Spinal surgery once meant large incisions, long recovery periods, and painful rehab. Fortunately, surgical advances like the microdiscectomy procedure have improved the process.
Microdiscectomy, also sometimes called microdecompression or microdiskectomy, is a minimally invasive surgical procedure performed on patients with a herniated lumbar disc. During this surgery, a surgeon will remove portions of the herniated disc to relieve pressure on the spinal nerve column.
According to the Spine Institute of San Diego, a microdiscectomy procedure is up to 95 percent effective at eliminating sciatica pain caused by disc herniation. Sciatica is a pain condition caused by compression of the spinal nerve. This compression is most often the result of a herniated lumbar disc.
As the hernia develops and the damaged tissue extends into the spinal column, it pushes on the nerves. This causes the nerves to send pain signals to the brain. The pain is interpreted to be coming from the legs.
Most cases of sciatica will heal naturally without surgery in a few weeks. If the pain from sciatica lasts more than 12 weeks, you may benefit from a microdiscectomy.
A microdiscectomy is not effective in relieving back pain.
The goal of a microdiscectomy is to remove the disc material placing pressure on the nerves. The procedure is done under general anesthesia. You will be unconscious during the entire procedure and unable to feel anything. The procedure is performed with the patient lying face down. The process goes as follows:
- A 1- to 1 1/2-inch incision will be made directly over the affected disc.
- A lighted microscope is used to help your surgeon see the affected area.
- The surgeon may remove a small portion of bone that protects the root nerve.
- With a scissor-like tool, your surgeon will remove the damaged herniated tissue, relieving the pressure on the nerve.
- The incision is closed with sutures.
- The patient is usually discharged the same day or the next morning.
The spinal nerve now has the space it needs inside the spinal column, so any pain caused by pinching on the nerve should stop.
The recovery time is shorter than other, more invasive procedures. Most people can expect to leave the hospital that same day, or within 24 hours.
You’ll likely meet with a physical therapist and occupational therapist before leaving the hospital. These therapists will give you instructions on how to reduce the bending, lifting, and twisting you do with your back. The therapist may tell you what exercises you can do to improve the strength and flexibility of the muscles around your spine.
You should avoid driving, sitting for a prolonged period, lifting anything heavy, and bending over immediately after the surgery. Although you won’t be able to resume normal activities immediately, your lifestyle shouldn’t be greatly impacted. For the first week or two, you may need to reduce your workload or be absent from work while you recover. You’ll also need to avoid lifting heavy objects for two to four weeks after the surgery. This generally includes anything more than 5 pounds.
You may also need to slowly progress your way back to normal physical activity. For example, you may not be able to resume exercise or physical hobbies for two to four weeks after the procedure. The typical time to a full recovery is about six weeks.
Microdiscectomy is a safe procedure and complications are rare. However, like any surgery, there are some risks. These include:
- dural tear (cerebrospinal fluid leak) in 1 to 2 percent of surgeries
- nerve root damage
- recurrent disc herniation (5 percent of cases)
- bowel/bladder incontinence (very rare)
A microdiscectomy is a specialized surgery that requires a surgeon with special training. Because of this, it can be more expensive than other back surgeries. Prices for the surgery vary and can range anywhere from $15,000 to $50,000. This price may not include any follow-up visits or care.
Your health insurance may cover a large portion of this expense once you pay your deductible and coinsurance. If you don’t have insurance, be sure to talk with your hospital, surgeon, and all other medical professionals before receiving the procedure. Ask if you can negotiate a lowered rate because you are paying from your own pocket.
Microdiscectomy is a minimally invasive procedure with an outstanding track record for relieving pain. While most patients who experience sciatica will not require surgery, if all other treatments fail, a microdiscectomy may be warranted. Your doctor will review your unique circumstances and determine if the procedure is right for you. If you’re a candidate, you should discuss the risks and benefits of the surgery with your doctor.
Are there any alternatives to this surgery?
With microdiscectomy, more surgeons are using local or epidural anesthesia, resulting in less complications and improved patient satisfaction. Another alternative is a radiofrequency neurotomy, in which heated radio waves target the affected nerves to block the pain. A spine specialist may recommend injection therapy to reduce inflammation and swelling in the areas around the disc and nerve.
However, if surgery is not an option, other methods are available. These include physical therapy and chiropractic adjustments. Spinal decompression using a traction table could also be helpful. In addition, acupuncture may help manage your pain.Dr. Mark LaFlammeAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.