A lumbar microdiscectomy may be performed for patients who have a herniated disc in their spine. When the disc presses on the nerve there is often pain that travels through the buttock and down a leg to the ankle or the foot. There may also be weakness in certain muscles in one or both legs, pain in the front of the thigh and severe deep muscle pain spasms.
Following general or spinal anesthesia, a cut, approximately one inch long is made in the skin. The muscle is moved often using a series of metal tubes so as to spare the muscle in order to expose the shielding bone of the spine, called the lamina. Removing this small part of the lamina does not affect the strength of the back. A small part of this lamina is removed to reveal the nerves. Then, through a microscope, the nerve is moved aside and the part of the disc that presses on the nerve is removed. Most commonly, the disc fragment is already loose and no “cutting” of the disc is necessary. Additional degenerated disc material is also removed. The wound is then closed with absorbable sutures that dissolve in 4-6 weeks.
Finally a glue is applied to the surface of the skin which will waterproof the incision. There are no stitches on the surface to remove and the glue allows the patient to take a shower within several hours of the surgery. Most patients leave the hospital or surgery center within 4 hours.
As with any surgery, there are risks of bleeding, infection and nerve injury. However, these risks are small and generally occur in less than 5% of the cases. Despite the natural fear of having surgery, the possibilities of either death or paralysis are extremely unusual with this type of procedure.
Following the surgery, you will be expected to be able to walk right away. While recovery varies considerably from one patient to another, most people resume their normal activities of daily living within the first couple of days. Although there is soreness at the surgery site, the pain radiating down the leg that you had experienced before the operation will generally improve but may never entirely go away. In place of this shooting pain, patients often describe a feeling of numbness and tingling along the leg. Most patients can return to a sedentary job within 1-2 weeks, active job within 4-6 weeks and a demanding or heavy job (e.g. construction) within in 3 months.
Of the patients who have this surgery, 80-90% report substantial pain improvement. In the remaining 10%, the lack of improvement stems from pain which may be caused by problems other than nerve pressure. In some instances, removing the pressure to the nerve will not reverse the damage already done to the nerve.
Despite relieving pressure on the nerve, a microdiscectomy does not improve the strength of your back. Core strengthening exercises, supervised by a physical therapist, followed by regular home exercise are recommended to help stabilize the back.
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