What is Lumbar Microdiscectomy Surgery?
Lumbar disc herniations are very common and often don’t cause any symptoms. The herniated disc contents cannot be pushed back but will often dry out and shrink back into position itself. However, sometimes the disc has degenerated and must be removed.
Disc degeneration means the disc is no longer able to perform its shock-absorbing functions, and also becomes reduced in height. Spinal discs are intended to be flexible, thereby allowing the spine to move forwards, backwards and sideways. This then leads to added strain on areas, promoting spinal instability, and an inability to hold normal loads. Ultimately, this can contribute to lower back pain.
Where surgery is indicated, a microdiscectomy removes the degenerated disc to allow normal function and movement of the spine. During the microdiscectomy, only the loose parts of the nucleus within the disc and spinal canal are removed. The annulus tear cannot be repaired, but usually repairs over time by scarring, and the back pain may also settle with it. A prosthesis (or artificial replacement) is used in the procedure. By completely removing the disc the pain is eliminated.
Disc replacement surgery is now seen as the alternative option to undergoing spinal fusion surgery.
A discectomy is performed to relieve pressure on nerves and the resulting leg symptoms. It is not performed for back pain.
Advantages of Disc Replacement Surgery
As opposed to a spinal fusion, disc replacement surgery:
- Allows motion in the area
- Reduce risk to to adjacent discs
- Allow a quicker return to everyday activities
Possible symptoms affecting one or both legs due to an acute herniation include:
- Pins and needles
Usually these symptoms will improve without surgery in 6-12 weeks. If the symptoms are not controlled after six to twelve weeks of conservative treatments, then Dr Parkinson will consider operating.
The size of the hernia is not related to the amount of pain or leg symptoms, however if the herniated disc is pushing on spinal nerves and causing severe pain, bowel or bladder problems, then urgent surgery is considered. Signs of this include an inability to pass urine, or numbness in the crotch or buttocks.
When is it recommended?
The surgery may be considered if:
- Your back pain mainly comes from one or two particular discs
- You don’t have any compression on the nerves
- You aren’t excessively overweight
- You don’t have a spinal deformity
- You haven’t had any previous major surgery on the spine
The aim of a microdiscectomy is to remove the protruding part of the intervertebral disc and to to maintain motion in the affected area, and also reduce the stress on adjacent discs.