A microdiscectomy is an operation which involves removing the damaged part of the intervertebral disc which has herniated and is compressing the spinal nerve root or roots.
This surgical procedure is used to treat patients who are suffering with symptoms (such as sciatica, numbness or weakness) from a lumbar disc herniation. The surgery aims to alleviate and prevent deterioration of symptoms, e.g. pain, numbness and weakness, caused by the compression.
Lumbar spine surgery is usually carried out under general anaesthetic. Dr Laban uses intra-operative X-ray guidance and operative microscope to minimise risk, increase accuracy and reduce complications.
Depending on the complexity of the operation and your level of mobility before the operation, you will be able to leave hospital one or two days after the procedure. Most people are able to walk unassisted, climb stairs and safely partake in light activities the day after surgery. More strenuous activities will need to be avoided for about 6 – 12 weeks.
In general, Dr Laban advises no driving for two weeks (and until you can safely perform an emergency stop and are no longer taking strong painkillers), carrying no more than 5 kg for the first 6 weeks and no more than 10kg from 6 – 12 weeks following the operation. Return to activities should be graded (stepwise) with the above caveats.
The wound should be kept clean and dry for one to two weeks (until well healed).
Risks of lumbar spine surgery
Complications are uncommon or rare but, like all surgery, a microdiscectomy carries risk. These risks include (but are not limited to):
- abnormal scarring or bleeding;
- leak of the spinal fluid (CSF leak) which surrounds the nerves;
- damage to the spinal nerves or cord resulting in pain, numbness, weakness, paralysis, incontinence or sexual dysfunction (this is rare);
- symptoms remaining the same, increasing or recurring;
- recurrent disc protrusion (further herniation of the disc substance known as nucleus pulposus);
- instability or adjacent segment disease;
- the need for further procedures;
- venous thromboembolism: a blood clot in a vein, usually in the leg which in rare cases can dislodge and travel to the lungs;
- cardiorespiratory complications; and
- general anaesthetic risks.
Minimally invasive microdiscectomy
Minimally invasive spine surgery, such as a minimally invasive microdiscectomy, involves the use of special surgical instruments and / or advanced imaging techniques to perform the operation through smaller incisions. In general, incisions are made and instruments are guided through these incisions to provide access to spinal nerves, vertebrae and discs. Using minimally invasive techniques may minimise the damage to the muscles and soft tissues and decreases the blood loss during the operation.
Minimally invasive surgical approaches can be safer, faster and require less recovery time as a result of reduce trauma to the muscles and soft tissue in comparison to an open procedure. Potential benefits of minimally invasive spine surgery are smaller skin incisions, resulting in better cosmetic results, less blood loss during surgery, reduced risk of infection and postoperative pain and a faster return to work and normal activities.