When one of your spinal discs herniates, particularly in the mid to lower back, it can push outward and put pressure on the nearby nerves. This can create significant pain that often radiates down into the leg. This kind of herniation won’t likely improve on its own, so Dr. Albert performs lumbar microdiscectomy surgery to relieve the pressure on the nerve and remove the source of the pain.
What is A microdiscectomy?
Microdiscectomy, also known as microdecompression, is one of the most common spine surgery procedures. The goal is to remove the portion of the herniated disc that is pressing on the nerve to relieve the pain and protect against permanent nerve damage.
Microdiscectomy uses special instruments to allow the surgeon to make very small incisions. This makes for a much quicker, less painful recovery. Microdiscectomy is very effective for relieving sciatica, more so than for relieving lower back pain.
What is a herniated disc?
It helps to have an understanding of herniated discs. Between your vertebrae are rubbery cushions, the discs, which keep the bones apart. Discs have a softer gel in the interior encased in a tough outer skin. Sometimes an injury causes a tear to develop in the outer skin and the inner gel pushes outward. When the gel pushes on an adjacent nerve it results in pain, numbness, or weakness in an arm or leg. When the exiting nerve heads down to the leg, this pain is called sciatica, and the pain can be quite sharp. Over time, the nerve compression can lead to weakness or loss of function.
Am I a Candidate for a Microdiscectomy?
Dr. Albert performs a microdiscectomy to decrease pain and allow you to regain normal movement and function. These are situations where this surgery could be the best solution:
- You have very bad leg pain, numbness, and weakness that is impeding your daily activities.
- Your leg symptoms don’t respond to nonsurgical treatment.
- You are showing signs of weakness, loss of range of motion, and abnormal feelings, particularly in your leg and foot.
- The procedure can be an emergency if you suddenly are losing bowel or bladder control, if you have new weakness in usually both legs, and if you have new numbness or tingling in the buttocks, genital area, or legs.
In a microdiscectomy, Dr. Albert employs different methods, depending the on the situation, but the overall process is the same.
- First, with the patient lying on his or her stomach, a small incision is made in the area of the herniated disc.
- The back muscles need to be moved. Because they run vertically, they can simply be lifted off the bony arch, called the lamina, of the spine and pushed to the side to expose the vertebrae.
- Dr. Albert then removes a membrane over the nerve roots called the ligamentum flavum. At this point, it’s often necessary to remove a portion of the inside facet joint of the vertebra, both to provide access to the nerve root and to further relieve pressure on the area.
- The nerve root is then gently moved aside and the disc material pushing on it is cut away. Only the herniated portion of the disc is removed, so this doesn’t affect the cushioning function of the disc. With the portion of the disc that was pushing on the nerve root removed, the pressure is immediately gone and the nerve can begin healing and returning to normal, painless function.
- It takes times for the nerve root to heal, sometimes up to a year, but this usually simply involves a feeling of numbness, not pain. After microdiscectomy, patients feel almost immediate relief from the pain.
Is Surgery Painful?
Please keep in mind that pain is a very subjective experience and one’s reaction to surgery is affected by a variety of factors as mentioned above. It is not uncommon for a patient to experience “reminder” symptoms after surgery. These symptoms are often described as feeling similar to the patient’s preoperative symptoms but not as intense. This is very common as patients recover however if you are concerned please call the office to discuss your symptoms and concerns.
The typical risks of surgery such as infection and blood loss apply, but more specific complications are:
- Pain can return.
- A disc can re-herniate.
- The spinal cord, nerves, and blood vessels can be injured.
These issues are very rare, and Dr. Albert has very high success rates with this procedure.
Preparing for surgery
We ask that you refrain from taking any non-steroidal anti-inflammatory medicines 10 days before your surgery such as:
- Aspirin, Advil, & Aleve
- Herbal Supplements
- Vitamins E & K
- Fish oil
If you have a physician who recommends that you do not stop Aspirin prior to surgery please be sure to discuss this with our office.
The first visit is approximately 2-weeks after surgery however if you have any questions or concerns please call the office. If we think we should see you in the office we will schedule an earlier appointment. Patients require a formalized outpatient physical therapy program after a microdiscectomy procedure.
Most patients do not have sutures that require removal. There are internal sutures that will dissolve with time. There will also be steri-strips (white pieces of tape) over the incision that will either fall off or we will remove them from the office.
The average length of time out of work after a microdiscectomy surgery is between 1-4 weeks. Patients who perform labor intensive jobs are more likely to be out of work closer to 4 weeks. For the first 2 weeks, your activity will be limited to walking. We encourage you to walk as much as you are comfortable. During this time you may go up and down stairs, with the use of a railing, and you may also sleep in a normal bed. There is a 5 pound lifting limit for the first 2 weeks. After two weeks you will be able to resume low-impact cardiovascular activities and increase the amount of weight you are lifting. Within a reasonable amount of time after surgery, you will have very few restrictions on your activities. Please be sure to discuss any specific questions with us in the office.
schedule a consultation
If you are suffering from herniated lumbar disc, Microdiscectomy Surgery might be the right option for you. Call (212) 606-1004 to schedule a consultation with Dr. Todd Albert, Orthopedic Surgeon in NYC.