 | Lumbar Microdisectomy |
What is a lumbar microdiscectomy?
Lumbar microdiscectomy, also known as microdecompression, is a common minimally invasive surgical procedure. The main objective of a lumbar microdiscectomy is to relieve pressure off the nerves and relieve back pain. A lumbar discectomy may be performed anywhere along the spine on the lower back.
When is a lumbar microdiscectomy needed?
Lumbar microdiscectomy is effective at eliminating back pain, called sciatica, which may be caused by a herniated disc. Sciatica is a medical condition which is commonly caused by the compression of the spinal nerve. When the tissues gets damaged and extend to the spinal column, it pushes on the nerves. This then results in the nerves sending pain signals to the brain.
Lumbar discectomy may also be recommended to treat degenerative disc disease where there is a formation of bone spurs, bones naturally wearing out, or the facet joints are inflamed. This results in the discs drying out and shrink, which may lead to loss of flexibility and cushioning properties.
What does a lumbar microdiscectomy entail?
A lumbar microdiscectomy is normally done under general anaesthesia. The neurosurgeon will cleanse and prep the area where he will make an incision. He will then make an incision in your lower back, down the middle of your back. A fluoroscope will be passed through the incision in order to locate the affected vertebra and disc. Large dilators are then passed, which will help gradually separate the muscles and create a pathway to the affected vertebra.
A small opening is made with a drill on the lamina, above and below the spinal nerves. With the use of a fluoroscope, the neurosurgeon will locate the herniated disc and remove a portion of the ruptured disc in order to decompress the spinal nerve root. Bone spurs or synovial cysts may be removed as well.
Spinal fusion may also be performed if you have recurrent disc herniation or spinal instability. After the procedure, the dilator will be removed, and the muscles and incisions will be stitched closed with sutures or staples.
- Degenerative arthritis of the spine called spondylosis. This may lead to the formation of bone spurs
- Degeneration of the intervertebral discs, which may lead to the formation of a bulge in the foramen
- Enlargement of nearby ligaments
- Spondylolisthesis
- Cysts or tumours
- Skeletal disease such as Paget disease
- Congenital problems such as dwarfism
A compressed nerve may cause symptoms such as lower back pain in the affected area, a tingling sensation, and weakness in the affected limb. Foraminotomy is normally recommended when conservative treatment has been exhausted. These treatments such as physical therapy, pain medicines and epidural injections.
What does foraminotomy entail?
During the procedure, you will be under general anaesthesia. Your vitals, such as your heart rate and blood pressure, will be carefully monitored. The neurosurgeon will make an incision next to your spine or above the affected vertebrae. He will then use surgical instruments to push back the muscles to expose the blocked intervertebral foramen.
The neurosurgeon will then remove the blockage as well as a bone spur or a bulging disc. This will relieve pressure on the nerves. A laminectomy may also be performed, which involves the removal of a portion of the vertebra. After the procedure, the incision will be stitched closed.
