Microdiscectomy is a minimally invasive surgical procedure that involves removing portions of a herniated disc, which can relieve pain in conditions like sciatica.

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Microdiscectomy, also sometimes called microdecompression or microdiskectomy, is a minimally invasive surgical procedure performed on patients with a herniated lumbar disc.

During this surgery, a surgeon will remove portions of the herniated disc to relieve pressure on the spinal nerve column.

Sciatica is a pain condition caused by compression of the nerve root that originates from the spinal cord. This compression is most commonly the result of a herniated lumbar disc.

As the hernia develops and the damaged tissue extends into the spinal column, it pushes on the nerves. This causes the nerves to send pain signals to the brain. The pain can be interpreted as coming from the legs.

Most cases of sciatica will heal naturally within 4 to 6 weeks without the need for surgery. If the pain from sciatica lasts over 6 months, you may benefit from a microdiscectomy, especially if it is done early.

The goal of a microdiscectomy is to remove the disc material placing pressure on the nerves.

The procedure is done under general anesthesia. You will be unconscious during the entire procedure and unable to feel anything. The procedure is performed with the patient lying face down. The process goes as follows:

  • A 1- to 1 1/2-inch incision will be made directly over the affected disc.
  • A lighted microscope is used to help your surgeon see the affected area.
  • The surgeon may remove a small portion of bone that protects the root nerve.
  • With a scissor-like tool, your surgeon will remove the damaged herniated tissue, relieving the pressure on the nerve.
  • The incision is closed with sutures.
  • The patient is usually discharged the same day or the next morning.

The spinal nerve now has the space it needs inside the spinal column, so any pain caused by pinching on the nerve should stop.

The recovery time is shorter than other, more invasive procedures. Most people can expect to leave the hospital that same day, or within 24 hours.

You’ll likely meet with a physical therapist and occupational therapist before leaving the hospital. These therapists will give you instructions on how to reduce the bending, lifting, and twisting you do with your back.

The therapist may recommend exercises to improve the strength and flexibility of the muscles surrounding your spine. Exercise after microdiscectomy may improve:

  • pain
  • quality of life
  • muscle strength

It may also reduce the time it takes to return to work.

You should avoid driving, sitting for prolonged periods, lifting anything heavy, and bending over immediately after surgery. Although you won’t be able to resume normal activities immediately, your lifestyle shouldn’t be greatly impacted.

For the first week or two, you may need to reduce your workload or be absent from work while you recover. You’ll also need to avoid lifting heavy objects for 2 to 4 weeks after the surgery. This generally includes anything more than 5 pounds.

You may also need to gradually progress back to your normal physical activity. For example, you may not be able to resume exercise or physical hobbies for 2 to 4 weeks after the procedure.

The typical time to a full recovery is about 6 weeks.

Microdiscectomy is a safe procedure, and complications are rare. However, like any surgery, there are some risks.

Complications may include:

  • dural tear (cerebrospinal fluid leak) in 2.85% of surgeries
  • nerve root damage
  • recurrent disc herniation
  • bleeding
  • infection

A microdiscectomy is a specialized surgery that requires a surgeon with special training. Because of this, it can be more expensive than other back surgeries.

Prices for the surgery vary and can range anywhere from $15,000 to $50,000. This price may not include any follow-up visits or care.

Your health insurance may cover a large portion of this expense once you pay your deductible and coinsurance.

If you don’t have insurance, be sure to talk with your hospital, surgeon, and all other medical professionals before receiving the procedure. Ask if you can negotiate a lowered rate because you are paying from your own pocket.

Q:

Are there any alternatives to this surgery?

Anonymous

A:

With microdiscectomy, more surgeons are using local or epidural anesthesia, resulting in less complications and improved patient satisfaction. Another alternative is a radiofrequency neurotomy, in which heated radio waves target the affected nerves to block the pain. A spine specialist may recommend injection therapy to reduce inflammation and swelling in the areas around the disc and nerve.

However, if surgery is not an option, other methods are available. These include physical therapy and chiropractic adjustments. Spinal decompression using a traction table could also be helpful. In addition, acupuncture may help manage your pain.

Dr. Mark LaFlammeAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Microdiscectomy is a minimally invasive procedure with an outstanding track record for relieving pain.

Nonoperative treatment will precede surgery. While most people who experience sciatica do not require surgery, a microdiscectomy may be warranted if all other treatments fail.

Your doctor will review your unique circumstances and determine if the procedure is right for you. If you’re a candidate, you should discuss the risks and benefits of the surgery with your doctor.