VIDEO: Lumbar Microdiscectomy
This minimally invasive procedure is performed to relieve pressure on the spinal nerve column caused by a herniated lumbar (lower back) disc. The goal of the procedure is to decrease pain and allow you to regain normal movement and function.
In a “discectomy,” the herniated portion of a disc is removed to relieve the pressure on nearby nerves as they exit the spinal canal. The disc is like a jelly donut, acting as the functional shock absorber between two bony vertebrae. An injury, or damage from a lifting incident, may cause the jelly center to break through the wall of the disc. When the disc herniates, the jelly center can press on nearby nerves. This causes back or leg pain when the herniation is in the low back
Many ruptured discs may be resolved on their own, non-surgically so that a microdiscectomy is not necessary.
Dr. Radcliff performs a microdiscectomy using a special microscope to view the disc and nerves. Using this microscope gives Dr. Radcliff a larger view, which, in turn, allows him to make a smaller incision. The smaller the incision, the less damage is made to surrounding tissue.
The goal of a lumbar microdiscectomy is to remove the disc material placing pressure on the nerves by the herniated disc. Since the procedure is done under general anesthesia, you’ll be unconscious during the entire procedure.
Dr. Radcliff will typically only remove the portion of the disc that is causing a problem, not the entire disc. If you have a herniated disc, keep in mind that a disc has a purpose. When you remove the whole disc, it may cause instability in the joint, and a fusion may be recommended to re-stabilize the area. Dr. Radcliff can remove the damaged piece of disc through a traditional incision in the back with a surgical probe, such as in percutaneous discectomy. Depending on the nature of your disc problem, Dr. Radcliff will recommend the most appropriate type of surgery for you.
During the surgery, a fluoroscope is used to project live x-ray pictures onto a monitor giving the surgeon a clearer view of the area being treated. Dr. Radcliff typically performs most of the surgery to repair the ruptured disc while watching it on the monitor. Dr. Radcliff will wear safety glasses with a microscope attached to each eye to increase their vision of the small area being operated on.
About a one-inch incision is made over the injured disc on the patient’s back. Small wires are slowly inserted into the incision site to help split the muscle in the spine and allow for a small opening for the spine surgeon to work within. The wires help spread the muscles instead of cutting them and causing unnecessary damage. A specially fitted retractor is used to hold the muscles to the side and out of the way during the operation. A very tiny amount of bone (lamina) is removed to allow for more space between the two vertebrae, in which no instability results from this. Then the nerve is retracted towards the middle of the spine. This procedure helps remove pressure on the pinched nerve.
Patients are typically discharged the same day or the morning after an overnight stay in the hospital. Most patients will notice significant improvements in their pain level and will benefit from physical therapy to help restore strength and flexibility and to reduce recurring back pain or disc herniation.