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Microdiscectomy

Back pain is the single leading cause of disability worldwide. In the US alone, more than half of all working Americans say they suffer from some form of back pain.

Doctors and surgeons are reluctant to recommend surgery unless necessary, and usually only after all other non-surgical options have been exhausted.

But for more than 500,000 Americans every year,  back surgery is necessary to improve their quality of life and alleviate the constant, debilitating pain. Here is a video that explains the leading cause of back pain.

In this article, we’re looking at a particular type of back surgery called a microdiscectomy. This procedure is effective at helping patients suffering from a herniated disc.

If you’re suffering from a herniated disc and have tried several non-surgical methods without success, here is a closer look at what a microdiscectomy is, the risks, benefits, and alternatives to help cure your back pain.

What is Microdiscectomy?

A microdiscectomy is an open back surgery performed on patients suffering from a herniated lumbar disc. The surgery typically involves removing the herniated material causing the pain.

A herniated lumbar disc can cause a wide range of painful symptoms and is one of the leading causes of sciatica, a condition referring to the pain felt along the sciatic nerve. For this reason, microdiscectomy procedures are commonly performed on patients suffering from sciatica.

The first microdiscectomy performed on a herniated disc was carried out in the 1970s. Since then, there have been considerable advancements in technology and how microdiscectomy is performed.

A microdiscectomy is one of the more minimally invasive types of back surgery. Surgeons will make a 1-1.5 inch incision directly over the affected disc and use specialized instruments to perform the surgery.

lumbar-microdiscectomy-location

Image credit - lumbar microdiscectomy location.

Why is it done?

A microdiscectomy is performed to relieve pressure on the spinal nerve caused by a herniated disc.

There are connecting tissue joints positioned between each of the 33 vertebral members that interlock to form the spinal column in the spine.

These tissue joints are the intervertebral discs, and they are often structured with a soft jelly-like core, the nucleus pulposus, enclosed within the exterior annulus fibrosus. In some cases, a tear might occur on the outer layer of the annulus fibrosus, allowing a portion of the nucleus pulposus to squeeze through. A herniated disc is the medical term for this condition.

microdiscectomy

Image credit - Bulging nucleus pushing against a nerve

If the herniation compresses and inflames a nerve, it can cause substantial pain and discomfort. Some of the most common symptoms of a herniated disc include:

Numbness or tingling - A common symptom is a radiating numbness or tingling sensation in the area of the body affected by the herniation.

Weakness - Muscles controlled by the affected nerves can also be impacted, leading to a loss of strength, making it challenging to balance objects and execute daily duties.

Back pain - This can range from mild tingling to debilitating ‘electric’ shocks shooting through and around your back.

What causes back pain? Back Pain Explained.

Arm and leg pain - It is not just your back that will hurt. It’s common for a herniated lumbar disc to cause pain in the legs, buttocks, and sometimes down to the feet. Other herniated discs can also cause pain up to the neck, arms, and shoulders.

A herniated disc can occur anywhere on the spine, but it’s far more common in the lower back due to the increased pressure in this area.

It also has various effects on different people. For example, you could have a herniated disc yet be utterly ignorant of it because you are experiencing no symptoms. Spinal imaging, on the other hand, will indicate the condition.

A herniated disc can get better on its own. However, if you’re experiencing any of the symptoms outlined above, you should consult with a medical professional. 

Microdiscectomy Procedure

The microdiscectomy procedure is straightforward. The goal is to remove the excess disc tissue irritating the spinal nerves, relieving the inflammation, and treating the patient's symptoms.

The procedure is performed with the patient lying face down and under general anesthesia. You'll be unconscious during the procedure, and you will not feel anything.

An outline of the process is as follows:

  • The surgeon will make an incision directly over the affected area of the spine, approximately 1-2 inches long.
  • The surgeon will then use an endoscope to inspect the affected area.
  • Next, using specific surgical tools, the surgeon will remove the intruding herniated tissue that puts pressure on the nerve. They will also remove some of the bone that protects the root nerve if necessary.
  • They will then remove the tools and tubes used in the procedure and close the incision with sutures.
  • You will then be moved to the recovery room, where you can gently come around from your anesthesia.

After you regain full consciousness, either the surgeon or another medical professional will inform you of how the procedure went.

