What is a Microdiscectomy?
Microdiscectomy is the most commonly used surgial treatment for herniated discs. A fibrocartilage disc sits atop each vertebra (backbone) of the spine. A herniated or bulging disc happens when the soft inner layer of these intervertebral discs bulges through the hard outer layer, which can then press on nerve roots branching from the spinal cord and cause pain, numbness, weakness and other symptoms.
A microdiscectomy is the surgical removal of the herniated part of a disc, as well as any fragments of the disc that may have broken off. During a microdiscectomy, surgeons will use an operating microscope and often special magnifying goggles called loupes to better see what they are doing.
Who is a candidate?
Although microdiscectomy is considered the standard of surgical treatment for herniated discs, it is not usually the first treatment. Much more commonly, people try conservative, nonsurgical management of herniated discs.
Nonoperative treatment can include:
- Exercise and physical therapy
- Corticosteroid injections
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Patients who have tried nonsurgical treatments for their herniated discs and did not experience relief of pain or other symptoms are candidates for microdiscectomy.
How is it performed?
Open microdiscectomy is considered the gold standard of herniated disc surgical treatment. Though it is considered an open procedure due to incisions, most microdiscectomies are performed with small incisions–1 to 1.5 inches–and little disruption to muscle and other tissue around the vertebra with the herniated disc.
Most microdiscectomies are performed under general anesthesia, meaning the patient is unconscious. The surgeon makes the incision over the vertebra in question. He or she moves aside muscle, connective tissue and nerve fibers to access the facet joint, the joint where two vertebrae connect to each other.
The surgeon will then, with the aid of the microscope and loupes, remove the bulging piece of disc as well as any fragments that may have broken off. Then the muscles, nerves and connective tissue are moved back to their correct place and the incision is closed.
A microdiscectomy is usually an outpatient procedure, meaning the patient can leave the hospital or surgery center within 24 hours of surgery. Symptoms may improve immediately after surgery, or it could take days to weeks.
Pain after surgery is likely, but can be managed with over-the-counter or prescription painkillers and anti-inflammatories. Doctors usually advise patients to ice the incision area a few times a day to cut down on pain and swelling. The worst pain should subside within about 48 hours, but there may be discomfort for a period of weeks after the surgery.
It is advised to follow the surgeon’s advice on limiting vigorous activity and strenuous exercise, for a period of up to six weeks. Do not lift anything heavy enough to cause strain, which will be different for everyone.
It is important to start moving right away to avoid becoming deconditioned and to speed the healing process. Doctors will usually prescribe stretching exercises that can be done as soon as the immediate pain of the surgery subsides. These exercises are meant to minimize scarring.
The surgeon may prescribe physical therapy to begin about two to three weeks after surgery. Physical therapy is aimed at strengthening the muscles of the back to protect and stabilize the spine.
If you are experiencing back pain, neck pain or pain in the arms or legs, request an appointment at Edison Spine Center. Our expert spine surgeons will be able to diagnose any herniated discs or other sources of pain, and will recommend an effective treatment plan that works for you and your circumstances.