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Cervical & Lumbar Microdiscectomies

Cervical Microdiscectomy

Your spine consists of 24 bones called vertebrae that are arranged one above the other and separated by intervertebral discs which act as shock absorbers during activity. Your neck or cervical area is made up of seven of these vertebrae. The intervertebral discs consist of 2 parts, namely annulus fibrosus (outer flexible ring) and nucleus pulposus (central soft jelly–like region). The discs can be damaged due to wear and tear or a sudden injury to the spine, and is termed herniated disc. In this condition, the nucleus of the disc pushes against the outer annulus fibrosus and pinches the cervical nerves of the spinal cord that pass through these bones, causing pain in the arm. Cervical microdiscectomy is a surgical procedure performed to treat herniated discs in the cervical region.

Procedure

The surgery is performed under general anesthesia. During the surgery, you will be lying on your stomach. An X-ray is taken to determine the exact location of the herniated disc. The back of your neck is cleaned and a small incision is made. The muscles are carefully separated to gain access to the damaged disc. A part of your spinal lamina and facet joint (bony prominences of the vertebrae) are removed to expose the nerve root. Your doctor then uses a microscope to view the herniated disc under the compressed nerve, and excises the herniated region of the disc. The muscles are released and the incision is stitched close.

Recovery

After the surgery, you may be able to return home on the same day. You can gradually start daily activities and can return to work 1 to 2 weeks after the surgery. Your wound area should always be kept clean and dry until it heals.

Risks and complications

One of the major risks of cervical microdiscectomy is the possibility of recurrence of the herniated disc. There is also a risk that the remaining portion of the disc may collapse and compress the spinal nerves. The other possible risks of this procedure include damage of the nerve root or spinal cord, unresolved pain, infection or bleeding.

Lumbar Microdiscectomy

Lumbar microdiscectomy is a surgical procedure employed to relieve the pressure over the spinal cord and/or nerve roots, caused by a ruptured (herniated) intervertebral disc. A herniated disc, common in the lower back (lumbar spine) occurs when the inner gelatinous substance of the disc escapes through a tear in the outer, fibrous ring (annulus fibrosis). This may compress the spinal cord or the surrounding nerves, resulting in pain, sensory changes, or weakness in the lower extremities.

It is usually indicated in patients with herniated lumbar disc, who have not found adequate pain relief with conservative treatment. This procedure involves the use of microsurgical techniques to gain access to the lumbar spine. Only a small portion of the herniated disc that compresses the spinal nerve is removed.

Procedure

A microdiscectomy is performed under general anaesthesia. Your surgeon will make a small incision in the midline over your lower back. Through this incision, a series of progressively larger tubes are placed and positioned over the herniated disc. The affected nerve root is then identified. Your surgeon removes a small portion of the bony structure or disc material that is pressing on the spinal nerve using microsurgical techniques. The incisions are closed with absorbable sutures and covered with a dressing.

Postoperative Care

Following the surgery, patients will be discharged home on the same day or the next day. Post-operatively, patients are advised to gradually increase their activity levels. If required, physical therapy is started after four to six weeks of the surgery to improve strength and range of motion.

Benefits of microdiscectomy include:

  • Less muscle and soft tissue disruption
  • Shorter recovery time
  • Minimal postoperative pain and discomfort
  • Fewer risks of complications