They will also explain everything you need to know about post-surgery care and any follow-up therapy you might need.

Risks of Microdiscectomy

Microdiscectomy is a minimally invasive and safe procedure. While complications are rare, there is always risk involved with any surgery.

The main risks associated with microdiscectomy surgeries include:

  • A significant risk is a Cerebrospinal fluid leak, also known as a dural tear. When the spinal dura mater has a tear, cerebrospinal fluid squeezes out and can cause symptoms like nausea, pain, tightness in the back, and other complications. This condition typically develops in just 1-7% of surgeries.
  • Bleeding, blood clots and infection are also risks that are associated with medical procedures. 
  • Nerve root damage, which can lead to permanent weakness or numbness.
  • Bowel/bladder incontinence is very rare but may potentially be a long-term complication.

Benefits of Microdiscectomy

The obvious main benefit of a microdiscectomy is that you're going to be free of back pain, will regain full mobility, and can resume living a whole and active life.

There are more benefits to having this surgery than just that end goal. Some other things to consider are:

  • You'll no longer have to rely on pain medications. There is a long list of side effects and other reasons why taking long-term medications is terrible for your mental and physical health.
  • Resolving a herniated disc prevents the symptoms from escalating and becoming more painful. You deserve to live a life free of pain and restrictions.
  • A microdiscectomy is one of the less invasive types of back surgery. Minimally invasive surgeries have a lot of benefits over ‘open’ surgeries. There are fewer potential complications, the surgical wound is minor, and it’s an all-around more convenient and comfortable procedure.
  • The recovery is quick, and most patients are mobile within hours of the surgery. Therefore, within days or weeks, you can start getting back to work and normal activities.
  • It's one of the quickest ways you can get immediate pain relief for a herniated disc. If you’ve tried other alternative treatments, you’ll know how frustrating it is trying to get back pain under control. A microdiscectomy is the most reliable way to put that pain behind you with the highest chance of success.
  • Your family and friends will also benefit. If you’ve been suffering, we’re sure those close to you also have. You cannot overlook the positive impact seeing you happy and healthy will have on your loved ones.

Microdiscectomy Recovery Time

Because a microdiscectomy is a minimally invasive procedure that only requires a small incision, the overall recovery time is much shorter than more invasive types of back surgery.

Most patients will leave the hospital the same day or may be required to stay overnight if it’s late in the day or observations are required.

A physical therapist will meet with you and explain everything you need to know and do as part of your recovery process at home. They will cover what you should or shouldn’t do in terms of twisting, bending, lifting, and putting pressure on your back. This post-surgery orientation also encompasses what exercises you can do to improve the flexibility and strength of your back muscles to speed up your recovery.

Generally speaking, most patients can go back to ‘normal’ daily tasks within days of surgery. However, it would be best to take it easy for a couple of weeks and certainly not attempt to lift heavy objects for 2 to 4 weeks.

The typical time for a full recovery is approximately six weeks. That is, after six weeks, most patients can resume exercising and lifting heavy items.

How to prepare for Microdiscectomy

Surgery can be stressful. Even a minimally invasive microdiscectomy can create some anxiety, so it helps to be prepared both mentally and physically.

Some of the things you should do to prepare for a microdiscectomy include:

Arrange help to get home - Patients will not be able to drive after leaving the hospital due to the effects of anesthesia and pain mediation. Be sure to have a friend or family member with you when you are out of surgery and help you get home.

Tell the surgeon about any medications - Your doctor may have already asked you about any medications or herbal health products you’re taking. If not, make sure you discuss this, as some medications increase the risk of complications during surgery.

Make sure you understand the procedure - The better you understand the procedure, the more comfortable you’re going to feel. If there is anything that you do not understand, there will be someone at the hospital/spine institute happy to answer your questions.

What to expect after Microdiscectomy

Most patients can walk out of the hospital or clinic within a couple of hours of the procedure.

However, while you will be mobile and recovery is expected to be reasonably quick, there are some post-surgery best practices you need to be aware of to aid your recovery.

These are:

Caring for the incision - You must follow instructions on how best to care for the incision, so it heals quickly. Failure to do so could result in infection and cause some complications.

Being too passive - There is a fine line between being too sedentary and being too active. It would help if you met with a physical therapist as part of your post-surgery care, where they will explain what exercises you need to do to strengthen the muscles in your back and speed up recovery without overdoing it.

