Lumbar Microdiscectomy

Overview of Lumbar Microdiscectomy in India

Microdiscectomy is a kind of minimally invasive surgical procedure intended to relieve pressure on the spinal nerves by removing small fragments of disc material that are pinching the nerve roots. This technique is conducted using the help of microscopes or other magnification instruments, which allow the surgeon to work precisely, causing minimal damage to surrounding tissues.

The major objective of microdiscectomy is to relieve pain, numbness, and weakness in the legs or arms, caused by nerve compression. This surgical technique is especially useful for patients with lumbar disc herniation – the lower back discs start bulging or rupturing, resulting in sciatica – a painful condition characterised by radiating pain in the leg. By removing the herniated part of the disc, microdiscectomy helps to restore the normal functioning of the patient.

Microdiscectomy is performed under general anesthesia and usually requires making a cut about one to two inches long in the patient's back. After carefully opening the tissues, the surgeon gains access to the affected disc and uses special instruments to remove the herniated part of the disc. The minimally invasive procedure causes less pain and faster recovery compared to traditional surgery.

What is Lumbar Microdiscectomy?

Lumbar microdiscectomy, which is alternatively called microdiscectomy, is a type of minimally invasive procedure performed on patients suffering from lower back pain caused by a herniated disc. The section of the intervertebral disc that causes pressure on the nerves of the spinal cord, leading to pain, weakness, and tingling in the leg muscles, can be removed by microdiscectomy. This type of surgery involves making small incisions in the lower back region, where the doctor can access the injured disc area and perform the operation.

This operation aims to alleviate the patient’s symptoms and speed up recovery by removing the injured disc sections and bone spurs. After undergoing this operation, most patients feel immediate pain relief and are able to get back to normal activity within a week, as long as they follow all the instructions given to them by their physicians concerning physical restrictions and physiotherapy exercises. Moreover, another operation called cervical microdiscectomy treats a herniated disc located in the neck region.

Types of Lumbar Microdiscectomy:

The lumbar microdiscectomy is a gold standard procedure that is used mostly to treat some particular conditions of the spine, more specifically of the lumbar area of the spine. The conditions that are usually treated include:

Lumbar Herniated Disc: In case the inner nucleus of the lumbar disc (nucleus pulposus) pushes outwards beyond the outer fibrous part (annulus fibrosus), then there will be additional pressure on spinal nerves resulting in pain, numbness or weakness. Such a condition can be called a slipped or ruptured disc.

Sciatica: This condition includes the presence of pain running from the lower back to the hip through the leg due to pressure on nerve roots from the herniated disc.

Cauda Equina Syndrome: This is a rare but severe condition, which occurs because of a large herniation of a disc and pressure put on a group of nerves at the end of the spinal cord (cauda equina). Cauda equina syndrome causes such symptoms as severe pain, numbness and loss of control of the bladder and bowels.

Radiculopathy: Radiculopathy involves such symptoms as pain, numbness, tingling or weakness in the legs due to pressure on nerve roots. In the case of the lumbar region, it will be pain in the legs.

Recurrent Disc Herniation: Sometimes the already herniated disc can herniate again after initial treatment. In such a case, a lumbar microdiscectomy might be needed.

Procedure:

Patients may feel less anxious about the surgery if they are aware of the microdiscectomy procedure. Here is a detailed rundown of what to anticipate prior to, during, and following the surgery.

Before the Procedure:

Arrival: The patients will arrive at the surgery centre or hospital, where they will register and complete all necessary paperwork.

Pre-operative assessment: A nurse will perform a preoperative assessment, such as checking the vitals and marking the surgical site.

Anesthesia: An anesthesiologist will come to talk to the patient regarding anesthesia. Microdiscectomies are generally done under general anesthesia; hence, the patients will be asleep during the process.

During the Procedure:

Positioning: After the patient is put to sleep, the positioning phase will begin with the patient placed face-down on the operating table. In this way, the doctor gets the best access to the spine.

Making an incision: The surgeon makes a small incision in the lower back, approximately 1 to 2 inches long. This method reduces the trauma to the tissue and speeds up recovery.

Getting to the Disc: With the help of special equipment, the surgeon pushes the tissues and muscles to get to the problem disc. Fluoroscopy (X-rays) can be used to help the surgeon.

Herniated Part Removal: The doctor identifies the part of the disc that has moved out of place and applies pressure to the spinal nerve. Then he removes this herniated part.

Closing of the Incision: After the removal of the herniated part, the surgeon closes the incision using stitches or staples.

After the Procedure:

Recovery Room: Patients will be taken to the recovery room, where they will be observed while waking up from anesthesia. Their vital signs will be monitored on a regular basis.

Pain Management: Pain management will be provided, and patients will get instructions on pain management at home.

Discharge Instructions: Stable patients will be given discharge instructions that include information on activity limitations, wound care, and future appointments. Most patients will be allowed to go home on the same day as the procedure.

Follow-Up: A follow-up visit is usually arranged one or two weeks after the surgery.