Is Microdiscectomy Right for You?
Minimally invasive spinal procedure can fix herniated disc
Minimally invasive spinal procedure can fix herniated disc
One of the most common causes of leg pain has nothing to do with a problem in your leg. Instead, it may be coming from a herniated disc in your spine.
A herniated disc can cause pain felt in the leg or lower back. If medication and other treatments don’t provide relief, a minimally invasive surgical procedure called microdiscectomy may be an option. This surgery involves taking out a small part of the disc to ease pressure on the spinal nerve.
“The success rate for microdiscectomy is very high,” says Stephen Stephan, MD an orthopedic spine surgeon at Scripps Clinic Torrey Pines and Scripps Clinic Encinitas. “If you’re having pain from a herniated disc and nothing is helping, consider talking with an orthopedic surgeon. You don’t have to keep living with chronic pain.”
What causes herniated disc?
A herniated disc, also called a slipped disc, happens when the discs in the spine get injured. This can be due to injury, being overweight or poor posture. The damage can cause the disc to bulge, rupture or move out of place. When this happens, the disc may press on a spinal nerve.
Depending on the location of the damaged disc, the irritated nerve can cause pain, weakness or numbness in the arm, leg or lower back. Most herniated discs occur in the lumbar area of the lower spine; only about 10% affect the upper spine.
Leg pain caused by a herniated disc is called radiculopathy and sciatica. It is marked by a sharp or burning pain that goes down the leg.
Who has herniated discs?
A herniated disc most often occurs in people between the ages of 30 and 50, although it can affect younger and older people.
“Many patients, especially younger people, will recover from a herniated disc with nonsurgical treatments, such as medication, cortisone injections and physical therapy,” says Dr. Stephan. “If none of these treatments are effective after six to 12 weeks, microdiscectomy may be the best option.”
In rare cases, surgery may be needed sooner if the irritated nerve causes major weakness or affects bowel/bladder function.
What is microdiscectomy?
Surgeries for herniated discs used to require large incisions to remove tissue pressing on a nerve. Most spine surgeons today use advanced techniques for microdiscectomies. These procedures are less invasive than other back surgeries, causing less pain, reducing infection risk and allowing for a faster recovery.
The surgeon in less invasive procedures makes a small incision in the back to access the herniated disc and uses small tools and a microscope to remove the part of the disc causing nerve pressure.
Microdiscectomy techniques
A microdiscectomy can be performed using one of three minimally invasive techniques to gain access to the herniated disc and nerve:
- Midline microdiscectomy: The surgeon makes the incision in the back and separates the surrounding muscles around the vertebrae to access the herniated disc.
- Tubular microdiscectomy: Rather than moving the muscles, the surgeon accesses the damaged disc by inserting small tubes through the incision to form a tunnel through the muscles.
- Endoscopic microdiscectomy: Using a tiny camera and surgical instruments inserted through a small incision, the surgeon performs the procedure guided by video from the camera.
Recovery process
Microdiscectomy is usually done as an outpatient procedure, meaning you can go home the same day. The surgery is done with general anesthesia and takes about 30 to 60 minutes. Afterward, you will spend a few hours in the recovery room.
After you get home, you should rest for two weeks to let your tissue heal. Try to avoid strenuous activities for around six weeks.
You may begin physical therapy a few weeks after surgery to help you rebuild your strength and mobility and learn how to move safely to avoid new injuries. Your therapist can show you how to modify your activities, evaluate how you move at work and give you exercises to do at home.
Many patients feel relief from a herniated disc almost immediately after surgery. If the nerves have been irritated and causing you pain for a long time, it may take a bit longer for the pain caused by the herniated disc to subside.