Make lifestyle modifications- Certain patients might be required to make some modifications to minimize the risk of having another herniated disc. Such modifications include no more smoking, maintaining a healthy weight, and maintaining a good posture.

Following the post-surgery plan - You'll be given a post-surgery plan to follow. The more closely you adhere to this plan, the quicker you're going to recover from your surgery. This means taking recommended medications, attending follow-up consultations, and adhering to general advice from your physical therapist.

As long as you follow all of the advice above, you will enjoy your recovery with minimal pain and discomfort. In addition, after recovery, you can start doing all the things that your back pain held you back from and live a more fulfilling life.

Microdiscectomy success rates

Microdiscectomy is considered to be one of the back surgeries with a high rate of success. There have been extensive medical studies on microdiscectomies’ success rate, and the results show it has an 84% success rate

Microdiscectomy video

Minimally Invasive Microdiscectomy L5-S1

What does a Microdiscectomy cost?

Pricing for medical services varies considerably based on individual needs. To find out how much a microdiscectomy will cost, you’ll need to have a consultation with a surgeon where they can look at your specific needs.

Alternative Procedures to Microdiscectomy

1. Deuk Laser Disc Repair 

What is it: Deuk Laser Disc Repair is a minimally invasive procedure and is a method of laser surgery unique to Deuk Spine Institute.

This type of surgery is a form of endoscopic surgery and is performed using precision laser technology. Patients are relaxed under twilight sedation, so you’ll not feel a thing and will be able to recover quickly after surgery.

This form of surgery is commonly used to treat bulging discs, sciatica, spinal stenosis, pinched nerves, herniated discs, and other conditions that cause chronic pain.

During the procedure, the surgeon uses an endoscope (a narrow tube with a light and camera attached) to reach the spine. By using precision laser technology, the surgeon removes 5-10% of the damaged disc tissue, leaving the healthy disc. No spinal implants, like artificial discs, rods, or screws, are required. 

The procedure is peer-reviewed and published as a safe and effective FDA-approved treatment for back pain from annular tears, herniated discs, bulging discs, degenerated discs, and spinal stenosis.

There is no other surgery available like Deuk Laser Disc Repair on the market right now. It has a higher success rate than other laser surgeries and traditional fusions at 95%, is less invasive, does not use fusion or metal implants, and has the quickest recovery time.

Deuk-laser-disc-repair

Image credit

Recovery time: Deuk Laser Disc Repair has the fastest recovery time of all comparable back surgeries. Most patients can walk out of the recovery room within an hour and are back to enjoying their everyday lives, without pain, within just a few days.

The surgical incision made is about 4-millimeters in length, small enough to be concealed entirely with a single band-aid. All required is some primary post-surgical care, and the incision will be fully healed within weeks.

Patients are encouraged to use hot/cold packs to lessen the pain if required and are advised not to lift anything over 20 lbs. If a patient does experience any swelling, redness, or joint pain, they can contact the facility for post-op care.

Benefits

  • With zero complications and a 95% success rate, this non-invasive procedure guarantees limited disruption to surrounding nerves and, if patients choose, comes with a surgical warranty
  • No metal implants are acquired, neither does it involve any fusion. This dramatically reduces the chance of complications during and after surgery.
  • Patients can return to work and everyday active life quickly. Deuk Laser Disc repair will have you back in action and as close to 100% sooner than any other type of back surgery.
  • It has the smallest incision scar of any laser disc surgery, leaving no internal or external scarring. 

Deuk Laser Disc Repair surgery video

Risks:

There are always risks with any surgery. However, Deuk Spine has had zero complications in the twelve years that Dr. Deukmedjian performed laser spinal surgery.

Dr. Deukmedjian is so confident in Deuk Laser Disc Repair that he is the first surgeon to offer a surgical warranty.

Cost

Pricing varies based on an individual's needs. To determine if this surgery is the most appropriate for you and how much it will cost, you can book a free MRI review here.

