Lumbar Microdiscectomy

A lumbar microdiscectomy is a surgical procedure used to treat a herniated disc in the lower back, also known as the lumbar spine. The goal of the procedure is to relieve pressure on the spinal nerves caused by the herniated disc, which can cause pain, numbness, tingling, and weakness in the legs.

Indications for Lumbar Microdiscectomy

The following are indications for a lumbar microdiscectomy:

• Herniated disc in the lumbar spine that is causing symptoms such as pain, numbness, tingling, and weakness in the legs
• Disc herniation that is compressing a spinal nerve, causing radiculopathy (nerve root pain)
• Failed conservative treatment, such as physical therapy, medication, and injections
• Severe or progressive neurological deficits, such as numbness, tingling, or weakness in the legs

Procedure

The lumbar microdiscectomy procedure typically involves the following steps:

1. The patient is given general anesthesia and positioned on their stomach on the operating table.
2. A small incision (about 1-2 inches) is made in the lower back, and the muscles are gently retracted to expose the affected disc.
3. A microscope or endoscope is used to visualize the disc and surrounding nerves.
4. The herniated disc material is carefully removed, and any fragments that are compressing the spinal nerve are extracted.
5. The incision is closed with sutures or staples, and the patient is taken to the recovery room.

Types of Lumbar Microdiscectomy

There are two main types of lumbar microdiscectomy:

• Open microdiscectomy: This is a traditional open surgery approach, where a larger incision is made to access the disc.
• Minimally invasive microdiscectomy: This is a less invasive approach, where a smaller incision is made and specialized instruments are used to remove the herniated disc material.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with lumbar microdiscectomy, including:

• Bleeding or hematoma
• Infection
• Nerve damage or numbness
• Recurrence of herniated disc
• Adverse reaction to anesthesia

Recovery and Rehabilitation

After a lumbar microdiscectomy, patients typically experience:

• Immediate relief from pain and numbness in the legs
• A hospital stay of 1-2 days
• A recovery period of 2-6 weeks, during which time they should avoid heavy lifting, bending, or strenuous activities
• A physical therapy program to improve strength, flexibility, and range of motion in the back and legs

Success Rates

The success rate for lumbar microdiscectomy is generally high, with:

• 80-90% of patients experiencing significant improvement in symptoms
• 50-70% of patients returning to normal activities and work within 6-12 weeks

Alternative Treatments

Before considering surgery, patients may want to explore alternative treatments, such as:

• Physical therapy and exercise
• Pain management with medication or injections
• Chiropractic care or spinal manipulation
• Lifestyle modifications, such as weight loss, smoking cessation, and stress reduction