiscectomy procedure are achieved with 80 to 90 percent of patients. Additionally, the minimally invasive approach provides comparable results to the open approach and patients benefit from the shorter operating time, reduced blood loss and less disruption to the muscles. Minimally invasive surgical patients will recover more quickly in most cases.

The ideal outcome of a Lumbar Microdiscectomy is to relieve the pain faster than nonsurgical treatments.

What are the risks of a Lumbar Microdiscectomy?

All surgeries are subject to risks generally including bleeding, blood clots, infection and adverse reactions to the anesthesia. When it comes to spine surgery, other risks such as nerve pain, nerve injury, failure to relieve symptoms or the need for additional surgery in the future are also possible.

Deep vein thrombosis, or DVT, occurs when blood clots form within the veins of the patient’s legs. If the clots travel to the lungs, the outcome could be serious resulting in lung collapse or death. DVT can be prevented by movement as soon as possible following surgery to promote blood flow. Drugs such as aspirin, Heparin or Coumadin may treat the risk of DVT, as well as support hose or pulsatile stockings (sequential compression devices) to prevent blood from pooling in the veins and leading to a clot.

The flow of oxygen is essential to healing tissues and cells after surgery. If portions of the lungs collapse, it could lead to the build-up of mucus and bacteria. This could result in more serious conditions such as pneumonia. Following surgery, patients are encouraged to breathe deeply and cough often to promote oxygen circulation.

The risk of nerve damage causing persistent pain is also a possibility. If the nerves or spinal cord are impaired, numbness or paralysis could occur. The nerves could also be damaged from the disc herniation itself, which may be permanent. Additionally, approximately five to 15 percent of disc herniation patients experience recurrent disc herniations in the same location or on the opposite side of the previous herniation. Prior to surgery, your surgeon and medical personnel will thoroughly discuss the procedure, possible outcomes and what to expect during recovery.