Quick Facts
Possible Symptoms
- Leg pain, numbness, and/or weakness
- Back pain, especially with movement
- Bowel or bladder incontinence
Typical X-Ray Findings
- Herniated disk compressing the nerve roots (MRI, CT myelogram).
Average Procedure Time
- 1.5 hours
Average Recovery Time
- Home the same day
- Off work 2-8 weeks, depending on duties
Postperative Limitations
- No bending, twisting, lifting, or strenuous exercises (8 weeks)
- No driving while on narcotics
The Procedure
In the lumbar spine, discectomies are generally performed from a posterior approach, that is, from behind. An incision is made in the skin and carried to the bone. A small window in the bone (a laminotomy) is made and the nerve is found and retracted. Finally a partial discectomy is performed to decompress the affected nerve.
Lumbar discectomies can also be performed from an anterior approach (from the front) , or a lateral approach (from the side), however these approaches are usually performed with the help of a general surgeon, and are most often done in preparation for a fusion.
Thoracic discectomies can be performed from a posterior approach or an anterior or lateral approach, depending on the size or consistency (ie hard or soft) of the disk herniation. Anterior or lateral approaches usually are done with a general or thoracic surgeon.
Traditional Microdiscectomy vs. Minimally Invasive Microdiscectomy
An incision is made in the midline. Muscle is burned and then peeled off of enough of the spine in order to expose the bone that needs to be removed. A spiked retractor holds the muscle off of the bone while the discectomy is performed.
An incision is made 1-2 centimeters off of the midline. Muscle bundles are separated bluntly (with a gloved finger) through natural tissue planes in order to place a fiberoptically lit tubular retractor. The discectomy is then performed under a microscope with specialized instruments.