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Complete Guide on Lumbar microdisectomy

  • Posted on- Jan 06, 2018
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Lumbar Microdiscectomy is a surgical procedure used to remove lumbar herniated disc material that is putting pressure on a nerve root or spinal cord.

It tends to be done as microdiscectomy, which uses a special microscope to view the disc and nerves. This larger view allows the surgeon to use a smaller cut (incision) and this causes less damage to surrounding tissue.

A small piece of bone from vertebra will be removed before the disc material is removed. This is called a laminotomy or laminectomy. It allows the surgeon to better see the herniated disc.

What is the procedure of lumbar Microdiscectomy?



The goal of a microdiscectomy is to remove the disc material placing pressure on the nerves. The procedure is done under general anesthesia. There will be zero feeling period and you will be unconscious during all the procedure. The patient will be lying upside down during the procedure. The process goes as follows:

  1. A small portion of bone can be removed by the surgeon, which protects the root nerve.
  2. The surgeon may remove a small portion of bone that protects the root nerve.
  3. With a scissor-like tool, your surgeon will remove the damaged herniated tissue, relieving the pressure on the nerve.
  4. The incision is closed with sutures.
  5. The patient is usually discharged the same day or the next morning.
  6. Then the space needed by spinal nerve will be provided to it inside the spinal column and then pinch nerve causing pain will be stopped.


Why is lumbar Microdiscectomy needed?



Surgery is done to decrease pain and allow you to regain normal movement and function.

You and your doctor may consider surgery if:
  1. You have very bad leg pain, numbness, or weakness that keeps you from being able to do your daily activities.
  2. Your leg symptoms do not get better after at least 4 weeks of nonsurgical treatment.
  3. Results of a physical exam show that you have the weakness, loss of motion, or abnormal feeling that is likely to get better after surgery.
  4. Surgery is considered an emergency if you have cauda equina syndrome. Signs include:
  5. New loss of bowel or bladder control.
  6. New weakness in the legs (usually both legs).
  7. New numbness or tingling in the buttocks, genital area, or legs (usually both legs).

What happens after lumbar Microdiscectomy?  


 
After surgery, you will be encouraged to get out of bed and walk as soon as the numbness wears off. You can use prescription medicines to control pain while you recover. Exercises and other activities could be resuming within a week.

You should also remind all these things:

  1. You may not be comfortable sitting at first. Most people avoid having to sit for longer than 15 or 20 minutes. But sitting will feel more comfortable over time.
  2. Walk as often as you can for the first several weeks. Getting up often to walk around will help lower the risk that too much scar tissue will form.
  3. Many people are able to resume work and daily activities soon after surgery. In some cases, your doctor may suggest a rehabilitation program. This may include physical therapy and home exercises.
  4. If you work in an office, you may go back to work in 2 to 4 weeks. If your job requires physical labor (such as lifting or operating machinery that vibrates) you may be able to go back to work 4 to 8 weeks after surgery.

What are the risks of lumbar Microdiscectomy?



There are several risk and complication associated with microdiscectomy with any form of spine surgery.

A Dural tear (cerebrospinal fluid leak) occurs in about 1% to 7% of microdiscectomy surgeries. Surgery can’t be changed with the leak, but the patient can be awaited for one or two days to recover the leakage after the surgery.

Other risks and complications include the following:

  1. Nerve root damage
  2. Bowel/bladder incontinence
  3. Bleeding
  4. Infection
  5. Possible buildup of fluid in the lungs that may lead to pneumonia
  6. Deep vein thrombosis, which occurs when blood clots form in the leg
  7. Pain that persists after the surgery

What is the recovery period of lumbar Microdiscectomy?



Schedule a follow-up appointment with your surgeon for 2 weeks after surgery. Physical therapy may be necessary for some people.

The recovery time varies from 1 to 4 weeks depending on the underlying disease treated and your general health. You may feel pain at the site of the incision. After the surgery, all the pain wouldn’t be completely relieved. Always keep a positive attitude and perform your therapy exercises if prescribed.

Most people can return to work in 2 to 4 weeks or less with jobs that are not physically challenging. Most of the patient has to wait for minimum 8 to 12 weeks for getting back to jobs which require lifting heavy materials or operating heavy machines.

Recurrences of back pain are common. The key to avoiding the recurrence is prevention:

  1. Proper lifting techniques
  2. Good posture during sitting, standing, moving, and sleeping
  3. Appropriate exercise program
  4. ergonomic work area
  5. Healthy weight and lean body mass
  6. A positive attitude and relaxation techniques (e.g., stress management)
  7. No smoking
Lumbar microdiscectomy minimum costs for Rs. 2,60,000 to maximum Rs. 5,20,000.

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