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LUMBAR MICRODISCECTOMY
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Page 3
Page 4
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The
Surgical Procedure
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| The
Surgeon's Role |
Your surgeon will:
- review your neurological history and examination;
- review your diagnostic studies (such as a myelogram, CAT scan or MRI);
- plan a surgical approach; and
- review the procedure with you.
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| Your
Role |
You must have a thorough understanding of the
diagnosis (what is causing your back and/or leg symptoms) and the risks
and benefits of the proposed surgery. Once you are confident that surgery
is the correct option for you, turn your thoughts to the future and the
recovery process. |
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| Beginning
the Operation |
In the operating room, a lumbar microdiscectomy begins with a small incision
in your lower back. Through this opening, your surgeon will insert microsurgical
instruments. Because the work is viewed through a microscope (Fig.
6, above), this approach requires a relatively small incision.
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| Reaching
The "Pinched" Nerve |
Guided by diagnostic studies, your surgeon will remove a small portion
of bony material from the back of your vertebra (Fig. 7). Once
this material is removed, the surgeon can locate the exact area where
the nerve root is being pinched.
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| Identifying
the Cause of the Pressure |
Once the "pinched" nerve is located, the extent of the pressure on the
nerve can be determined. Using microsurgical procedures, your surgeon
will remove the ruptured portion of the disc and any disc fragments which
have broken off from the main disc (Fig. 8). The amount of work
required to complete your microdiscectomy will depend in part on the number
of disc fragments present and the difficulty presented in finding and
removing them.
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| Closing
the Incision |
The operation is completed when each layer of
the incision is closed with suture material (stitches) or surgical staples.
If the outer incision is closed with staples or non-absorbable sutures,
they will have to be removed after the incision has healed. |
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| The
Healing and Recovery Process |
Once the ruptured disc has been removed, healing can begin (Fig. 9).
Healing is the body's natural process of restoring its damaged
tissues to a normal, or nearly normal condition. Healing occurs on its
own, but is influenced by such factors as general good health, physical
fitness, nutrition and rest. Recovery is the process during which
you work at becoming well. You must commit yourself to staying
in good health (exercising), maintaining a positive mental attitude and
following your physician's instructions.
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What to Expect After Surgery
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Have Realistic
Expectations
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Recognize that healing and recovery will not
happen overnight. It is a process. You may find that much of your
progress will be like taking "two steps forward and one step back." Accept
it! And then do all that you can to make sure your steps "forward" are large
ones and your steps "backward" are small ones. |
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| Be
Patient anf Persistent |
During the recovery period in the hospital and at home, try to rebuild
your strength gradually. Rest when you feel fatigued - but be persistent
in your efforts.
It is important for you to recognize that we all heal at a different
rate. The speed at which you will recover depends in part on your
age, your general level of health, your overall physical fitness and your
mental attitude. Generally, you will heal more slowly if you are overweight,
out of shape or smoke, or if you are a diabetic or have other pre-existing
medical problems.
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| Expect
Some Pain After Surgery |
It is normal to have some pain after any operation. After a lumbar microdiscectomy,
there may be some leg "aching" which occurs as the nerve(s) attempts to
heal. You also may feel some muscle spasms across your back and down your
leg(s). And if there was inflammation in the nerve root, some pain may
persist until this inflammation diminishes. You will be given appropriate
medication to control your pain, relieve back spasms and reduce inflammation.
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| Be
Prepared for Some Emotional Changes |
It is not unusual to feel tired and discouraged
for several days following surgery. These feelings may be your body's natural
reaction to the cutback of extra hormones it generated during surgery. Although
some emotional letdown can be expected, you must not let it get in the way
of your recovery. Don't look back at past problems. It is important for
you to look at even the smallest positive steps you make as progress towards
your recovery goal. |
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| Develop
a Positive Mental Attitude |
You should begin to work on a positive mental
attitude even before the surgery is performed. Direct your energies
toward the solution of your problem, rather than worrying about what
caused your problem. Don't be discouraged by minor setbacks during the recovery
process. Concentrate on the progress you make, and will continue to make
in the future.
Commit to a Healthy Lifestyle
Now is the time to commit yourself to a healthier lifestyle. You can
begin by taking these important steps:
* Watch your weight: If you are overweight, you must gradually
return to your proper weight. Crash diets rarely work. Commit yourself
to better eating habits and stay with them for the rest of your life.
* Become more active: Your physician will tell you when you
can resume normal physical activities after surgery. Make up your mind
now that you will develop a regular aerobic exercise routine, such as
walking, swimming or riding a bike. However, always
check with your physician before starting any exercise program.
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Last updated:
10/10/02
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