The goal of Lumbar Microdiscectomy, also sometimes called microdecompression or microdiskectomy, is a minimally invasive surgical procedure performed on patients to resolve a herniated lumbar disc.
During a microdiscectomy, Dr. Paul removes and uses a small 1 to 1.5-inch incision to access the spine. The incision is longer if there is more than one level of surgery scheduled. A minimally invasive retractor is used to move muscles to the side gently.
A small amount of bone and ligament are removed to expose the affected nerve. The nerves are moved to expose the disc fragment compressing the nerve and are then removed. While he does look in the disc to remove any other loose pieces, Dr. Paul leaves the remaining disc in place.
If there is any spinal stenosis or bone spurs, he removes those as well to ensure there is no pressure on the nerve.
The entire procedure is done using magnifying loupes (glasses) with additional lighting and is done microscopically. The procedure is done under general anesthesia. You will be unconscious during the entire procedure and unable to feel anything. The procedure is performed with you lying face down.
We have attempted to define the more common risks of surgery under each of the procedures outlined. It is impossible to outline all potential poor outcomes, but we have attempted to do so in good faith. It has not been formed as legal protection for us – only to better inform you. Please read them thoroughly.
Infections are a known complication of lumbar surgery. Infection rates are more associated with smoking, poorly controlled diabetes, obesity as well as other health factors. Less invasive and shorter procedures also have lower complication rates. Infections requiring additional surgery are extremely rare in Dr. Paul’s practice.
Bleeding can be a serious complication since blood accumulation can compress the spinal cord or nerve roots. For that reason we require discontinuing blood thinners, some anti-inflammatories and all herbal medications.
Spinal Leaks are a known complication in spine surgery but typically can be managed. They occur approximately 3 to 5% of the time They can be the result of adherent bone, disc, ligament or scar tissue to the dura and the membrane surrounding your nerves or spinal cord. They are far more associated with revision surgery, severe nerve compression and advanced age. If this occurs, we typically repair the leak during your operation. You may be required to lay flat for a short period of time afterwards. Late presenting or persisting spinal leaks can require additional surgery. Spinal leaks typically do not affect long term outcomes.
Your surgery was performed because you have a degenerative condition that can affect the rest of your spine. Therefore, if you have had surgery at one level in your spine, it would be reasonable to assume you could have problems at the same or other levels. Since the spine has 36 levels, this is not unusual. Most people handle degenerative difficulties with self-care and non-operative care. That being said, Dr. Paul and his team go to great lengths to minimize the chances of needing additional care for your spine. That includes careful surgical planning, intraoperative decision making, and post-operative care.