2. Spinal Fusion Surgery 

What is it: Traditional Spinal Fusion surgery is far more invasive than laser spine surgery or discectomies. The outcomes of fusion are better for the treatment of back pain and neck pain when compared to discectomy because the fusion stops movement at a painful joint. Fusions are harder for spine surgeons to perform correctly, and many spinal fusions are done with poor planning and technique resulting in bad outcomes for the patient

lumbar-fusion-microdiscectomy

Image credit - Lumbar fusion

Recovery time: The average time of a traditional two-level fusion is two and a half hours, with an additional three to four hours in the recovery room. 

3. Laminectomy / Laminotomy Surgery

What is it: A laminectomy is a type of back surgery used to relieve compression on the spinal cord. It’s commonly performed as a treatment for patients suffering from Spinal Stenosis. This condition results in the narrowing of the foraminal openings in the spine, thereby putting pressure on the spinal nerves.

Spinal stenosis causes several symptoms, from extreme arm, leg, and neck pain to weakness, numbness, tingling, cramping, and more.

There are two types of surgeries depending on the patient’s condition, these are:

  • Laminectomy Surgery - this procedure involves either fully or partially removing the lamina bone or the compressive matter that is damaging the spinal nerves or spinal cord.
  • Laminotomy Surgery - this procedure involves decompressing the spinal canal to relieve the pressure.

The lamina is the part of the vertebrae that form the vertebral arch in the rear end of the bone. Removing the lamina creates more space for the spinal cord and nerves, thus relieving leg and arm symptoms. 

A laminectomy is one of the more invasive types of back surgery and is often performed alongside a  Foraminotomy and spinal fusion. The procedure involves making a large incision, moving skin, muscle, and ligaments, and then removing bone spurs or lamina bone that could be causing compression and inflammation.

lumbar-laminectomy

Image credits

Recovery time: The typical recovery time for a laminectomy procedure is long and could take even longer if a spinal fusion is required. Most patients will spend up to a week in the hospital, with around six months of recovery at home before considering returning to work. 

Laminectomy is significant surgery, and the first few weeks at home can be challenging. You will not be able to lift anything heavy, exercise will be limited, you will not be able to drive, and you'll likely be on pain-relieving medicines.

However, this isn’t the case if you have your surgery at any of our Deuk Spine Institutes. At Deuk Spine Institute, we have some of the quickest recovery times in the nation.

4. Discectomy surgery 

What is it: Discectomy surgery is similar to microdiscectomy, the difference being that a discectomy is performed as an ‘open’ surgery while a microdiscectomy uses microscopic magnification and is minimally invasive.

Both procedures are performed to remove the herniated or ruptured disc tissue. Discs are positioned between the vertebrae of the spine to reduce rubbing and provide support. Over time these discs may become affected with annular tears or weaken naturally due to age or injury. When this happens, the inner disc core bulges out, putting pressure on surrounding nerves. 

A herniated disc puts pressure on the spinal nerves, causing patients a great deal of discomfort and a range of symptoms from numbness and tingling to loss of motion and radiating pain down the legs and arms when the nerve becomes inflamed.

An ‘open’ discectomy involves making a large incision in the patient’s back so the surgeon can reach the damaged disc. The surgeon will often need to remove part of the lamina to access the disc. The amount of tissue and bone removed will depend on the severity of the herniated disc condition.

microdiscectomy

Image credits

Recovery time: A discectomy involves an “open” surgical technique which results in patients usually having to stay in the hospital for the days following. This is to ensure the surgical incision is free from infection and healing properly and ensure no complications related to the surgery.

Patients are free to return to desk work within a month and should be wary of the heavy lifting for at least 2-3 months. Surgeons will suggest physical therapy to help gain the whole movement back to the spine. 

If you would like to enjoy premium patient-oriented care delivered by world-class physicians, contact us at Deuk Spine Institute today. We also offer free consultation on your MRI scan. Visit our site here to start your treatment.

Cure your back and neck pain once and for all.

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About Deuk Spine Institute
World leader in Laser Spine Surgery
With world-class physicians on staff, the newest and most advanced technology, and a patient experience pathway that is unrivaled in it’s efficiency and and pedagogy of care, Deuk Spine Institute has performed thousands of procedures and achieves a 95% success rate in elimination of pain.

 The services we offer are not offered anywhere else in the world, and the treatments are curative, not palliative.  On top of that, Dr. Deukmedjian is personally invested in the well-being of each and every patient, and has spared no expense to guarantee the best possible outcomes.
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