A microdiscectomy is generally considered as the gold standard for removing the herniated portion of a disc that is pressing on a nerve, as the procedure has a long history and many spine surgeons have extensive expertise in this approach. This approach is a workhorse for spinal deformity correction surgery in conditions like scoliosis, kyphosis and spinal reconstructions
Most of the patients with Lumbar disc herniation can be treated with non-operative treatments like rest, pain medications, pain blocks and physiotherapy. Some patients require surgery to remove the herniated disc and free the compressed nerve roots. Microdiscectomy (Microscope assisted discectomy), is also called a microdecompression is usually more effective for relieving leg pain than back pain. Leg pain is also known as radiculopathy, or sciatica. In case of leg pain patient normally gets pain relief immediately after the procedure. While for the syptoms such as numbness, weakness, or other neurological symptoms in the leg and foot, it may take weeks or months for the nerve root to heal completely and to subside numbness or weakness.
Microdiscectomy is recommended in situations such as leg pain has been experienced for at least six weeks, MRI scan or other test shows a herniated disc, leg pain (sciatica) is the patient’s main symptom, rather than simply lower back pain, nonsurgical treatments such as oral steroids, NSAIDs, and physical therapy have not brought sufficient pain relief. The results of surgery could be less favorable after three to six months have passed since the onset of symptoms, so surgeons advise patients not to postpone surgery beyond 3 to 6 months.
The procedure is performed under general anesthesia. The goal of a microdiscectomy is to remove the disc material placing pressure on the nerves. The procedure is performed in the position with the patient lying face down. A 1- to 1 1/2-inch incision is made directly over the affected disc. A lighted microscope is used by surgeon to see the affected area. The surgeon may remove a small portion of bone that protects the root nerve. With a scissor-like tool, surgeon removes the damaged herniated tissue, relieving the pressure on the nerve and the incision is closed with sutures. The spinal nerve gets the necessary space it needs inside the spinal column, hence any pain caused by pinching on the nerve stops. The patient is discharged from the hospital the same day or the next morning.