Lumbar microdiscectomy is a common surgical procedure for disc prolapse in your lower back. The procedure is called microdiscectomy because an operating microscope is used to perform the surgery. All the structures including the prolpased disc, spinal cord and spinal nerves are can be seen very clearly in great detail. Therefore the chances of injury to the nerve or recurrence of disc prolapse are very minimal.
Lumbar disc prolapse is a condition where the soft cushions between the bones of your spine called ‘discs’ bulges out as shown in the picture (above). As you can see that prolapsed disc bulges out and presses on the spinal nerve that comes out of your spinal-cord. It traps the spinal nerve (pinched nerve) and any movement causes severe back pain with leg pain. This spinal nerves gives sensation and power to your legs. That is why the pain radiates from the back down to your leg called ‘sciatica’.
When does your Spine Surgeon recommend Lumbar Microdiscectomy for Disc prolapse?
Your Spine surgeon initially recommends gentle physiotherapy sessions that will stretch your back muscles that is very sore. This is because that they have gone into ‘spasm’. These sessions helps to stretch the muscles and nerves around the Disc prolapse. This improves the “Core Stability” for your lower back. Your muscles around the spine gets strengthened and your posture becomes pain-free.
FOLLOWED BY SPINE INJECTIONS – SPINAL NERVE ROOT INJECTIONS
Physiotherapy may not be successful in managing your back and leg pain caused by a prolapsed disc. The spinal nerve that is trapped in your back is the cause your ‘sciatic’ pain in the leg. This will stop you from doing physiotherapy exercises. A mixture of a local anaesthetic and steroid will be required to reduce the pain and inflammation. These injections are called Spinal Nerve Root Injections.
If both these interventions do not work then your spine surgeon will recommend
“Lumbar Microdiscectomy” procedure
What happens before the Microdiscectomy for Lumbar Disc Prolapse?
You’ll be required to come to the hospital the night before so that they can perform simple blood tests, check your temperature and blood pressure. This ensures that you are safe and healthy for the procedure. You’re also be seen by an experienced anaesthetist who will arrange your anaesthesia during the procedure. He will also review your medication and advice on the time of fasting for the procedure.
Your spine surgeon and his team will make sure that you have all the necessary information on Microdiscectomy before the procedure.
Most probably you will be advised to:
- Bring are your medications including the prescription
- Stop all tablets that causes your blood to become thin
- Have a blood test to check your fitness for the procedure
How is the Lumbar Microdiscectomy procedure performed?
You will be brought to the anaesthetic room and the anaesthetist and his team will greet you so that you are very relaxed before the procedure. You will gradually drift off to sleep. You would lie flat on your tummy for a period of time and Spine surgeon makes a small incision in the middle of your back. With the use of a microscope he gains access to the spinal canal and removes just the portion of the disc that actually presses on the nerve that causes your back and leg pain. The surgical injection is closed with absorbable sutures with a small dressing.
The benefits of the microscopic lumbar discectomy include unlimited muscle dissection, good clarity and detail of the anatomy that ensures safety of the procedure. The pain and the risk of complication is much reduced and there is very little discomfort during recovery.
What happens after Lumbar Microdiscectomy for Disc prolapse?
After the procedure your Consultant anaesthetist will arrange transfer from the operating theatre into the recovery room. After you are fully awake, you will be then transferred to your room. Later in the day, the physiotherapist and the spinal specialist nurse will help you to set up and on the following day, will arrange for you to take a few steps. Once the consultant spinal surgeon hand his team are satisfied with your progress you will be discharged with a clear set of instructions to follow. You will be expected to stay for a period of 1 to 2 days.
After discharge from the hospital
After discharge from the hospital you will be given a discharge summary and a booklet. This will contain all the details of the Lumbar Microdiscectomy. The summary will contain the list of medications that you might need to take to control your pain after surgery. It will also help you move around. The physiotherapist will help you with the exercises for Microdiscectomy surgery. This will improve your muscle tone and aids faster return to normal activity. There will be a wound check at one week and a further appointment to remove any stitches. You will be advised on the level of activity permitted.
What should I do at home after Microdiscectomy?
The spine surgeon and his team will expect you to have had a good rest. This will allow the soft tissues enough time to heal after disc prolpase surgery. This will reduce complications like infection and bleeding. You can gradually increase your daily activities with support during the first few days. Please follow the physiotherapist advice on how to sit, stand and get on and off the bed. You’ll be required to take your medications for the first few weeks so that you’ll be able to mobilise without any pain.
What do I need to be careful about after Microdiscectomy Surgery?
Please make sure that your Microdicectomy surgical wound does not get wet or soiled when you wash and clean yourself in the first 14 days. Do not bend or lift until the spine surgeon advises you to do so. Continue physiotherapy exercises and this will increase the tone and strength of your back muscles for faster recovery back to normal from disc prolapse surgery
Get in touch if there are any concerns.
Follow up appointment after Microdiscectomy
The secretary will arrange a follow-up appointment in about two weeks’ time for a review with the spine surgeon after surgery for disc prolapse. You may need to continue physiotherapy rehabilitation for a period of up to 6 weeks.