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Lumbar microdiscectomy is a surgical procedure in which a small portion of a vertebra is removed to free a nerve which is being pinched by a herniated disc. This surgery is most typically performed to address a herniated disc in the lumbar spine which is causing leg pain. Back pain may not be treatable with lumbar microdiscectomy. Because surgery is a radical step, it is only recommended after other treatment options fail, or if a patient begins to experience numbness, tingling, and similar issues.
In a lumbar microdiscectomy, the patient is usually placed under general anesthesia, although some surgeons may operate on patients with spinal anesthesia. The patient is placed on her or his stomach and supported with blocks and padding to expose the back. The surgeon makes a small incision which is used to insert surgical instruments under x-ray guidance, carefully moving the surrounding muscles to clear the surgical site for the purpose of removing the impinging bone. The structure of the spine is not changed, and the procedure usually takes less than an hour.
Often, lumbar microdiscectomy is performed as an outpatient procedure, with the patient leaving on the same day after recovering from anesthesia. Other patients may be asked to stay overnight. When discharged, the patient will need a ride home, as driving shortly after anesthesia is not advised. Patients can return to a normal activity level very quickly after the procedure, although they will need to take antibiotics to prevent infection and do breathing exercises to help their lungs recover from the anesthesia, if they were placed under general anesthesia for the procedure.
As with all surgical procedures, lumbar microdiscectomy has some risks. General anesthesia can be dangerous for some patients, even with a very skilled anesthesiologist, and the patient could experience complications such as nerve damage, infection, or incontinence as a result of the surgery. Some patients also develop dural tears, which allow cerebrospinal fluid to leak. In this case, the patient will be confined to bed for several days to recover.
This surgery has around a 90% success rate, with many patients experiencing immediate relief. Some patients develop a recurrence of the original herniation, which may require additional surgery and other treatments. Lumbar microdiscectomy recovery is usually very rapid, and includes follow up appointments so that the surgeon can conduct a neurological exam to confirm that the problem has been addressed. Because each surgery is slightly different, a patient may want to discuss the details of a specific surgery with the surgeon before proceeding.