A lumbar microdiscectomy is a spine surgery to remove part of a vertebral disc in the lower back. The term “lumbar” describes the spinal bones in lower back, starting at the bottom of the rib cage and ending at the pelvis. The answer to the question “what is a microdiscectomy?” requires a definition for “micro-” in this context. The “micro-” in microdiscectomy simply means that the spine surgeon will use lenses that magnify the surgical area (as in microscope) to provide a highly detailed and up-close image of the spinal disc and its surroundings.
The “minimally invasive” part of minimally invasive lumbar microdiscectomy means that the spine surgeon will make very small incisions and use a camera embedded within a flexible tube called an endoscope to visualize the surgical area. Lumbar microdiscectomy without the term “minimally invasive” indicates that it is an “open” procedure. An open lumbar microdiscectomy means that the spine surgeon will make slightly larger surgical incisions and view the surgical area through an external microscope. Because of smaller incisions, minimally invasive lumbar microdiscectomy recovery may be faster and easier for patients than the open procedure.
Minimally invasive lumbar microdiscectomy surgery is indicated for people who have a ruptured disc in the lower back is causing moderate to severe symptoms such as pain, weakness, numbness, and/or tingling. Lumbar microdiscectomy can be used to treat a ruptured spinal disc or bone spur that is pressing on nearby nerves—the disc is partially removed, and the nerve is decompressed, which usually relieves most symptoms.
Minimally invasive lumbar microdiscectomy surgery is often the best surgical option for patients who have nerve compression caused by a spinal disc and who do not want or need lumbar disc fusion or artificial disc replacement.
Recovery is usually faster and milder after minimally invasive lumbar microdiscectomy than with the open procedure, so from the patient’s perspective, it is usually the better choice. However, endoscopic lumbar microdiscectomy is more technically challenging than open lumbar microdiscectomy, so if you choose the endoscopic approach, make sure to find a spine surgeon who is experienced and skilled in minimally invasive spine surgery. While the incision for endoscopic lumbar microdiscectomy is smaller, the “open” lumbar microdiscectomy incision is rather small in its own right. Thus, talk to your spine surgeon about the risks and benefits of both approaches.
Since your spine surgeon will need to gain access to your lower back, lumbar microdiscectomy surgery is performed while you are lying face down. Once you are under general anesthesia, your spine surgeon will make a small incision in your lower back and carefully move your back muscles to uncover the lumbar spine. In the “open” procedure, standard retractors hold the muscles apart, while in the minimally invasive microdiscectomy approach, a tubular retractor in the endoscope does this. Once the surgeon can clearly see the spine through the endoscope or surgical microscope, a small piece of spinal bone called the lamina is removed (i.e., a laminectomy) along with any bone spurs of spinal disc material that is pressing on nerves. Once the nerves are decompressed, and the area if clear, the retractors are removed, the muscles are placed in their original alignment, and the skin is closed with sutures (stitches) or staples.
Every surgery poses certain risks, including infection, bleeding, or a poor reaction to anesthesia; however, the overall risk of any of these occurring is low. Specific lumbar microdiscectomy risks include injury to the spine, nerve root, or nerve that could lead to numbness, tingling, or weakness. In skilled hands, these lumbar microdiscectomy risks are unlikely to occur. Be sure to speak with your spine surgeon about how lumbar microdiscectomy risks apply in your specific clinical situation.
Even though the incisions are smaller, minimally invasive lumbar microdiscectomy recovery does take time. You may or may not need to spend a night in the hospital after lumbar microdiscectomy back disk surgery. Prepare to stay overnight, however. It is always best to prepare for an overnight stay and not need one than to have an unexpected hospital stay.
Lumbar microdiscectomy recovery tends to be rather mild, especially with the minimally invasive approach. You can expect to be up and walking around within several hours after surgery. In fact, walking is considered an important part of the healing process. Because the surgery affects the lower back, sitting for long periods may be uncomfortable initially. Pain medications may be prescribed for a few days after surgery and can help with discomfort during lumbar microdiscectomy recovery.
While patients invariably ask, “what is a microdiscectomy recovery time?” the answer varies from person to person. People may be able to return to office work within as little as two weeks, though people who must lift or perform manual labor as part of their job may not be able to return to work for up to two months. Since lumbar microdiscectomy recovery time can affect your decision of whether to have the surgery, be sure to talk to your spine surgeon about recovery time during your consultation.
Narrow your search to only board-certified spine surgeons.
Minimally invasive lumbar microdiscectomy is a technically challenging surgery, so look for providers who are board-certified to perform spine surgery—either neurosurgeons or orthopedic surgeons who have completed a spine surgery fellowship.
Collect your clinic notes, lab reports, and imaging studies.
Most people start by speaking with a primary care doctor about their lower back pain symptoms. Consequently, these professionals may perform neurological examinations or order X-rays or MRIs. It is helpful for your spine surgeon to be able to review these notes—especially any results from imaging. If you can bring results to your visit or have them sent to the surgical practice electronically, you will get the most out of your consultation.
Be prepared to discuss your symptoms.
The minimally invasive lumbar microdiscectomy specialist will likely ask how your symptoms started, what makes them better or worse, and whether the symptoms interfere with your daily life. Be prepared to share any treatments you have tried to treat your lower back pain symptoms and how long you have been suffering with the problem.
Ask the tough questions.
Be sure to ask your spine surgeon about their success rate, complication rate, and how many minimally invasive lumbar microdiscectomies they have performed. If you are considering an endoscopic procedure, ask the surgeon if they are comfortable performing the procedure through an endoscope. If you are still undecided, ask about the differences between open and endoscopic lumbar microdiscectomy so you can make an informed choice.
FOLLOW US ON SOCIAL MEDIA | @ADRSPINE