A Microdiscectomy is a surgical procedure to remove the portion of the herniated disc that is inflaming and irritating the nerve root.
A Microdiscectomy is performed through a small incision in the mid line of the lower back. First the back muscles called the erector spinae are lifted off the boney arch called the lamina of the spine (laminotomy). The back muscles lie vertically therefore rather than being cut they can usually just moved out of the way. The surgeon then enters the spine by removing a membrane that lies over the nerve roots called the ligamentum flavem so that the epidural space can be accessed. Sometimes a small amount of the inside facet joint is removed in order to allow access to the nerve root and also to relief some pressure of the nerve. The nerve root is then carefully moved to the side and the herniated portion of the disc material is removed from underneath it, leaving the healthy portion in tact. Once this portion of disc that is irritating the nerve has been removed it instantly relieves pressure and enables it to heal.
Whilst it may take a few weeks or months for the nerve root to fully heal and full strength and sensation in the leg to be restored, patients usually feel immediate pain relief after having microdiscectomy surgery. However, different patients respond differently to surgery, therefore whilst the majority will be able to return to work within 2-8 weeks, some patients will require further surgery or treatment. Possible complications of the surgery that your Mr Hutchinson will discuss with you are:
- nerve injury and paralysis
- haemorrhage (severe bleeding)
- temporary dysaesthesia (impaired sensation)
Mr Hutchinson will also speak with you regarding his experience of performing this surgery and the likelihood of any complications arising. He will assess and advise you whether you are a safe candidate to have this surgery and how long the recovery period should be for you. Some patients are given a rehabilitation programme such as exercise on the lower back which may start four to six weeks post surgery. Studies have shown these programmes help to decrease pain levels and facilitate patients to get back to a normal standard of living.