One of the most common minimally invasive spinal surgeries, microdiscectomy, also known as microdecompression, is used to relieve the pressure on the affected spinal nerve to provide pain relief.
This procedure can be used to remove a part of the disc that is bulging and pressing on the nerve. It can also be used to remove fragments of the disc that have broken away from the disc causing compression on the nerves.
What Does a Microdiscectomy Treat?
To fully determine the necessity of a microdiscectomy, we will review what conservative treatments have been attempted and their success rate. This includes physical therapy, pain killers, injections, and other pain management techniques. We would suggest a microdiscectomy only if we find that these treatments are ineffective in giving you pain relief.
When Do You Need a Microdiscectomy?
In most cases, a herniated disc will heal after conservative treatments. Only 10% of patients with a herniated disc or degenerative disc disease don’t respond positively to a conservative treatment path and should be considered for a microdiscectomy.
After reviewing your body’s response to conservative treatments for your herniated disc or degenerative disc, your patient care coordinator and the spinal surgeons at Inspired Spine will use the following diagnostics and determine the extent of your pain levels:
- diagnostic tests including MRI, CT, myelogram
- significant pain, weakness, or numbness in your leg or foot
- advanced sciatica pain in your leg(s)
- loss of strength in your leg(s)
- numbness in the genital area
- reduction or loss of bladder or bowel control
Of course, you make the final decision, yet our spinal surgeons will make the recommendation of microdiscectomy if its absolutely necessary.
What to Expect
Just like traditional open discectomies, microdiscectomy aims to remove the part of the intervertebral disc that bulges out and is compressing the nerve and causing pain. Like other minimally invasive spinal surgeries, this procedure also requires special instruments and cameras that allow the surgeon to make small incisions and view the anatomy of the spine. These small tools help to reduce the damage to the surrounding structures during the procedure, leading to a faster and less painful recovery.
There are 3 Main Techniques for Microdiscectomy
- Mini-open technique – most similar to an open discectomy, but special instruments are used to view the spine through smaller incisions.
- Tubular technique – a tube is inserted into a small incision and pushed gently till it reaches the spine. Expanding tubes are inserted to gradually dilate the area (push away structures instead of having to cut them away) and instruments are used to remove part of the disc.
- Endoscopic – a tiny camera (endoscope) is inserted through a tube to allow visual access and the disc is removed using specialized instruments. This procedure usually takes about an hour to complete. Most patients report significant pain relief and can return quickly to their routines and activities, usually in about 2 weeks.
Microdiscectomy at Inspired Spine
Anesthesia & Surgical Preparation
The microdiscectomy procedure is performed using general anesthesia. The Inspired Spine spinal surgeon inserts a small breathing tube (called an endotracheal cannula) into the mouth and down the trachea. This is used to provide breathing during surgery.
After positioning the patient face down (prone) on a padded operating table, the skin of the back is cleaned and prepped with an antiseptic. Sterile drapes are positioned around the surgical site.
The Surgical Procedure
A small 2-centimeter incision is made in the middle of the lower back, right over the region of the herniated disc. A special retractor device is used to open the site. The surgeon uses a tiny microscope to visualize the area of the spine in question, so there is little need to cut or remove adjacent muscles and soft tissues. Once retractors are positioned, an x-ray is done to confirm the disc.
To visualize the disc herniation, the surgeon removes a few millimeters of bone of the superior lamina. The nerve root and other structures are protected using the retractor, so the herniated disc material can be removed from the spinal column. Small, specialized instruments are used to grasp and remove the protrusions. All surrounding areas are cleansed with saline/antibiotic solution to remove disc fragments as well. The surgeon closes the deep fascial layer and subcutaneous tissues using strong sutures. A bandage is applied over the surgical site.
How Effective is a Microdiscectomy?
A recent study evaluated 197 patients who had a single-level lumbar microdiscectomy surgery. All patients failed with physical therapy, epidural steroid injections, and medications.
After surgery, researchers concluded that the procedure was successful, with 84% of patients returning to unrestricted activities on the job. In addition, 80% of patients reported decreased pain, and overall, 85% of patients were satisfied with the procedure.
Contact Inspired Spine Today
Our patient care coordinators are here to answer questions about relieving your back pain using conservative and minimally invasive treatments. Most major insurance plans are accepted, including Medicare.
OR call 727-MY-SPINE to talk to a patient care specialist.