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What is microdiscectomy?

Mr Nicholas Thomas explains to us the procedure for a microdiscectomy.


A microdiscectomy is a minimally invasive procedure that is done to treat patients that are suffering from a herniated lumbar disc. During the surgery, the aim is to remove parts of the herniated disc from the lower spine, which will, in turn, alleviate their pain.


A microdiscectomy is keyhole surgery and we are able to perform procedures like this thanks to pioneering medical equipment and technologies.


What is a herniated disc?

A herniated disc is described as a protrusion of the soft tissue, sitting between the individual bones of the spine, pushing out through the spinal canal via a tear or rupture in the annulus.

Symptoms of a herniated disc that require a microdiscectomy

  • Worsening sciatic pain

  • No improvement using treatments

  • Worsening muscle weakness and numbness

  • If a patient got a herniated disc after a serious accident



The patient’s symptoms will differ depending on the severity of their herniated disc, this will help a doctor decide whether the patient needs to go ahead with surgery to correct their herniated disc. If it is decided that surgery is not necessary at that point, other simpler and less invasive treatments can be recommended as many conservative treatments can successful- surgery is always considered a last resort.


What are the risks associated with a microdiscectomy?

Every surgical procedure carries risk, but with microdiscectomies complications are very rare.

  • Bleeding

  • Nerve root damage

  • Infection

  • Recurrent disc herniation

  • Bladder/bowel incontinence

  • Blood clot


Surgery

Microdiscectomies are performed under general anaesthesia, meaning that the patient will be fully unconscious during the operation. During the surgery disc material that is putting pressure on the spinal cord is removed to improve the patient’s pain.


Before the surgery takes place, the patient will have scans which will identify the areas that need operating. Scans are also necessary as it means that they can keep track of any changes that may be happening to the herniated disc.


The patient is positioned prone (lying flat on their stomach) on the operating table. A microscope is used to ensure that the surgeon has an accurate and clear visualisation of the affected area. An X-ray machine is used to locate the herniated disc and ensure that the incision is made in the correct place. Part of the ligamentum flavum is removed, using a burr that enters into the spine to utilise the microsurgical instruments. A ball tip probe is used to gently mobilise the nerve root, this frees up the nerve and allows it to be retracted out of the way. Fragments from the herniated disc are removed using rongeurs.


Patients will usually stay in hospital overnight and be discharged from the hospital the following day. The recovery time is usually around 6 weeks, in this time it is essential that they stay mobile however also very important that they avoid lifting heavy weights or strenuous tasks. A follow up will be organised to ensure that your recovery is going well.


This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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