What Is Microdiscectomy?
Microdiscectomy, also known as microdecompression, is one of the most common minimally invasive spine surgery procedures.
The main goal of microdiscectomy is to take pressure off your nerves to relieve your back pain.
Traditionally, discectomies are performed using an open technique. Your surgeon makes a relatively large incision, including cutting some of your back muscles, so that he or she can see your spine. While this technique is effective, it can cause significant muscle damage, and recovery is generally painful and slow.
Microdiscectomies have the same goal as open discectomies—remove the part of your intervertebral disc that's putting pressure on your nerve and causing you pain.
However, as in other minimally invasive procedures, surgeons use special instruments and visualization tools that allow them to make very small incisions to reduce injury to your back muscles. The results can be a quicker, less painful recovery
When Is Microdiscectomy Used?
A microdiscectomy is typically performed for 2 reasons:
- A fragment of your intervertebral disc may have broken away from your disc, and it's pressing on your spinal nerves or your spinal cord.
- Your disc may still be intact, but part of it may be bulging or protruding and pressing on your spinal nerves or your spinal cord.
How Is a Microdiscectomy Performed?
Microdiscectomies can be performed using 3 main techniques:
- Mini-open: This is similar to an open discectomy, but your surgeon uses advanced technology to view your spine through smaller incisions.
- Tubular: Your surgeon inserts a tube through a small incision. This tube is gently pushed through your back muscles until it reaches your spine, and then a series of expanding tubes is inserted, one around the other. These tubes gradually open up (or dilate) the area where the surgery will be done. Your surgeon then uses specially-designed instruments to remove part of your disc through this tube.
- Endoscopic: This involves inserting a tiny video camera (called an endoscope) through a tube to enable your surgeon to see your spine and remove disc material with miniaturized instruments.
For the procedure, you'll typically have general anesthesia, and during the surgery, you'll be positioned lying on your stomach. Using one of the techniques above, your surgeon will remove the part of your disc that's pressing on your nerve or spinal cord.
Your surgeon will pay careful attention to your nerve roots during surgery and will check the areas surrounding your disc to make sure there are no other additional disc fragments that need to be removed. Usually, only a small part of your disc is removed—surgeons rarely remove most or all of your disc.
Most microdiscectomies take about an hour to complete.
Besides the typical risks of surgery, including infection and blood loss, there are other possible complications for microdiscectomy:
- Your pain can come back.
- Your disc can re-herniate.
- Not all of your disc material may have been removed during your procedure.
- Your spinal cord, nerves, and blood vessels can be injured.
The good news is that many patients have significant pain relief from a microdiscectomy and can quickly return to their normal lives, generally in less than 2 weeks. However, your doctor will advise you on how quickly you can return to exercise and your other daily activities.
A successful microdiscectomy should accomplish what a traditional open discectomy accomplishes—but with a faster, less painful recovery.