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Lumbar Microdiscectomy

What does “Lumbar Microdiscectomy” mean?

Here is the meaning of each word:

1. Lumbar: the area of the spine located in the low-back

2. Microdiscectomy: small surgical procedure where a piece of the disc is removed, often with the help of a Microscope

Altogether, “Lumbar Microdiscectomy” means removing a piece of herniated disc from low back with a minimally invasive procedure which often uses a microscope.

What is a Lumbar Microdiscectomy?      

A Lumbar Microdiscectomy is a small surgical procedure usually done for a disc herniation in the low-back. Disc herniations in this part of the spine are extremely common and often cause sciatica. After an incision is made, small retractors (hold tissue out of the way) are used to cause minimal trauma to the spine’s anatomy. A small piece of lamina bone is removed and the disc is found under the spinal nerve. A microscope is usually used while the disc herniation is removed.

Why is a Lumbar Microdiscectomy done?

A Lumbar Microdiscectomy is done for a disc herniation in the low-back which is either pushing (compressing) on a spinal nerve or the cauda equina (bundle of nerves below the spinal cord).

What is the difference between a Lumbar Discectomy, Lumbar Microdiscectomy, a Lumbar Endoscopic Discectomy, and a Lumbar Percutaneous Discectomy?

1. A Lumbar Discectomy is an open surgery, done with a larger incision and more of a dissection (moving more of the anatomy aside to be able to see the disc). It is usually done for larger, more complicated disc herniations.

2. A Lumbar Microdiscectomy is done with a smaller cut (incision) than a Lumbar Discectomy and often uses small retractors and Microscope to see the disc herniation.

3. A Lumbar Endoscopic Discectomy is done through a small tube which is placed into the spine. A small scope is then placed through the tube to see the disc. This procedure is usually done for smaller, uncomplicated disc herniations.

4. A Lumbar Percutanous Discectomy is done through a needle. It is usually done for very small disc herniations and can only remove very small amounts of disc material.

How is a Lumbar Microdiscectomy done?

Here are some of the steps of how a Lumbar Microdiscectomy is performed:

  1. This surgery is done in an Operating Room.
  2. An intravenous catheter (IV) is placed before surgery and antibiotics are given.
  3. In the Operating Room, the patient is initially place on the back (supine) and a General Anesthetic is given.
  4. The patient is then carefully placed on the stomach (prone).
  5. The low-back (lumbar spine) is cleaned with a sterile surgical solution and sterile sheets (drapes) are placed around the surgical site.
  6. The surgeon makes a small cut (incision) over the spine.
  7. The tissue and muscles under the skin are freed up from the bone and moved to the side.
  8. A small retractor which is often in the shape of a tube is placed down to the lamina bone.
  9. The lamina bone on the back of the spine is seen and a small portion removed.
  10. A ligament (ligamentum flavum) is seen under the lamina and a portion removed.
  11. The spinal nerve and dura (lining of the spinal cord and spinal fluid, which contains the cauda equina) is now seen.
  12. The disc herniation behind the spinal nerve or dura is located and removed.
  13. The tissue and skin are closed with stitches (sutures).
  14. A bandage (dressing) is placed on the surgical site.
  15. The patient is turned on the back (supine) and awoken from Anesthesia.
  16. The patient is brought to the Recovery Room.

How long does it take to perform a Lumbar Microdiscectomy?

A Lumbar Microdiscectomy may take 45 minutes to 2 hours or more to complete.

What is the recovery like from a Lumbar Microdiscectomy?

Here are some of the steps during a recovery from this type of surgery:

  1. The patient is usually admitted to the hospital for at least an overnight stay.
  2. After discharge, activity restrictions about lifting, bending, twisting, running, etc. will be given.
  3. The wound will heal within 2-4 weeks on average.
  4. The surgeon will typically evaluate the patient again within several weeks after the surgery.

What benefit can patients gain from a Lumbar Microdiscectomy?

A Lumbar Microdiscectomy will remove pressure on the spinal nerve or cauda equina. The symptoms often improve over weeks and months following the surgery.

Depending on how long a nerve was compressed and the severity of the compression, some symptoms may remain.