(Microdiscectomy; Microcompression Spine Surgery)
DefinitionIntervertebral discs are located between each vertebra in the spinal column. When damaged, these discs can put pressure on nerves as they leave the spinal cord. An intervertebral discectomy is a back surgery that removes all or part of these discs. The procedure is most often done on lumbar discs (located in the lower back). It may also be done on cervical discs in the neck. There are two methods for this surgery:
- Open—A large incision is made.
- Microdiscectomy—Small incisions are made, and the doctor inserts tiny instruments through these incisions.
Reasons for ProcedureThese discs normally serve as cushions between the bones. The discs can become damaged or dry with age. Injury can also cause a disc to bulge (or herniate ). These changes can create pressure on nerves leaving the spine. This can cause pain, numbness, and weakness.
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- Physical therapy
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Nerve damage
- Bladder or bowel incontinence
- Leakage of spinal fluid
- Another herniated disc (may happen within the first 3 months after surgery)
What to Expect
Prior to ProcedureYour doctor will likely do the following:
- Physical exam
- Ask about the pain and when it started
- Use imaging studies to look at the disc and structures in the area, includind
- You may be asked to stop taking some medications up to one week before the procedure.
- Arrange to have someone drive you home. Also, arrange for someone to help you at home.
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
- Wear comfortable clothing to the hospital.
AnesthesiaGeneral anesthesia —you will be asleep during the procedure
Description of the ProcedureThere are different types of surgical procedures, including:Anterior Cervical Discectomy A cut will be made in the skin on the left or right side of the neck. The doctor will go through a muscle to reach the spine. The disc material will be removed after the doctor uses an x-ray to confirm that it is the correct disc. A portion of the bone may be removed to give the nerve more space. A bone graft may be placed to fuse the vertebrae. Posterior Cervical Discectomy A cut will be made in the skin at the back of the neck. The muscles will be pushed aside. A small piece of bone will be removed to get to the disc space ( laminectomy ). Next, the doctor will gently push the nerve aside and remove the disc material. Lumbar DiscectomyThe doctor will make a 1-1½ inch cut in the skin on the lower back. The muscles will be moved out of the way. A small part of the bone may need to be removed to gain access to the nerve and disc. The disc or disc fragments will then be removed.
|The disc is removed from between the vertebrae.|
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How Long Will It Take?It depends on the type of surgery you had or needed.
How Much Will It Hurt?Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital StayThis surgery is most commonly done in a hospital setting. It may be possible to go home on the same day of the surgery. If you have a cervical discectomy, you may have to stay in the hospital for a few days.
Post-procedure CareDuring your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
Call Your DoctorIt is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Numbness or tingling
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or bleeding in the urine
- Cough, shortness of breath or chest pain
- Loss of bladder or bowel control
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Bach HG, Lim RD. Minimally invasive spine surgery for low back pain. Dis Mon. 2005;51:34-57.
Lavelle W, Carl A, et al. Invasive and minimally invasive surgical techniques for back pain conditions. Anesthesiol Clin. 2007;25:899-911.
Lumbar disk herniation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 26, 2014. Accessed December 18, 2014.
6/7/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Peul WC, van Houwelingen HC, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/20/2014