Lumbar MicroDiscectomy
This minimally-invasive surgical procedure is used to treat herniated discs in the lower (lumbar) region of the spine. It can also be called microdecompression. It is very effective at relieving buttock and leg pain, often referred to as sciatica, which occurs when a spinal nerve is compressed. This procedure is not used to treat back pain.
Lumbar Microdiscectomy is recommended for patients who have disc herniation in their lumbar spine who no longer respond or have not responded to conservative forms of treatment for their pain. Conservative treatment options include: physical therapy, oral steroids or anti-inflammatory medications, epidural steroid injections, or radio frequency neurotomy.
If you and your OSC Spine Specialist have decided that Lumbar Microdiscectomy is the appropriate treatment, you will meet with an OSC Surgical Scheduler to plan your surgery. Lumbar Microdiscectomy is almost always performed as outpatient surgery. A hospital location and date for surgery will be chosen and the surgery scheduler will discuss all aspects of your surgery and recovery and provide you with written information to take home to review. You will be instructed to discontinue any anti-inflammatory medication 10 days before surgery and get any appropriate medical releases, should you have a heart condition, diabetes, or other chronic health issues. You may be required to have certain tests before surgery, such as a chest x-ray.
You will be called by the hospital the day before your surgery and be given a time to report for surgery. Be sure not to eat or drink anything for 8 hours before your scheduled surgery time, unless you are approved to take your medication (with a sip of water) by your OSC surgeon.
On the day of surgery, you will report to the hospital or surgery center at your appointed time. You will be checked in and taken to a room to change into a hospital gown. Your vitals will be taken, an IV started and you will be visited by your anesthesiologist and surgeon. Be prepared to answer a lot of questions that will be asked by the OR team to ensure your safety. A family member or friend will be allowed to sit with you until you are taken to the OR for surgery.
This procedure is performed under general anesthesia, which means you will be totally sedated, be unconscious and feel no pain. Your breathing will be controlled by the anesthesiologist, by insertion of a tube into your trachea (windpipe) called intubation. This ensures that your airway is kept open and that you can easily be given oxygen or other drugs during surgery. The anesthesiologist will carefully monitor your breathing, blood pressure and vital signs during surgery.
The patient is positioned on the operating table lying face down. A small incision is made in the area of the back over the problematic disc. Using small instruments, an OSC spine surgeon will remove portions of the disc that are herniated and pressing on the spinal nerve, causing pain. If necessary, a small portion of bone in the vertebrae may also be removed. The incision is closed with sutures and the patient goes into the recovery room to wake up.
When you wake up, you may feel disoriented and groggy. Notify the recovery room nurse if you have any pain or nausea. Pain medication will be given as needed for any post-operative pain. Your companion will be allowed to come into the recovery room with you. You will be asked to sip some water or ginger-ale and to go to the restroom before being allowed to leave for home. You will not be required to wear a back brace, have Home Health Nursing care or undergo any Physical Therapy post-operatively.
Some activities will be restricted while you recover, such as lifting and twisting, to allow for your surgery site to heal. However, your physician will instruct you to get moving and do easy exercise, such as walking, as soon as possible. Walking is helpful during the recovery process and aids in healing.
Typical recovery time is about 4-6 weeks and this varies, based on your overall condition and health before surgery. Your surgeon will let you know when you can resume normal activities, such as work and driving.
As with any surgical procedure, there are risks and complications can occur. Although rare, they can include:
• Damage to the nerve root
• A tear to the dura (spinal cord covering) causing a leak of the cerebrospinal fluid (1-2%)
• Infection
• Bleeding
• The disc herniates again (5%)
• Incontinence of the bladder or bowel (extremely rare)
Lumbar Microdiscectomy is a very successful and safe procedure that provides pain relief in the vast majority of patients. If you think that LM might be right for you, please make an appointment to consult with one of our Fellowship-trained Spine Specialists.