 |
|
|
Microdiscectomy (microdecompression) spine surgery |
|
|
In a microdiscectomy or a microdecompression spine spine surgery, a small portion
of the bone over the nerve root and/or disc material from under the nerve root is
removed to relieve neural impingement and provide more room for the nerve to heal.
A microdiscectomy spine surgery is typically performed for lumbar herniated disc.
|
 |
|
|
|
Microdiscectomy helps leg pain |
|
|
A microdiscectomy surgery is actually more effective for treating leg
pain
(radiculopathy)
than for lower back pain. The impingement on the nerve root (compression) can cause
substantial leg pain, and while it may take weeks or months for the nerve root to
fully heal and any numbness or weakness get better, patients normally feel relief
from leg pain almost immediately after a microdiscectomy surgery.
|
|
|
Microdiscectomy spine surgery procedure |
|
|
A microdiscectomy spine surgery is performed through a small (1 inch to 1 1/2 inch)
incision in the midline of the low back. |
|
|
 |
First, the back muscles (erector spinae) are lifted off the bony arch (lamina) of
the spine. |
|
|
|
The surgeon is then able to enter the spine by removing a membrane over the nerve
roots (ligamentum flavum), and uses either operating glasses (loupes) or an operating
microscope to visualize the nerve root. |
|
|
|
Often, a small portion of the inside facet joint is removed both to facilitate access
to the nerve root and to relieve pressure over the nerve. |
|
|
|
The nerve root is then gently moved to the side and the disc material is removed
from under the nerve root. |
|
|
|
Importantly, since almost all of the joints, ligaments and muscles are left intact,
a microdiscectomy spine surgery does not change the mechanical structure of the
patient's lower spine (lumbar spine). |
|
|
When to have microdiscectomy spine surgery |
|
|
In general, if a patient's leg pain due to a disc herniation is going to get better,
it will do so in about six to twelve weeks. As long as the pain is tolerable and
the patient can function adequately, it is usually advisable to postpone back surgery
for a short period of time to see if the pain will resolve with conservative (non-surgical)
treatment alone. |
|
|
If the leg pain does not get better with conservative treatments, then a microdiscectomy
surgery is a reasonable option to relieve pressure on the nerve root and speed the
healing. Immediate spine surgery is only necessary in cases of bowel/bladder incontinence
(cauda equina syndrome) or progressive neurological deficits. It may also be reasonable
to consider back surgery acutely if the leg pain is severe. |
|
|
Microdiscectomy spine surgery is typically recommended for patients who have experienced
leg pain for at least six weeks and have not found sufficient pain relief with conservative
treatment (such as oral steroids, NSAID's, and physical therapy). However, after
three to six months, the results of the spine surgery are not quite as favorable,
so it is not generally advisable to postpone microdiscectomy surgery for a prolonged
period of time (more than three to six months).
|
|
|
